The Process of Therapy

Introduction

It can be difficult to know when and how to engage in professional help for concerns about your mood and coping with MS.    

Here, we’ll walk through the steps involved in this process, including: 

• Making the decision to seek treatment  
• How to find an appropriate mental health professional, and 

• What is involved in the therapy process 

When to Seek Treatment

There are many reasons you might want to seek treatment. And while you can certainly seek out a mental health professional at any time, here are a few indicators to know when you should: 

• When your mood, behavioral changes, or emotion/cognition symptoms are interfering with your daily activities, functions, or relationships. 

• When you regularly experience “toxic” emotions such as guilt, shame, resentment. 
• When you keep doing the same things expecting or hoping for different results and feel unable to generate new options—leaving you feeling stuck. 
• When you find yourself dwelling on and/or replaying the same thoughts, conversations, future events (this is called rumination, which is nonproductive and wears you out!) 
• When people you trust and have your best interests in mind express concern to you about your mood and behavior. 

When you have concerns about your mood, your behavior, and your coping, tell someone! 

Tips to Find a Psychologist, Therapist, or Counselor

There are plenty of resources to help you find a mental health professional. 

• Call the National MS Society (800-344-4867) to speak to an MS Navigator about therapists in your community. 

• Research through a psychological association. Most state and local psychological associations have online referral programs that list psychologists by zip codes, counties, insurance accepted, and areas of experience (e.g. chronic illnesses). 
• Ask your current providers, including your MS care team, your primary care provider, or your OB-GYN (if applicable). 
• Check with your insurance company about your mental health benefits and what services are covered. They should be able to provide names of therapists covered by your insurance and located in your area. 
• You can ask potential mental health providers what codes they use for billing such as individual, family, and group therapy. Some providers use Health & Behavior codes when medical issues are a primary focus of treatment. 
• When at all possible, look for someone who has had experience working with people who have chronic health conditions, especially health psychologists or providers with behavioral health experience. 

What To Expect When You See A Mental Health Professional

You might be wondering: what does a therapist do?  

• Provides support and validation; challenge client as appropriate 
• Works with you to identify goals for your treatment 

• Assists with clarifying your sources of stress and identifying your symptoms, which guides towards an appropriate diagnosis and treatment recommendations 
• Listens for themes/patterns and assists you in becoming more aware of them 
• Teaches research-based strategies for dealing with symptoms (e.g. better sleep habits or stress-reduction techniques) 
• Focuses on client strengths and skill-building as needed 
• Encourages and assists with problem-solving as you develop possible solutions and ideas for your life 

• Helps you assess what is working and what isn’t working 
• When appropriate, helps you determine how the past may be influencing the present and addresses this as needed 
• When you are having difficulty following through with recommendations, helps you identify obstacles and strategies for working through and overcoming obstacles 

Preparing For Your First Appointment

Like any other visit with a healthcare team member, it is helpful to be prepared. 

• Make notes about what is bringing you to treatment, including your current concerns, your symptoms, and any changes in your functioning 
• Note any previous experience with therapy, including what was helpful and what was not 
• Make a list of questions you have about office procedures, such as the best ways to communicate with your therapist, how long you will likely wait for a call to be returned, and how you can reach someone after normal office hours 
• You might want to know if the therapist would agree to talking with other people in your life (if that feels like it could be helpful).

You might be wondering: what usually happens during a first appointment?

• You will be asked about: 

• Your concerns and what brought you to therapy at this time 
• Your physical, mental health, work, relationship and substance use history –        this will likely include information about any previous treatment, including psychological counseling and/or medication for depression, anxiety, and/or ADHD 

• Family members’ mental health and behavioral difficulties 
• Treatment goals – what you want to accomplish in therapy 
• Frequency and scheduling of treatment sessions 
• You may also be asked to complete paper-and-pencil questionnaires about your symptoms, including depression and anxiety, to assess the severity of your distress and related symptoms.  Be sure to ask the therapist to review the results with you. 
• Bring a list of your medications, as therapists often want to review them. 

You may also be wondering: What are some common treatment goals that you can work towards in therapy? 

• Reduction of symptoms, e.g., less depression, anxiety; better sleep 
• Learning and using new skills, e.g., more effective ways of communicating, stress-management strategies 
• Improvement in relationships, especially communication 
• Greater self-confidence 
• Ability to generate options and solutions 
• More effective management of chronic illness symptoms such as fatigue, cognitive changes, pain 
• More consistent adherence to disease-related treatments recommendation such as exercise, medications, health eating 

Your Role In Therapy

Remember, seeing a therapist is meant to help you work together towards a common goal. Your role may include: 

• Regularly attending and actively participating in sessions 
• Completing homework whenever possible and identifying obstacles when completing homework is difficult or doesn’t happen 
• Being as open and honest as possible 
• Asking questions when you need clarification or experience confusion 
• Communicating with your therapist about how treatment is going for you.  Keep in mind, a good therapist responds appropriately to feedback 

How To Work Towards Effective Therapy

To set yourself up for success, consider seeking these traits and behaviors between you and your therapist.  

• You and your therapist are engaged in a working partnership with mutual respect, trust, and effort 
• Working on common goals in an atmosphere that encourages curiosity and questions 
• Empathy and honesty 
• Regular feedback, including acknowledgement of effort, progress, and successes 

• Sense of humor 

Mental health information and help with finding a therapist: 

National MS Society (800-344-4867) to reach an MS Navigator for screening of your symptoms and help finding mental health professionals in your area 

Mental Health America 

Downloadable brochures from National MS Society.