Addressing Therapy Skepticism: Coming Around To Mental Health Treatment
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According to the National Institute of Mental Health (NAMI), 52.8% of US adults with mental illness received treatment in 2021. While more than half of those with mental illness received treatment, this statistic indicates that a significant number of people who could benefit from professional support haven’t sought it. NAMI also reports that the average gap between the onset of mental health symptoms and seeking professional support for them is 11 years. While systemic barriers to healthcare tend to be a major reason for many people not reaching out for help, therapy skepticism could also be a roadblock. Here, we'll discuss what therapy skepticism is, where it might come from, and ways both societies and individuals might combat it.
What is therapy skepticism?
Therapy skepticism is when a person has doubts about seeking mental health care in the form of therapy or counseling. They may be nervous about what it will be like or doubtful that it could be effective. A “healthy dose” of skepticism may help a person learn more and take in enough information to make the right decision for them. However, too much therapy skepticism could prevent a person who needs support or treatment from reaching out for it.
Therapy skepticism could take the form of statements like the following:
- “I don’t need a therapist; I already understand what my ‘problems’ are.” A therapist’s job isn’t to point out your problems or flaws, but to broaden your perspective and support you as you process and address your emotions and behaviors.
- “Therapy wouldn’t work for people like me.” While culturally competent care is important, virtually everyone has the potential to benefit from therapy.
- “Seeking therapy is a sign of weakness.” On the contrary, seeking therapy can be a sign of self-awareness, proactivity, and strength.
- “A therapist is going to judge me.” Typically, therapists are specifically trained in creating a welcoming, nonjudgmental, compassionate environment.
Why people may not feel comfortable seeking mental health treatment
Therapy skepticism can come from many different sources. Below are a few of the most common.
Stigma around mental health treatment
The American Psychological Association defines stigma as “the negative social attitude attached to a characteristic,” which “implies social disapproval and can lead unfairly to discrimination against and exclusion of the individual.” Mental health stigma means that many people fear talking about or seeking help for mental health symptoms due to concerns about potentially being judged or excluded by others. Despite the fact that many communities and organizations have made strides in fighting stigma around mental health in recent years, it persists for many.
According to the National Council on Aging (NCOA), one in five US adults lives with a mental illness. The NCOA also estimates that as many as 83% of people who could benefit from mental health treatment don’t pursue it. Stigma can not only prevent a person from feeling comfortable seeking mental health care, but it can also lead them to doubt its effectiveness or its benefits, potentially creating or adding to therapy skepticism. It’s also possible for a person to cite skepticism about therapy’s effectiveness as their reason for not seeking care when the fear and shame stemming from mental health stigma are the true, underlying culprits.
Therapist or general healthcare provider mistrust
Many people have come to distrust healthcare providers in general. For example, a person who associates all healthcare settings with fear, loss of control, judgment, trauma, or grief due to a negative past experience may be skeptical about going to therapy, especially in an in-person setting. Many people hold such associations—particularly members of marginalized groups.
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For instance, according to a 2024 survey of over 41,000 adults, over 36% report having experienced discrimination in a medical setting. The report on this study indicates that “adults with relative social and medical disadvantages” are more likely to experience this. LGBTQIA+ individuals, Black individuals, other people of color, those in larger bodies, and those with disabilities are examples of people who commonly experience this healthcare barrier—particularly if they hold more than one of these identities. Someone who has been discriminated against in a healthcare setting in the past may be likely to mistrust providers overall. These experiences may lead them to be skeptical of how they could ever feel comfortable with or helped by a mental health professional.
Lack of knowledge or misinformation on what therapy can help with
Finally, some people may not be aware of exactly how therapy works or what it can be used for. Most people associate it with treatment for a mental illness, especially more severe conditions like schizophrenia or bipolar disorder. Not everyone recognizes that persistent worry, a sense of hopelessness, sleep problems, and other symptoms associated with conditions like anxiety and depression can also be addressed in therapy.
A person may also be unaware that therapy can help them address all kinds of life challenges, from grief and low self-esteem to relationship difficulties and life transitions. Without this critical knowledge, a person may be skeptical that therapy could be beneficial for them. Virtually anyone can seek and potentially benefit from therapy at any phase of life—even if they're not currently experiencing symptoms of a diagnosable mental illness.
The potential benefits of seeking evidence-based mental health care
Research suggests that there are many potential benefits of seeking evidence-based mental health care like therapy. First, symptoms of a diagnosable mental health condition typically don’t resolve without professional treatment. In this way, therapy may improve a person's quality of life, daily function, and relationships. In some cases, therapy can even be life-saving.
While some therapy skeptics may question what “just talking to someone” could really do, consider the fact that therapists have highly specialized training in the science of talk therapy. They’re typically required to have at least a master's degree, as well as hundreds or even thousands of hours of supervised clinical care, before they can take on clients of their own.
Therapists are often trained specifically in creating an environment where their clients feel comfortable and welcomed, per the principle of “unconditional positive regard.” Using various evidence-based methods of interaction, a therapist can help clients learn to recognize their own patterns, process emotions and past experiences, and shift to a healthier perspective.
How communities can encourage help-seeking behaviors
There are several ways communities and societies may be able to encourage and normalize help-seeking behaviors, like reaching out for therapeutic support. Below are a few examples:
- Eliminate barriers to receiving mental health care
- Improve availability of education, nutritious food, free social spaces, meaningful employment, and other basic needs
- Provide nonjudgmental mental health education in schools from a young age
- Address the stigmatizing ways in which mental illnesses and mental health care are often portrayed in the media
How individuals can cope with their own therapy skepticism
If you’re curious about therapy or believe that you may need to seek this type of support but are still skeptical, there are a few approaches that might help. First, there’s the information-gathering strategy. You could spend some time reading about how therapy works and finding statistics on its effectiveness. You might also look up stories of individuals who have received crucial help from a therapist or ask someone you know who has been to therapy if they’d be willing to talk about their experience.
How to seek cognitive behavioral therapy yourself
If you’re interested in exploring cognitive behavioral therapy or another modality despite your skepticism, it’s possible to take smaller steps toward getting started. For instance, you might consider chatting with a therapist without committing to appointments yet. Many providers offer free initial consultations to answer prospective client questions.
If you're ready to book an official session to try things out, you might feel more comfortable meeting with a provider virtually rather than in an office. We'll talk more about the option of online therapy below.
Also note that it may be worth searching for a provider who has some similar life experiences to yours to help you feel more comfortable, especially if you’ve had discriminatory healthcare experiences before. For example, a person of color might feel more comfortable with a therapist of color or a provider who has undergone cultural competence training.
Why meeting with a therapist online may be preferable for therapy skeptics
For those who are therapy skeptics due to stigma, traveling to in-person appointments with a provider in their community might seem too vulnerable. With online therapy, in contrast, you can meet with a qualified therapist remotely—from home, work, or anywhere else you have a stable internet connection. That way, it may be easier to keep your decision to seek treatment to yourself if you choose to.
Online therapy is often more affordable than in-person therapy sessions without insurance. Since a therapy skeptic may not be interested in spending a significant amount of money on something they’re not sure will be helpful, this potential cost savings could be appealing.
Finally, if you decide that the provider you are matched with through an online therapy platform like BetterHelp isn’t the right fit, switching is easy. Although you’ll initially be matched with a BetterHelp provider according to the needs and preferences you outline in a brief onboarding questionnaire, you can switch therapists at any time, for any reason, at no additional cost. This feature may make it easier to find a therapist who can provide the type of support you need each week, even if you still feel skeptical of the first provider or two you speak with.
Is online cognitive behavioral therapy an evidence-based method?
Cognitive behavioral therapy (CBT) is one of the traditional approaches to talk therapy. It’s the modality any therapist you see is most likely to practice. It can be used to address symptoms of depression, anxiety, and other conditions, as well as high stress levels, low self-esteem, emotional pain, and other challenges.
A growing body of research suggests that methods like CBT are often as effective when delivered virtually as they are when delivered in person. This means you can pursue a therapy experience that's even more personalized to your needs, since you can generally trust that you'll be receiving quality care whether it’s online or in person.
Takeaway
What are some examples of skepticism?
When it comes to therapy skepticism in particular, a person may make negative or dismissive comments about therapy or, in some cases, judge others for seeking it. Therapy skepticism often stems from stigma, negative past experiences, or a lack of reliable, helpful information on the therapy process and its potential benefits.
Why does it feel like therapy isn't working?
There are several reasons why it may seem like therapy isn’t working. You may have unrealistic expectations for therapy or for the timeline in which you believe change or improvement should occur. Alternatively, you may not have a strong therapeutic alliance with your therapist, or you may benefit more from a different therapeutic modality. Each modality typically uses a different mechanism to promote change, and there are many options to try.
How can you overcome skepticism?
Adopting a growth mindset rather than a fixed mindset may be one way to overcome skepticism. When it comes to skepticism about therapy specifically, researching the efficacy of various modalities and speaking to people who have gone to therapy may be helpful.
What are the weaknesses of skepticism?
Skepticism may contribute to an overall negative mindset for some people. It may create unnecessary limitations in your life and make it harder to connect with others. However, skepticism can also come with benefits in certain situations.
What are the characteristics of a skeptical person?
In general, skeptical people challenge widely-held beliefs and carefully analyze ideas. They are usually open to evidence but don’t immediately believe everything they hear. Skeptics are often willing to engage in deep conversations about various topics.
Why do most people avoid therapy?
Many people avoid therapy due to stigma, a belief that therapy won’t make a difference, a lack of financial resources, or a lack of time to attend appointments. Some may believe that it’s best to manage mental health challenges on their own. They may think that seeking help or choosing to access support is a sign of weakness.
Why am I so hesitant to go to therapy?
There are many reasons why you could be hesitant to attend therapy. You may be nervous about engaging in a new experience, or you may question whether therapy will really work for you.
Is it normal to not like going to therapy?
Therapy can often be challenging and uncomfortable. However, if you dread going to therapy sessions, it’s possible that you could benefit more from working with a different therapist or trying a new modality. In general, the therapy process should be a positive one that allows you to reflect on the past, develop new coping skills, and learn to better manage difficult situations and feelings in the future.
How do you know when you don't need a therapist anymore?
Having a discussion with your therapist about whether it’s time to end your sessions may be the best way to determine whether you no longer need to go to therapy. Additional signs that you may no longer need a therapist include the following:
- You’ve been attending therapy consistently for a while and have accomplished the goals you set at the beginning of the process
- You’re no longer struggling with the concerns that brought you to therapy
- You’ve developed a sense of satisfaction with your life
- You’ve developed a strong belief in your own self-efficacy
- You no longer avoid difficult feelings and situations
- Your therapist has previously suggested decreasing the frequency of your appointments or ending therapy
How do you know if therapy isn't for you?
Nearly everyone can benefit from therapy in one way or another. If you have the sense that therapy “isn’t for you,” it’s possible you haven’t found the right fit in terms of modality or therapist. For example, if you’ve only tried cognitive behavioral therapy (CBT) but it doesn’t seem to be working as expected, you might try acceptance and commitment therapy (ACT) instead. It’s essential to find a modality that makes sense to you, combined with a professional with whom you feel comfortable.
Why do I feel like I have nothing to say to my therapist?
Having nothing to say to your therapist isn’t necessarily a bad thing. It might mean there isn’t a pressing issue or new development that you need to talk about. In some cases, though, it could indicate that you haven’t developed enough trust with your therapist to confide in them.
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