- Oh Sheena, I feel like this year's already off to a wild start between the hospital and life and parenting.

My brain is like.

(screeching) - Well, Alok, don't be so hard on yourself.

You're a doctor, it's a pandemic and you have a newborn, but you know what?

It sounds like you could use a therapist.

- I probably could.

So could a lot of people, just saying.

- According to the US Census Bureau, a whopping 42% of Americans reported feeling anxiety or depression during the pandemic.

And about 21% of those people actually met the criteria for mental illness.

- And here are some more numbers.

84% of psychologists say the demand for treating anxiety is going up.

And two thirds of them say that the waiting list to see professionals is only getting longer.

But honestly, talking to a stranger can be kind of difficult.

It's difficult to spill your guts to someone you've never met before.

- Alok, what do you think, have you gone to therapy?

How did you feel about it?

What's your take on it?

- I have, and I was one of those people who was like, I don't need therapy.

I'm strong, I am in tune with my emotions.

I meditate, but like real talk.

I was in residency, super stressed out.

Wasn't paying any attention to self care, wasn't sleeping well.

And then I went through a breakup and I was like a mess.

And I feel like that that's what toppled down the entire tower.

I went to a therapist, like you said, I felt completely comfortable in just being raw and open and talking about everything.

And I honestly think that was like a very important rebuilding process.

In fact, my wife, Jenna credits therapy in turning me into the person that she eventually fell for.

So, hey therapist, thank you for getting me a successful marriage.

- So we're talking therapy, therapy is a broad medical term but here we're talking about therapy for emotional and mental distress.

So, when do you know that you need therapy?

Everyone has their ups and downs.

When do you say, I need therapy?

- Yeah, that's a really great question.

So if these difficulties have been going off for just a couple of days, maybe a week, maybe that's that normal sort of mental distress that you may experience given a particular situation.

But if you notice that these things are lasting, two weeks or longer, then it's definitely time where you may want to consider reaching out to find a therapist or a psychologist that can help you to address those concerns.

- And is counseling and therapy the same thing?

Can I think of those in kind of the same category?

- As you sort of mentioned we use these terms interchangeably but counseling tends to be more sort of brief interventions of those that may not be more related to severe types of distress.

- The American Psychological Association breaks psychotherapy down into five broad category.

The first two are mostly based on talking, exploring those deep thoughts, think of psychoanalysis, something you would do with Freud, where you're sitting down and you're exploring those deep subconscious motivations.

The APA also talks about the humanistic approach, a focus on expanding your potential in the search for meaning.

- The next two categories you might say, they're more like practical advice.

A behavioral approach focuses on trying to change specific behaviors and what they call a cognitive approach is to try to change your thought patterns to make them more rational.

When we combine these two, we get cognitive behavioral therapy.

- And that makes the point that these categories are not hard and rigid.

And there is some mixing, the APA even has a fifth category.

They call integrative or holistic meaning therapies can mix and match depending on the need.

- Okay, big question here.

And the question that I think is the most important, what can you really expect?

Does therapy actually make you feel better?

- Well, there is one landmark study done in 1986 by someone named Kenneth Howard.

- It basically says that after eight therapy sessions, half of them said that they saw some benefit.

And after weekly sessions for six months, 75% of them said that they felt better.

- But not all studies are so positive.

In 2017, there was that meta analysis of 247 other meta analyses.

- Wait, wait, hold on a meta study of meta studies, really?

Like, are you serious?

- Yeah, it's like meta of meta, but basically they looked at data from 5,000 randomized control in 247 meta analyses.

And they found that just 7% that 16 studies showed a significant benefit from therapy.

- Now, there's a huge range of studies but generally speaking in problems like anxiety and depression, therapy alone works just about as well as medication alone, like an antidepressant.

In larger study on depression, the best results come when you combine medication with therapy.

- Now, obviously when indicated medications are important but with just therapy you have less chance of those risky side effects.

And also we gotta talk about bills depending on what type of health insurance you have, antidepressants can sometimes cost a pretty penny.

All right, you've decided it's time, you're gonna go look for a therapist, good for you.

But what do you look for in the process?

- Well, you want to look for professional credentials.

- But, I'm looking online and you've also got MA, MS, LPC, LMHC, LPHC, LPCC, LCMFC, LMHP, CID, ED, MSW, MFT, LMFT, LC, MFT.

These are a lot of letters, I'm out of breath.

I mean, can you give us an idea of what these letters mean to you or to the average person?

I mean, if I see this, I could see how it can be overwhelming for someone.

How can I use these credentials to find the right therapist for me?

- Absolutely, yeah, it's a lot of letters.

The letters sort of provide us as professionals a way to think about what is the level of education and training that a licensed professional has.

So, a licensed clinical social worker or LPC licensed professional counselor.

Oftentimes those individuals may have, two to three years of education and then maybe some two to three more years of supervised experience before they actually, can go out into the field and maybe work independently.

If we think about those that may have a CID or a PhD.

So doctorate of psychology, those individuals have anywhere from four to six years of education, and then maybe two to three more years of training post graduation.

- Now those credentials will go a long way in determining how much you pay.

The typical cost is a hundred to $200 an hour, but that will vary depending on the credentials, where you live and other factors.

- The traditional model is usually a 45, 50 minute meeting, one-on-one in person.

- But a bigger experiment is underway and it was triggered by COVID.

- Call it the Zoom boom in 2019, right before the pandemic just 21% of therapists offered telehealth appointments.

By fall 2021, that number was up to 96%.

- Telehealth is not for everyone but the fact is most research dating back even way before COVID found that it was just as good as in person therapy, at least for depression.

- Now, if the tech doesn't bother you, text therapy is actually a viable option.

Now, most professionals will say the jury is still out but at least one big study looking at over 10,000 patients found that therapy via text actually could be beneficial.

- But how about sharing your problems with a robot?

The first demo of using therapy in artificial intelligence, an automated chat bot was at a Stanford University conference in 1972.

- And as you would imagine, this has gotten way more sophisticated as technology has advanced.

There are some small studies that have shown a benefit but this is all preliminary, still hasn't stopped companies from trying to jump into the game.

Would you feel comfortable in getting therapy from artificial intelligence, therapy via a robot?

- So on one hand, I feel like it's super impersonal.

I really like having the relatability with my therapist and her giving me advice from her point of view, but on the other end, when I'm having low moments and just feeling disorganized mentally, I do kind of like talk to myself in my kitchen and have a little heart to heart with myself.

So maybe, talking to a robot wouldn't be so bad if you're kind of sorting things out yourself anyway, does that make sense?

- I like your point about self-reflection I'm like, okay maybe a robot or artificial intelligence is another version of just journaling.

- There are a lot of options out there but for too many people, they just aren't enough.

- And the numbers tell it like it is, White Americans were more likely to get mental healthcare when compared to other groups.

16.6% of them were able to over the course of a year this is compared to 8.6% for Black Americans, 7.3% for Hispanic Americans and just 4.9% for Asian Americans.

- There's no single reason, but a lot of things can get into the way.

Cost, obviously, finding time away from work to actually have time for therapy.

- Some people really wanna find a therapist that looks like them, or as a similar cultural background, or in a specialty such as substance abuse, grief, adoption, or immigration.

- There are therapists who specialize in treating trauma connected with racism and LGBTQ issues.

- And I think the other piece too is that for a lot of people of color I think we are socialized from our culture to deal with a lot of stressors and handle things without getting that sort of help and support.

And especially when it comes to, going to therapy.

So I think if we, as people of color specifically can encourage people to like get help or talk about it and not, use these negative terms such as you're crazy for going to talk to somebody or things like that.

I think that's a huge factor that can't contribute to reducing more stigma.

- I know in my family, it's always been like a, you telling people your business or how can that stranger help you in that type of way.

And I think if you are describing it as more so like, no, I'm helping me.

And they're kind of just like a guide to help me figure out these emotions and how I should present myself with them.

I think that that's a huge factor in it too.

- If there's a factor in important to you, the internet can be your friend.

We've got some great resources listed below in our bio.

- I hope this really helps someone.

Tell us about your experience with therapy in the comments, or if you're just getting started, tell us about that too.

Shout out to you for taking that first leap, hit us up at PBS Vitals.

- And remember, regardless of what you're going through, you're never alone.

If someone you know, is struggling with depression or having suicidal thoughts or just needs emotional support, you can always reach out to the National Suicide Prevention Lifeline at 1800 273 8255.

Thank you for watching.

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