What should you start with? Ask yourself one seemingly simple question, although the answer is rarely obvious: what exactly makes your everyday functioning difficult? It may be growing anxiety, panic attacks, intrusive thoughts, burnout, the effects of difficult experiences, a crisis in a relationship, or problems with sleep or eating. The more precisely you name it, the easier it will be to choose appropriate help.
If suicidal thoughts appear, your well-being deteriorates rapidly, or self-harm occurs, treat it as a red light. Contact a psychiatrist immediately or report to a crisis intervention centre. In the event of a direct threat to life, call 112. This is a matter of safety, so do not delay.
Distinguishing the roles: who does what
To avoid wasting time, establish right away whether you need a psychotherapist or another specialist. Most misunderstandings concern the differences between a psychiatrist, psychotherapist and coach/adviser. Let us explain them briefly:
- A psychiatrist is a medical specialist. They diagnose mental disorders, select and modify medication, monitor the course of treatment and, after additional training, may also conduct psychotherapy;
- A psychotherapist treats mental disorders and uses psychological methods, which help people cope with life difficulties. They assess the condition, set goals, choose an approach, conduct sessions, assign independent work and track progress. They may prescribe medication only if they are also a doctor;
- Coaches and advisers do not treat disorders. They provide support in setting personal and professional goals, developing skills, career planning and productivity, as well as implementing changes.
Which psychotherapy method will be right for you?
The method is selected according to the problem and the goal. Usually, after 4–6 meetings, it becomes clear whether the plan is helping; further work is then refined. The approaches most frequently chosen by Polish professionals include, among others:
- Cognitive behavioural therapy (CBT) – effective in treating anxiety, depression, panic disorders and OCD;
- Dialectical behaviour therapy (DBT) – helpful in cases of intense emotional fluctuations and a tendency towards self-destructive behaviour;
- EMDR – a method for working with traumatic experiences;
- Interpersonal therapy (IPT) – most often used to treat depression;
- Couples and family therapy – helping organise communication and roles in a relationship and family;
- Psychodynamic psychotherapy – focused on identifying persistent patterns of functioning, self-image and the deeper causes of symptoms.
Do you value a clear structure and “homework”? CBT/DBT is more likely to suit you. If the main problem concerns relationships, consider IPT or couples/family therapy. If you want to understand the sources of your difficulties and change long-standing patterns, consider a psychodynamic approach. After 3–5 sessions, you should have a shared hypothesis and goals; if they are missing, it is worth seeking a second opinion.
Qualifications and framework for cooperation
Even the best rapport cannot replace solid preparation. Therefore, check where and in which therapeutic approach the therapist trained; it should be a several-year school in Poland or abroad, completed with a certificate. Current credentials matter, including those issued by the Polish Psychological Association, Polish Psychiatric Association, Polish Association for Cognitive and Behavioural Therapy, psychodynamic or systemic associations, and EMDR Europe/EMDR Polska. Ask about their practice: how many years and in what settings, such as a clinic, ward or private practice. Also ask about supervision: whether it takes place regularly and with whom. A few such questions say a great deal about the quality of the work.
Experience alone is not enough, however: the framework for cooperation with the specialist should be established precisely. Ideally, the agreement should be written down and you should give informed consent to it. It should cover payment, cancellation, confidentiality and contact arrangements. If the work takes place online, the specialist should provide an encrypted video connection and clear information about storing notes and data. As a rule, providing a private, safe space for sessions is the psychotherapist’s responsibility.
Transparency and progress assessment
Let us assume that you already have a psychotherapist and the sessions have begun. How can you make sure everything is moving in the right direction? Good therapy is a transparent process with measurable effects. Regardless of the nature of the problem, the method adopted and the context of the work, it proceeds in stages:
- The first meetings are used to take a history, assess risk and agree on goals;
- Subsequent sessions take place once a week and last 45–60 minutes. If symptoms worsen or more intensive work is needed, meetings may take place twice a week;
- Trauma therapy follows stages: first stabilisation, then processing experiences, followed by integration;
- The therapist may suggest combining individual and group sessions; this can be effective and ease the strain on your budget.
Measuring progress
It is worth tracking progress not only “by feel”, but also with validated tools, sensibly every 4–6 sessions, such as:
- PHQ-9 – severity of depressive symptoms;
- GAD-7 – generalised anxiety;
- PCL-5 – PTSD symptoms;
- CORE-OM – general psychological distress;
- ORS/SRS – therapy outcomes and the quality of the therapeutic alliance.
What matters is not only a decrease in scale scores, but also improved everyday functioning, such as returning to work, better sleep and greater energy.
Warning signs
Remain alert to signs that may indicate a lack of reliability or competence:
- Promises of “quick recovery” or a “guaranteed result”;
- Pressure to immediately purchase a “package of sessions”;
- Discrediting other specialists or methods;
- Boundary violations, such as flirting, “private” meetings outside the arrangements or late-night messages without prior consent;
- Imposing their own beliefs and values;
- Avoiding presenting a written agreement and obtaining informed consent.
The ability to part ethically is also an element of a healthy process. If after 4–6 meetings there is no clear work plan or no even minimal improvement in the scales and achievement of goals, speak openly about changing therapists.
The final selection formula
When choosing a psychotherapist, follow the four criteria below. This will increase your chances of success, regardless of the problem you want to solve:
- The problem, expectations and goals should be precisely established before therapy begins; without them, it is difficult to measure progress.
- Make sure the therapist uses an evidence-based approach suited to the reported problem.
- Confirmed training, regular supervision of clinical work and a written agreement are essential.
- Expect measurable improvement against the initial goals, periodically verified with scales or questionnaires.
Of course, remember that a constant sense of safety and trust in the relationship with the therapist is essential for open and effective work.