While we are all tired of hearing, talking, and thinking about the coronavirus, it does not appear that “normal life” will be returning anytime soon. As a result of the many ways this pandemic has impacted our daily lives, many people are experiencing worsening mental health concerns and may be considering formal mental health services for the first time. I thought it might be helpful to review various options for those in need of mental health services and answer some frequently asked questions.

What are my options?

Unless you are experiencing an acute mental health emergency, in which case you should call 911 or go to your local ER, there are two primary options for mental health treatment: counseling/therapy or medication.

A lot of research has been done comparing the effects of medication to those of therapy, and for most people, both options can be helpful in improving symptoms of depression and anxiety.

Many people find that using medication and therapy at the same time is the most helpful. Because most people are familiar with medication treatment and how it works, I will talk most about counseling and therapy options, because there can be some stigma and misconception about it.

Medication treatment is offered by medical providers, including local family care providers and psychiatrists. Especially in rural communities where mental health resources are limited, many people will talk first to their local primary care provider, and may be prescribed medicine for symptoms of anxiety or depression.

When symptoms do not respond to “first line treatments” like a standard antidepressant, or for more severe symptoms or complex cases, patients may be referred to a psychiatrist, who is a medical doctor who specializes in mental health issues (MD or DO).

Psychotherapy, also known as counseling, therapy, or talk therapy, helps people to improve their lives by exploring the way their thoughts, feelings, and behaviors are affecting their life and well-being.

Therapy is offered by mental health providers with many different credentials/titles, including psychologists, (doctors of psychology, PhD or PsyD), clinical social workers (LCSW or LISW), marriage and family therapists (LMFT), and licensed mental health counselors (LMHC).

What Is counseling?

Choosing to enter a counseling or therapy relationship means that you will work one-on-one with a mental health provider who will help you to explore and overcome your current struggles, and to find a way to live a happier and more fulfilling life.

Your therapist will work with you to set goals for therapy (and for your life) and will help you to achieve those, sometimes by working to improve your communication in relationships, taking better care of yourself, talking about past painful experiences or losses, problem-solving, etc.

Common therapy goals include working through grief or a loss (a death of a loved one, the end of a relationship, a life transition — even “good” life events such as getting married or having a child can be difficult and stressful), improving relationships, improving social support, or improving mood, anxiety, and sleep.

The positive effects of therapy have been studied over and over, and research shows that therapy can lead to many positive benefits including:

  • Improvements in mood
  • Reductions in anxiety
  • Improvements in sleep
  • Improvements in health outcomes (reduced impact of chronic pain or other health conditions on one’s life)
  • Improvements in relationships and communication
  • Overall improved well-being and quality of life

What should I expect?

Therapy involves talking about very private things, and making a call to inquire about therapy is a sign of your courage and desire to grow and overcome life’s challenges. You can think of an initial visit as an opportunity to learn more about the therapy process and your therapist, and to voice any questions or concerns you have.

On your first visit, your therapist will ask you to complete paperwork about your personal, family, work, and mental health history. You will then typically spend about an hour talking about your current concerns, your history, and your hopes for your future. If you feel ready to continue working in therapy, you will work together to come up with a plan to help you feel better, including how often you will meet and what your goals are for therapy and for your life.

How often do we meet?

If you decide to continue with your counseling process, your therapist will work with you to come up with a personalized treatment plan. How often and how long you attend therapy can vary a lot. Sometimes, people hit a bump in the road and just one or two visits with a therapist is enough to help them get back on their path and feel better. Other times, especially after trauma or with chronic mental health problems, you might meet regularly for a year or several years.

You might work through one problem and be ready to take a break from therapy and then find yourself struggling with something else. Just as you would with your family doctor, you can always come back for more support when you need it. Typically, within six to 10 sessions you will begin to feel better and to see some of the positive effects from therapy. You will continue to talk openly throughout the journey about your progress and your desires for therapy.

The therapy experience

Therapy works a little differently than a visit to your doctor or dentist, where you typically rely on the medical provider to provide you with a diagnosis and tell you what to do to get better. In therapy, you won’t be told what to do, but instead, you’ll work closely with your therapist to problem solve, feel emotions, work on relationships and communication, and make positive changes in your life.

It will be an active collaboration, and research has shown that good outcomes result from you being an active, engaged participant in the entire therapy process. What does this mean for you?

  • Help set goals for treatment.
  • Because behavior change is difficult, practice is also key. When you bring what you’ve learned between sessions back to your therapist, that information can inform what happens in his or her office to further help you.
  • As psychotherapy progresses, you may feel overwhelmed at times. You may feel more angry, sad or confused than you did at the beginning of the process. Sometimes things may feel worse before they get better. Don’t be afraid to talk about this with your therapist!

A good fit

It is important to recognize that mental health providers have different strengths and weaknesses and skill level, and the most important factor in positive outcomes is a strong relationship with your therapist and believing that the approach offered will be useful to you. If it does not feel like a good fit with your therapist, you can find a different mental health provider. Particularly with an increase in telehealth services due to COVID-19, there are options available even for those who have historically had little access to high quality mental health services.

Great places to start when looking for a therapist include www.psychologytoday.com or you can always contact me at www.prairiehomewellness.com and I am happy to help you find a good provider in your area.

In summary, the impact of the coronavirus is complex and many of us are experiencing new stresses as a result. Especially given increased access to mental health services through telehealth options, it may be a good time to consider formal mental health treatment. Both medication treatment and therapy or counseling are important options for improving mental health and well-being. While I am of course biased as a provider of therapy services, I do believe they can be life-changing, and hope you will consider reaching out for support if you need it.


Dr. Lauren Welter is a licensed psychologist. She lives on a livestock and crop farm near Monticello, Iowa, with her husband Dan and their children. Contact her through her website, www.prairiehomewellness.com or call 319-975-8705.