Author: Esther Krohner, MFT

Debunking the Therapy Stigma: Improving Mental Health in America One Grain of Sand at a Time

Have you had conversations with people who were hesitant to seek therapy due to the stigma of mental health treatment? As a therapist or mental health practitioner, chances are you’ve had some of them in a session. It’s essential to understand why the therapy stigma exists and how to overcome it to help clients effectively. Keep reading as we explore this pervasive issue, discussing the misconceptions and stereotypes that often surround therapy and proposing strategies to break down these barriers and promote a healthier mindset toward mental health services using the Brief Therapy model.

Why is There a Stigma Around Therapy?

Stigma is defined as a mark of disgrace associated with a particular circumstance, quality or person. And how is this related to our series on how to improve the Mental Health crisis in America

Therapy stigma is a vague concept that can be distilled into actions and messages around how we address social responsibility, status and care when we face problems. Are the messages, struggles and problems addressed together or separately? Do we shame and guilt? Do we provide open feedback or not? Do we acknowledge struggle or pain, and how? How much of mental health is private or secret? Do we blame as a key to solve a problem? Do we dismiss or ignore? 

All these communication elements provide information about how we relate to mental health. These components can often make people hesitate or avoid therapy. It adds a layer of isolation and shame, which often results in avoidance or dishonesty.

When someone comes to the Brief Therapy Center from MRI for therapy, one question we often ask is, “Why now?” This question helps to uncover the motivation and context around the person or people seeking help. Each culture, gender, career, systemic/familial role and personal frame of reference around mental health plays a key role in what drives someone to ask for help. It also impacts how long a person or people will wait before they seek help. When people carry a message that mental health is a negative indication of their worth or defines their identity negatively, getting help can be more complicated.

The Therapy Stigma is Further Enhanced by Individualism

Most people in the United States seem to agree that mental health is an individual endeavor. This is indicated in the available resources for treating mental health and reflected in the common practices about defining who is an identified patient. The person exhibiting the most life-threatening or money-consuming communication/behavior is often isolated as the person who needs to change. 

This is exemplified in the way our insurance billing practices make it difficult to bill for couple’s work or to do family therapy without the identified patient present. Interpersonal complexities are considered a separate component of care rather than the key that often brings someone in for help. To make matters worse, other people in the system are referred to other professionals, unnecessarily increasing complexity and making the process longer and more costly.

A good example is a person who drinks too much who shows up in our practice and, when asked, “Why now?” responds that their partner finally said that if they did not seek help, the relationship would be over. From the perspective of Problem-Solving Brief Therapy, the most motivated person to change is still sitting at home.

These facts shine a light on the major limitations of our standardized care practices. When we isolate symptoms as though they occur in a vacuum, we lose tremendous resources and may reinforce the stigma around mental health. It sends the message that only one person is responsible for creating the change. It points the finger arbitrarily at one person, who may or may not want to change the situation they are being “accused of,” making it less likely that they will actually want to change or even be interested in therapy.

The Therapy Stigma is Prevalent with Children, Too

In our minds, this is especially problematic when it comes to children. Thankfully, many child practitioners are learning tools to involve parents and caretakers. However, it is still seen as adjunctive work rather than the heart of the work. If we see this to be true with youth, how come we are ready to discard key contextual factors and relationships when working with adults? How much power does a child or youth actually have to promote changes in their own lives? 

How to Placate the Stigma of Mental Health Treatment

The stigma around mental health is prevalent, especially among the underserved, lower socio-economic brackets and ethnically diverse communities. “I am not crazy: I don’t need a therapist” is a phrase we have heard too many times at the Brief Therapy Center when working in inner-city schools. 

And we know the more people postpone asking for help, the likelier it is that they’ll encounter larger problems and increase the bill, for example, with frequent visits to emergency rooms with panic attacks or, even worse, threats of suicide.

The good news is that we’ve found we can start to undo the therapy stigma when we use descriptive language around the pain. For example, we broaden the view and zoom out so people can appreciate themselves and their resources from a practical and very observable frame of mind. 

When we ask questions that help people connect the dots between their mental processes, feelings and inner worlds to interactions and messages, we help free people from messages that keep them stuck. Even when we work with one person, we are working interactionally. When we ask questions that emphasize our behavior and communication in the context of the world and others, people can reduce the stigma around therapy and relax into a state of mind that allows them to think and behave with new possibilities.

Of course, it is a big topic, and how we see mental health is a web of many different elements of our lives. In our therapy model, we help people see the systemic messages, which helps to foster a point of view where mental health is not an indication of worth as a human being. 

You Can Help Debunk the Stigma Around Mental Health with Brief Therapy Center 

How we practice therapy says everything about where we place responsibility, how we distribute power and how we do or don’t endorse common practices that sadly (we are guilty at times too) endorse the therapy stigma and disempower people from seeking help or making change until much later. If you’re ready to make a change and take action to undo the stigma around mental health treatment, I invite you to join our upcoming training to learn more about this issue and how the Brief Therapy model works to get people the best help possible. Secure your spot for the online training today! 

Register for our next training

Esther Krohner

Master en Psic.
I have 14 years of experience working in mental health settings. I am and LMFT and RYT. I have been training and practicing  family therapy with Karin Schlanger for 5 years at the Mental Research Institute. I help couples, families, kids and teens  to make the changes they want to. When faced wit...

Related Blogs

Effective Therapy for Teens

Esther Krohner

It takes two to tango BUT only one to promote positi...

Esther Krohner LMFT & Karin Schalnger LMFT

Effective therapy needs to be brief–short, and solut...

Karin Schlanger, Esther Krohner

Our Trainings

We are different because we teach by focusing on the practical applications, not just theory. Our specialty trainings utilize real cases and high engagement with our trainers. We have specialized trainings of real cases and dynamics with our teachers.

Brief Therapy Certificate®

Entry level Problem Solving Brief Therapy. Around 250 hours of face to face training, readings and case analysis

Problem-Solving Brief Therapy

Exclusive offering for colleagues who have completed the BT Certificate. Supervision of participant’s cases and 40 hours of group supervision. (Limited enrollment)

Corporate Services

We take care of the Mental Health of your people so you can focus on what you do best