Ask a Therapist.

This question comes up sometimes so let’s start with the simple answer. No, going to therapy doesn’t mean that you are crazy. Crazy is a colloquial term anyway, and doesn’t have a clinical meaning. The legal equivalency would be the term insane. In therapy terms, a SMI (Serious Mental Illness) diagnosis is often considered severe and debilitating. These terms apply to very few people in our society.

So who does come to therapy at Sycamore Tree Counseling? Well, mostly, people just like us! (insert your favorite therapist are crazy joke here). The best description of most people we see is “the walking wounded.” Life tends to beat us up sometimes. Childhood events can stick with us, affecting our adult behaviors. Divorces happen. Sad times like the sudden and premature death of a loved one. Financial hardships. Struggling to get along with someone we care about. And, often, a combination of multiple stressors. Younger people are often struggling to find their way and older people are often struggling to process how things have gone. Both are working to answer the very important question, “how do I feel about what happened, and where do I go from here?”

So, No, being in therapy does not mean a person is “crazy.” I recommend therapy be thought of as a wellness behavior like going to the gym. I might start going to the gym to address a problem like weight gain or muscle loss, but you keep going because once it makes you healthy, it keeps you healthy. However, sometimes people handle therapy like they would physical therapy. They are there to address an issue and once it’s addressed then they are done. That’s fine too.

One last note, therapy is often imagined to be a highly emotional process, a place to go and talk about feelings. But quickly people learn that therapy is a Cognitive process and that we mostly are talking about memories, thoughts, life assessments and goals. Feelings drive us to understand these deeper underlying factors, but they aren’t always the focus. And because therapy is such a cognitive process, high functioning people tend to do really well at it.

Short answer is no, it is not an absolute requirement, although for many kids it is a good idea. Implicit in the question is the parent’s desire to avoid medication if it is not absolutely necessary. This is one of the easier situations in therapy to navigate- what we’ll be examining is the severity of symptoms behaviorally and academically. A child capable of making A’s and B’s but is making C’s and D’s should be medicated if possible. It’s a good and compassionate choice that will have long term dividends in improved academic outcomes. If the child’s behavior is overly disruptive to the classroom or if their number of infractions at school causes their behavior to stand out from the crowd, medication can improve impulse control to give them greater success in having a positive school experience.

Parents seeking good outcomes with minimal pharmaceutical intervention can use these benchmarks to discern the optimal course of action. I typically recommend a hybrid therapy approach- family and individual, so a partnership can develop between the parents and the child on shared life goals.

Educational note: ADHD medication decisions should be individualized with a qualified prescribing clinician. Grades alone do not determine whether medication is appropriate. Sycamore Tree Counseling Services does not prescribe medication.