Sivan Cohen, LCSW, PC

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One of the Most Important Therapeutic Interventions

According to the National Alliance on Mental Illness (NAMI), mental illness affects 18.5 percent or 1 in 5 individuals in the United States in a given year. There is also a percentage of individuals who do not reach out for help. When someone takes the step to ask for help it is imperative to consider the use of psychoeducation as a therapeutic intervention.

Psychoeducation encompasses the incorporation of information and education to those impacted by mental illness. This includes potentially inviting family members or supportive individuals into understanding the condition. It is to provide the type of information that is essential for clients to have; such as challenges of the condition, resources and treatment options, and recognizing their own areas of strength and need.

I had a very full circle moment the other day when speaking to the parents of my teenage client struggling with depression. I was asked why their daughter was not able to just “shake off” these feelings of sadness. “Why is she so sad, why can’t she just smile and get over it?” They went on to explain that they themselves have been through difficulties and that struggle is “simply a part of life.” I had a bit of an internal struggle in hearing this but quickly refocused the conversation.

My heart truly sought out the young girl as she sat in the room staring blankly at this interaction. I registered a couple of things at once. First, these parents may want to help but they simply do not understand depression or even mental illness. Second, they do not know how to help their daughter. Third, so many people are just like these parents. They are not approaching this from a malicious place, but rather a lack of knowledge on the subject matter. Fourth, it is not their fault that they don’t get it. And finally, it is my responsibility as a clinician working with this client, to ensure that those closest to her, those who will be supporting her through this journey, are aware of what she is going through and what they can do to help.

So I got on my soap box…

And I talked about the brain.

And I explained how depression affects 350 million people worldwide.

And I spoke about depression from a neurobiological platform, discussing neurotransmitters and firing power potential across synapses.

And I informed them that brain structures like the hippocampus (in charge of memory and emotion) are sometimes physically smaller in someone struggling with depression than someone who isn’t.

And I spoke about heredity and genetics including the impact of an individual’s serotonin transporter gene.

And then I explained how someone who is struggling with depression literally has a different type of brain processing than someone who is not struggling. The way in which this client sees the world is different right now. I have had clients struggling with depression who experienced sensations differently (think about walking into an office you have been to for years and all of a sudden noticing that the walls are brighter and more vibrant than ever before). I emphasized the right now because with the right type of treatment (in her case it would be a combination of psychopharmacology, individual therapy and family therapy) she may be able to function effectively through this. 

After my explanation, I saw both parents sit back and take it in. I looked to my left and saw a shimmer of understanding in the client’s eyes as she slowly absorbed this information. She then nodded as if processing what was just shared. It was one of the most rewarding moments as a clinician because I think she finally felt heard. Many clients feel as if there is something "wrong" or "off" or "damaged" within them.

Advocacy and empathy are imperative in treatment so that clients are able to see that their struggle is not their fault, and that help and hope is possible. Psychoeducation also helps to challenge mental health stigma and all that comes along with it. By explaining and exploring we are able to shed light on matters that are otherwise misunderstood or not discussed at all.