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Mental Health: What you can expect at a therapy appointment

Image of Richardson talking Army Sgt. Claude Richardson, an Army Reservist and suicide prevention instructor with the 358th Military Police Company, talks about his experience as an instructor during a 2018 video project hosted and organized by the 200th Military Police Command’s Suicide Prevention Program. (Photo by Army Master Sgt. Michel Sauret.)

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Fever, sore throat, and chills: Typically, these are signs that it’s time to visit your doctor, and you usually know what to expect. The nurse might weigh you, check your blood pressure, and take your temperature. The doc will arrive, ask what’s bothering you, take a look, maybe prescribe some medicine, and send you on your way.

However, when it comes to your mental health, it can be hard to decide when it’s time to make an appointment and even harder to know what to expect when you get there. That fear of the unfamiliar and unknown can give you pause in going to see a therapist, but the good news is a little knowledge can feel like a lot of power.

You don’t have to wait until you’re in crisis to see a mental health professional. Therapists are ready and trained to assist with issues such as grief over a loss, strain in your relationships, depression, anxiety, insomnia, and other issues. Or you might even need help with improving health behaviors such as quitting smoking or losing weight.

Similar to your physical health, it’s also important to catch and address psychological struggles early before things get worse or your symptoms start to impact your day-to-day functioning. And just like your annual physical, you might want to schedule regular checkups with your care provider to make sure you’re engaged in preventive maintenance—even if things seem just fine.

For starters, there likely will be some paperwork and questionnaires about how you’ve been feeling lately and any symptoms or problems you’re experiencing. During the first meeting, she or he will ask a lot of questions and get to know you. You also can ask questions to learn more about his or her approach and decide if it’s a good fit.

The first meeting usually takes about 60–90 minutes and, despite common misconceptions, rarely involves lying on a couch or talking about your childhood. Your therapist will ask questions that focus more on your specific problem to help understand what’s contributing to it and what your goals are for improvement.

It can be hard to open up to a stranger at first. Still, being open and honest, will help you get the most out of your visit. Your therapist is on your side and serious about maintaining your privacy as well. Mental health professionals are held to strict confidentiality guidelines, and it’s extremely rare that speaking with one will impact your security clearance.

Once there is a shared understanding of what your goals are and what you want to achieve, you also might discuss what stood between you and those goals in the past. Finally, you and your therapist will talk through your treatment plan. You’ll work together to build up your tool box, so you have the skills you need to excel when you reach your destination. Keep in mind many of the gains you make while working with a mental health professional happen outside of the therapy room, so you must be willing to put in the hard work. It’s also common for your therapist to assign “homework,” so it’s essential to practice what you’re learning between sessions.

Your therapist’s goal is to ensure you’re safe and help you reach your goals, improve your functioning and performance, and build resilience and strength to manage your current problem and any others you might face in the future. With this in mind, therapy isn’t intended to last forever. Once you’re equipped with the essential skills you need to thrive, sessions might become less frequent, and treatment will end while you still continue the work on your own.

Common barriers can make it hard to take action toward addressing your mental health. Working with a psychologist or other behavioral health provider can help you master the skills you need to manage many types of life challenges in a safe, confidential setting. Use the following resources to learn more and help locate a therapist:

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DHA AI 1020.01: Reasonable Accommodations (RA)

Policy

This Defense Health Agency-Administrative Instruction (DHA-AI), based on the authority of References (a) through (c), and in accordance with the guidance of References (d) through (s), establishes the Defense Health Agency's (DHA) procedures to: a. Set procedures, responsibilities, and implement guidance for administering the DHA RA Program in accordance with federal guidelines. b. Provide, submit, and respond to requests for RAs of qualified individuals with disabilities who are employees or applicants for employment. c. Process RA requests for DHA employees and applicants with disabilities to ensure an appropriate response in a timely manner. Further, these procedures establish criteria for collecting and annually reporting data on the numbers and types of request for RA considered.

  • Identification #: DHA AI 1020.01
  • Date: 11/2/2020
  • Type: Administrative Instructions
  • Topics: Physical Disability

DHA PM 6025-01: Primary Care Behavioral Health (PCBH) Standards

Policy

This Defense Health Agency-Procedures Manual (DHA-PM), based on the authority of References (a) and (b), and in accordance with the guidance of References (c) through (i), establishes the Defense Health Agency’s (DHA) procedures to establish required standards for: a. Military Medical Treatment Facilities (MTFs) and primary care clinics for adult, child and adolescent, health behavior, behavioral medicine, and behavioral health services in primary care. b. Behavioral Health Consultants (BHCs). c. Behavioral Health Care Facilitators (BHCFs). d. External Behavioral Health Consultants (EBHCs). e. Primary Care Clinic Leaders.

DHA PI 6490.02: Behavioral Health (BH) Treatment and Outcomes Monitoring

Policy

This Defense Health Agency-Procedural Instruction (DHA-PI), based on the authority of References (a) and (b), and in accordance with the guidance of References (c) through (k): a. Establishes the Defense Health Agency’s (DHA) procedures for the collection and analysis of BH outcome data. b. Addresses how DoD will standardize BH outcome data collection to: assess variations in mental health and substance use care among in-garrison medical treatment facilities (MTFs) and clinics; assess the relationship of treatment protocols and practices to BH outcomes; and identify barriers to provider implementation of evidence-based clinical guidance approved by DoD. c. Designates the Army as the DoD lead Service for maintenance and sustainment of the Behavioral Health Data Portal (BHDP) in specialty care mental health and substance use clinics, referred to collectively as BH clinics, until BHDP functionality can be integrated with GENESIS or another electronic health record (EHR) system managed by DHA. d. Designates DHA Information Operations (J-6) as lead on transitioning BHDP functional requirements related to outcomes monitoring to future EHR data collection platforms and processes.

  • Identification #: DHA PI 6490.02
  • Date: 7/12/2018
  • Type: DHA Procedural Instruction
  • Topics: Substance Abuse

DoD Instruction 6490.10: Continuity of Behavioral Health Care for Transferring and Transitioning Service Members

Policy

In accordance with the authority in Reference (a), this Instruction establishes policy for the Military Departments, assigns responsibilities, and prescribes guidelines for establishment of Military Department policy and procedures to ensure continuity of behavioral health (BH) care at the losing and gaining installations when Service members transition from one health care provider (HCP) to another when transferring to a new duty station or transitioning out of the Service.

  • Identification #: DoD Instruction 6490.10
  • Date: 10/28/2015
  • Type: Instructions
  • Topics: N/A

DoD Instruction 6490.15: Integration of Behavioral Health Personnel (BHP) Services Into Patient-Centered Medical Home (PCMH) Primary Care and Other Primary Care Service Settings

Policy

This instruction establishes policy, assigns responsibilities, and prescribes procedures for attainment of inter-Service standards for developing, initiating, and maintaining adult behavioral health services in primary care.

  • Identification #: DoD Instruction 6490.15
  • Date: 11/20/2014
  • Type: Instructions
  • Topics: N/A

DoD Instruction 6490.05: Maintenance of Psychological Health in Military Operations

Policy

This instruction establishes policy and assigns responsibilities in accordance with References (c), (d), and (e) for developing combat and operational stress control (COSC) programs within the Military Departments, the Combatant Commands, and joint Service operations.

  • Identification #: DoD Instruction 6490.05
  • Date: 10/2/2013
  • Type: Instructions
  • Topics: N/A

DoD Instruction 6490.12: Mental Health Assessments for Service Members Deployed in Connection with a Contingency Operation

Policy

This instruction establishes the policy for person-to-person deployment mental health assessments for each member of the Military Services deployed in connection with a contingency operation according to Section 1074m of Title 10, United States Code (Reference (b)).

  • Identification #: DoD Instruction 6490.12
  • Date: 10/2/2013
  • Type: Instructions
  • Topics: N/A

DoD Instruction 6490.04: Mental Health Evaluations of Members of the Military Services

Policy

Reissues DoD Instruction 6490.4 (Reference (b)), establishing policy, assigning responsibilities, and prescribing procedures for the referral, evaluation, treatment, and medical and command management of Service members who may require assessment for mental health issues, psychiatric hospitalization, and risk of imminent or potential danger to self or others.

  • Identification #: DoD Instruction 6490.04
  • Date: 4/3/2013
  • Type: Instructions
  • Topics: N/A

DoD Instruction 6490.08: Command Notification Requirements to Dispel Stigma in Providing Mental Health Care to Service Members

Policy

This instruction provides guidance for balance between patient confidentiality rights and the commander’s right to know for operation and risk management decisions.

  • Identification #: DoD Instruction 6490.08
  • Date: 8/17/2011
  • Type: Instructions
  • Topics: N/A

Mental Health Assessments for Members of the Armed Forces Deployed in Connection with a Contingency Operation

Policy

Policy Guidance for Deployment-Limiting Psychiatric Conditions and Medications

Policy

This policy provides guidance on deployment and continued service in a deployed environment for military personnel who experience psychiatric disorders and/or who are prescribed psychotropic medication.

HA 97-017: Policy for Post-Deployment Mental Health Screening in the Bosnian Theater

Policy

This memo describes a change in procedure for medical surveillance of U.S. forces deploying to Bosnia.

  • Identification #: HA 97-017
  • Date: 11/25/1996
  • Type: Memorandums
  • Topics: Deployment Health
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