Overcoming Fear of Therapy: How Person-Centered Mental Health Treatment Empowers Clients

One of the greatest fears people often have about therapy and mental health treatment is that they will lose their sense of agency. After all, people with mental illness have historically—and, in some settings, are still today—often treated as if they are unreliable narrators in their own lives, their illness used as proof that they cannot be trusted to navigate their own experiences. The power balance between treatment providers and clients can feel impossibly skewed, and you may worry that your will and your voice will get lost. And, indeed, that has at times been the case in the history of mental health treatment.

However, today the mental health community is increasingly moving toward person-centered care, a model of treatment that explicitly seeks to listen to, honor, and empower clients. As psychiatrists Lisa Dixon and Jeffrey Lieberman write:

This model of care places greater emphasis on the patient’s involvement in determining the goals of treatment that are meaningful to them and the nature of their care. It shifts the balance of authority and responsibility of the doctor-patient relationship and incorporates shared decision making between the clinician and the patient.

In other words, person-centered care is a collaborative process in which the focus of treatment expands from simply treating symptoms to improving quality of life in a way that makes sense for each person. You are an active participant in determining your treatment goals and how to achieve those goals. Additionally, person-centered care is strength-based, focusing on how you can best use your innate abilities to engage in the healing process. Rather than ignoring your voice, the person-centered model amplifies it and makes it a driving force in your treatment journey, giving you control over your life and your recovery.

Of course, the right approach to treatment must be combined with effective treatment. As such, it’s imperative that your mental health treatment provider practices evidence-based care. This means selecting “interventions which have scientific findings to demonstrate their effectiveness or efficacy in improving client outcomes.” Although mental health treatment is often regarded as a highly subjective discipline, there is a wealth of data indicating the efficacy of treatment modalities that can be used to create comprehensive curriculums that address each person’s struggles.

However, evidence-based care isn’t a one-size-fits-all prescription. As Dr. Susan Padrino says:

The concern is that once guidelines for treatment are established, medical decision-making will be unnecessary—simply follow the prescribed treatment and move on to the next patient. In practice, guidelines can only provide the basic strategy, and the details of the treatment plan depend on the patient and physician.

That is, the evidence gives you the information you need to make informed choices regarding treatment options, but whether any one option is right for you is a highly personal decision. What evidence-based care does is provide you with a roadmap of what has (and hasn’t) worked for others, statistics indicating the likelihood of treatment success, and the opportunity to make smart decisions regarding your own recovery. You and your clinicians can work together to determine whether a particular course of treatment is right for you based on the best information available with the understanding that each person’s experience is unique. “You don’t want [evidence-based care] to be done robotically,” explains Dr. Bonnie Spring, director of behavioral medicine at Northwestern University Medical School. “You want [it] done by caring, skilled, emphatic therapists who understand the principles of the treatment. They don’t have to follow the manual like a robot would.”