Back in the day, Hollywood’s view of mental health counseling looked pretty simple. Movies and TV shows that showed any portrayal of counseling showed the person lying on a couch and facing away from the counselor. Whether it was a psychologist or psychiatrist listening was up to the viewer to decide.

 Fast forward to today. Even though we’ve come a long way in treating mental illness, just ask someone you know what they think a counseling session looks like. Chances are, that person’s going to give you that same view of the “counseling couch” that people have had for years.

For Dr. Lucas Barton, medical director for Solutions Community Counseling & Recovery Centers – one of the providers that MHRS funds – misconceptions like these are nothing new.

“I’ve heard a lot of things about what people expect when they first come to counseling,” Barton said. “There are a lot of myths out there.”

 We sat down for a look at the misconceptions about mental health counseling. Here are a few:

“A pill is going to cure me.”

Dr. Barton said he’s heard this one a lot. “Some people think of mental health issues as curable – like a cold. But there are three things we do to help someone with a mental health concern: modify biology, modify psychology, and/or modify environment. It’s always a conversation during a first visit in my office, anyway.”

In most cases, he said, it’s a combination of at least two of those three. And the idea that a pill is a “cure all” for mental health problems is truly a misnomer. “You can mask a symptom and feel better with a pill, but you have to also address the root cause – and that can take some time. The pill itself can address a medical imbalance, but there may be other things at issue, too.”

Advertising also contributes to that thought, said Dr. Barton. “Drug companies market products to audiences, true enough. But some people think that pill is their answer. It can help, but it probably isn’t the only thing that will lead to wellness.

“A pill is going to make me a zombie.”

On the flip side of medications being a cure-all, there are those who think going on a medication to treat a mental health issue will just make them live every day in some “zoned out” state.

“The side effects of the older drugs they used did do that,” Dr. Barton said. “But things have changed. While some older medication side effects were pretty nasty, treatment has evolved. When meds are used in treatment, we may start with lower doses. As treatment moves forward, the dosages can be adjusted and monitored better than they used to be. It has to be a team effort.”

 “Once I start therapy, I’ll never stop.”

 While that could be true in some extreme cases, Dr. Barton said counseling does in fact end for many. It’s how honest they are about their progress that may lead to that last day.

“There’s some over-diagnosis going on in some ways, and some overprescribing of medications at times, too,” Dr. Barton said. “It leads to confusion over what a disorder really is.”

Let’s say someone’s been treated for depression. Dr. Barton says yes, depression can be resolved – or more accurately, the things that led to the depression can be resolved. Some other conditions, though, cannot and do not end. And then there may be the person who’s had a family member go through a bad experience with a medication. Those all feed into some people’s fear that they will never leave therapy.

 The main issue, says Dr. Barton, is how things change. “The check on this is what they are doing. I listen to whether someone is rationally thinking through coming off a medication or ending treatment. If they say they’ve used the skills they learned in therapy and that’s making things better, then sure – maybe it’s time to give moving off therapy a shot. It’s not whether they’ve checked the boxes, but whether they are changing things.”

 “Insurance is different for mental health than for physical health.”

 That may have been true several years ago, but mental health parity laws are changing that. And with the passage of the Affordable Care Act in 2010, access to treatment for mental health issues must be the same as access to treatment of physical health issues.

And more physicians are realizing the need to bring the two together. “We’re starting to see mental health and physical health exams being combined in a lot of doctor’s offices. And there’s expansion in the number of places doing psychological assessments, too. That’s helping to integrate diagnosis and treatment. More doctors are talking with each other about treating the whole person.

The notion of “being in therapy” is evolving a lot, said Dr. Barton. And that’s helping change the misconceptions people may have about going into treatment. The biggest thing, he says, is to communicate with your therapist.

 “You have to work as a team,” he said. “I encourage that. It’s talking face to face and asking questions that builds trust in each other. Treatment, when it’s needed, goes so much better. And the outcomes can be wonderful.”