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New class expectations, new living situations, and navigating newfound independence can give us all the feels—from super psyched to super stressed. Even if you’re loving your student life, dealing with all the stressors that come with college can be a lot to handle. According to experts, the best time to handle that stress is now. “If we don’t take care of our mental health, we may not be able to reach our goals, maintain good relationships, and function well in day-to-day situations,” says Dr. Chrissy Salley, a psychologist in New York who works with students of all ages. “Taking care of mental health is one of the best things someone can do.”

Now really is the time to start tuning into your mental health—the majority of mental health issues appear to begin between the ages of 14 and 24, according to a review of the World Health Organization World Mental Health surveys and other research (Current Opinion in Psychiatry, 2007). But help is available. Along with methods like mindfulness and meditation, talking to a therapist (such as a counselor, psychologist, or psychiatrist) can be a super-effective way to manage any mental health issue you may be facing or just a way to get extra support during times of stress, challenge, celebration, or change.

There’s a ton of research on how effective therapy really is—a 2015 meta-analysis of 15 studies of college students with depression found that outcomes were nearly 90 percent better for those who received therapeutic treatment than for those in control groups, most of whom received no treatment (Depression and Anxiety).

One of the most common and effective therapies is cognitive behavioral therapy (CBT), a short-term, goal-oriented therapy where a pro helps you find practical ways to deal with specific problems.

[/vc_column_text][vc_tta_accordion shape=”square” c_icon=”chevron” active_section=”0″ collapsible_all=”true”][vc_tta_section title=”More on CBT ” tab_id=”1508289452900-d340d698-c737″][vc_column_text]The goal of CBT is to help you change or reframe certain thought processes—the idea is that by changing your attitude about something, you can change your behaviors. For example, if you think something like, “I’m terrible at chemistry, so I know I’m going to fail this test—there’s no use studying,” you probably won’t ace your test. CBT can help you shift your thinking to something more like, “I know chemistry is really hard for me, but studying will help me do better.”[/vc_column_text][/vc_tta_section][/vc_tta_accordion][vc_column_text]And it works. There’s strong evidence that this therapeutic technique can help you handle just about anything you might have going on, according to a 2012 analysis of over 200 studies on CBT published in Cognitive Therapy and Research. The researchers found that CBT was effective for people struggling with anxiety, bulimia, anger issues, stress, and a number of other mental health issues.

OK, so we know that therapy is an essential and effective tool for keeping your mental health at its peak, but making that first appointment can feel intimidating. It doesn’t have to be. Our experts break down the therapy basics so you can embrace whatever you need to feel your best. Here’s what the pros want you to know.

Surveys show it’s not out of the ordinary to see a therapist—55 percent of college students have used campus counseling services, according to a 2012 report from the National Alliance on Mental Illness. If you feel uncomfortable with the idea of going to see a therapist, you’re not alone—and that’s totally OK, says Zachary Alti, a licensed social worker, psychotherapist, and professor at the Fordham University Graduate School of Social Service in New York. “Few people look forward to therapy, but students should be aware that therapy exists to help them, not to judge them,” he says. The process might not always be comfortable, but that doesn’t mean it’s not worth it. “I’d encourage students to keep an open mind and try it,” says Dr. Salley.

“Many [young people] tell me they’re reluctant to participate in therapy because they don’t want to talk about their feelings,” Dr. Salley says. Again, that’s totally normal. But going to therapy isn’t just about talking about how you feel; it’s also about walking away with real tools you can use in your life. “Therapy should also be action oriented—a time to learn new skills for coping and figuring out ways to solve problems,” Dr. Salley says.

“Therapy is like physical exercise,” says Alti. Just like hitting the gym is good for everyone’s physical health—not just those with diabetes or heart disease—seeing a therapist can benefit everyone’s mental health.

But really, any time is a good time to go. While anxiety and depression are still the most common reasons students seek counseling, according to a 2016 annual report from the Center for Collegiate Mental Health, you don’t have to be in the midst of a crisis or feel like you’re nearing a breakdown to see a pro—seeing a therapist can be helpful even when things are all good. “There are a lot of pink flags before you get to red ones,” says Dr. Dana Crawford, an individual and family therapist in New York. “Keeping things from becoming extreme is always better.” In other words, don’t wait for an emergency to take care of your mental health. “When bad things do happen, mental health will protect against the impact of these unfortunate events,” adds Alti.

Student perspective

“Being able to just have someone to really listen has promoted a lot of self-discovery. I trust my therapist with everything and I feel like he genuinely cares about what I have to say. He asks me questions that make me think about why I feel and do the things that I do. Once I know where something comes from, I can change it. It’s easier said than done, but it’s not something I think I could do on my own.”
—Second-year undergraduate student, University of Alabama[/vc_column_text][vc_column_text]

Real talk: College is full of huge life changes. “Even positive changes can be stressful,” says Dr. Salley. Luckily, therapists are particularly skilled at helping their clients deal with these transitions. “Having someone to talk to can be helpful, especially as you encounter new situations and people,” she says. While you’re dealing with a new set of responsibilities and expectations (everything from picking the right major to sorting through awkward roommate issues), a therapist can help you pinpoint how all the changes are impacting you and sort through the onslaught of emotions that everyone feels during this time.

Therapists aren’t one-size-fits-all—sometimes you have to try a few before you find the right fit. Don’t get turned off if your first therapy appointment isn’t super helpful—if something feels uncomfortable, listen to your gut, but don’t give up, says Dr. Crawford. “You would never go to the store, try on a pair of jeans, and say, ‘Oh, those don’t fit, I guess I won’t wear jeans.’ You would keep trying jeans until you found the right fit,” says Dr. Crawford. Same goes for therapists.

Finding that fit with a therapist is just as important for the outcome as the actual therapeutic technique, according to findings presented in Psychotherapy Relationships That Work (Oxford University Press, 2004). The research analysis found that three key things had a measurable positive impact on the outcome of individual therapy: 1) the strength of your collaborative relationship with your therapist—aka are you on the same page and making goals for your treatment together?; 2) your therapist’s ability to empathize or see where you’re coming from; and 3) the degree to which you and your therapist outline goals and reevaluate them together.

In other words, to get the most out of a therapy session, take the time to find someone you feel like you’re on the same page with, who gets you, and who’s willing to listen to your goals for therapy and help you develop them.[/vc_column_text][vc_tta_accordion shape=”square” c_icon=”chevron” active_section=”0″ collapsible_all=”true”][vc_tta_section title=”Ask these questions to help you find the right fit” tab_id=”1509035547084-fd2f65e1-167e”][vc_column_text]

• What types of therapy are you trained in?
• What issues do you specialize in?
• What populations do you specialize in? (While all therapists take on different types of clients, some specialize in specific groups such as working with LGBTQ+ people, people of color, or those who’ve been marginalized in some way.)
• How do you invite all aspects of your client into the room? (It’s important to know how your therapist will address all aspects of your culture, says Dr. Crawford. “You want to know that you can talk to your therapist about all parts of who you are.”)
• What are your beliefs about how people change?
• What’s your goal for ending therapy? (Some therapists believe therapy is an ongoing thing that you never really graduate from, while others see it as a tool to resolve a specific challenge. Make sure their goals line up with yours, and if not, ask if you can redefine them together.)

[/vc_column_text][/vc_tta_section][vc_tta_section title=”How to find a therapist ” tab_id=”1508289666996-a002b364-d7da”][vc_column_text]To find a therapist, start on campus—most schools offer a certain number of free counseling sessions through their counseling or psychological services.

Check with your insurance provider to see whether you need a referral to see a psychologist or counselor. If so, you may need to make an appointment with your primary care provider or the student counseling center to ask for one. Once you have the referral (if needed), you can seek out a therapist in a number of ways:

• Ask friends and family members if they have a therapist they recommend.
• Find out if your school counseling center has a list of recommended providers.
• Use the American Psychological Association’s online search tool.
• Call your insurance company or use their online services to find a list of therapists who are covered by your plan. If you get a personal recommendation from someone, you’ll also need to check that they’re covered under your insurance plan.

Once you have a name or a list of names and you’ve checked that the providers are covered by your insurance plan, call each therapist and leave a message to ask if they’re accepting new patients and to call you back with their available hours. When you hear back from the therapist, you may want to discuss what you’re looking to get out of treatment, what days and times you’re available to meet, and what their fees are—confirm that they take your insurance (it never hurts to double check this)—and ask about their training and make sure they’re licensed. Sometimes it can take a few tries to find someone whose schedule works with yours, but don’t let that deter you.[/vc_column_text][/vc_tta_section][/vc_tta_accordion][vc_column_text]

“Therapy can be useful by helping people acquire a better understanding of themselves and develop healthy habits,” says Dr. Salley. For example, if you have trouble getting up in time to make that optional early-morning lecture, but then you beat yourself up about missing it, a therapist can help you identify what you really value and then help you make decisions based on that. “It can be helpful to talk to someone who’s objective and not a friend to bounce your experiences and feelings off of,” says Dr. Crawford. “A therapist’s only investment is for you to be your best self.”

Once you’ve identified what’s really important to you, a therapist can help give you the tools to make your value-driven goals a reality. “Problems that are unaddressed remain problems,” says Dr. Crawford. “When you’re ready for something different in your life, it can change. Therapy can help you create the future you want.”

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You may be worried that all that talking might get out or that your therapist might tell your advisor or RA about what you’re struggling with. “A therapist isn’t allowed to do this unless the student poses a threat to themselves or others,” says Alti. “A therapist’s effectiveness is dependent on maintaining trust.” Bottom line: Unless they believe you’re in imminent danger (e.g., at risk of being seriously harmed or harming yourself or others), they can’t share what you say.

In short, everyone can benefit from talking to a therapist. “In the same way that everyone can benefit from going to the dentist, sometimes therapy is just a routine cleaning,” says Dr. Crawford. “Sometimes it’s just a time to reflect on where you are and where you want to go.” Whether you’re wrestling with anxiety and depression or mildly stressed about finding a summer internship, seeing a therapist can help—even if it’s just for a few sessions. (According to the CCMH report, the average student who uses campus psychology services attends between four and five sessions.)

Student perspective

“Therapy was a good way to talk through anything weighing on my mind. My therapist was very understanding, kind, and, of course, confidential. I’d recommend going to counseling services to everyone.”
—Third-year undergraduate student, Elizabethtown College, Pennsylvania[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text] [school_resource sh101resources=’no’ category=’mobileapp,counselingservices’] Get help or find out more

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Most of us have supported friends through difficult times, such as a break-up, academic pressure, or family issues. But how do we step up and provide support when friends and loved ones experience sexual assault and other forms of sexual violence? Especially when the person who experienced the assault is male?

Social pressure and stereotypes about gender can make it particularly challenging for men who’ve been assaulted to talk about their experiences. If one of your male friends or loved ones is assaulted, it’s important that you know you’re in a position to help.

Many of the challenges men face reflect social pressure: ideas that sexual assault makes them less masculine, that women can’t assault men, or that “real men” don’t talk about or get help for painful experiences. “Some men fear that they’ll be seen as less of a man,” says Dr. Jim Hopper, a researcher, therapist, and instructor at Harvard Medical School. “If they’re heterosexual, they may fear people will doubt their sexuality. And if they’re gay or bisexual, they may blame the assault on their sexuality in a way that further stigmatizes their being gay or bisexual.”

Addressing stereotypes

A common belief is that sexual violence only affects women. In fact, many men have unwanted sexual experiences, as both children and adults. One in six men in the US is sexually assaulted before age 18, according to studies from the 1980s to the early 2000s. In 2015, seven percent of men reported being sexually assaulted while attending college, according to a study by the Washington Post and the Kaiser Family Foundation. Regardless of the targeted man’s sexual orientation, both men and women perpetrate these assaults, according to the Centers for Disease Control and Prevention (CDC) (2013).

“Sex, gender identity, and race can all influence how an experience like this affects someone, but it’s very important you have no presumption about what it feels like to your friend—so listen,” says Dr. Melanie Boyd, assistant dean of student affairs and lecturer in women’s, gender, and sexuality studies at Yale University in Connecticut.

Talking to your friend about what happened

Everyone is different. People’s varying personalities and circumstances affect how they respond to an unwanted sexual experience and what we can do to help. For example, some people want lots of hugs, while some prefer verbal support. The most important thing is to relate to your friend in a way that can help him feel empowered and connected. As a friend, you’re in a great position to do this.

When a friend discloses an experience of violence, it’s normal to feel a wide range of emotions, such as shock, confusion, sadness, or anger. In the moment, keep the conversation focused on your friend’s emotions, not your own.

“Many people who experience sexual violence also experience some degree of self-blame,” says Dr. Boyd. “Partially, that’s just what people do when something bad happens: We go over the events in our head, hunting for things we could have done differently. It’s a way of regaining a sense of control. In the case of sexual violence, though, survivors also have to contend with victim-blaming patterns that run through our culture. So it’s important that friends help them push back against that. Be careful not to say or ask anything that might suggest blame—and affirm for your friend that he did the best he could in a difficult, complicated situation.”

Here are four ways you can be there for your friend

As challenging an experience as a sexual assault may be, it’s not as though your friend has become an entirely different person. The “othering” of people who’ve been assaulted—treating them differently—can be just as dangerous as ignoring or minimizing unwanted sexual experiences, according to researchers Nicola Gavey and Johanna Schmidt (Violence Against Women, 2011). Avoid thinking of the assault as something that cuts your friend off from the rest of the world; in fact, it’s up to you to be supportive and counteract that.

• Because of stereotypes about gender and sexual violence, male survivors may feel particularly othered: They might worry that people won’t take their experiences seriously, or that they’ll be viewed as weak. “It took me almost two years to come to terms with it, and I still feel like the few that I told sort of wrote it off because I’m a male,” said Chris*, a second-year undergraduate at the University of Kansas. To avoid othering, you can demonstrate that you take your friend’s experience seriously by using phrases like “that wasn’t okay” or “that sounds really messed up.”
• While it’s important to give your friend opportunities to talk about his experience of violence (if he chooses to), remember to maintain the other parts of your friendship too. It may be a relief to your friend to spend some time on normal activities that he enjoys. You can try statements like, “I’m happy to talk more about this if you want, but it’s also fine if you want to take a break from processing and go for a run together.”

Make sure to listen and focus on your friend’s feelings. “Pay attention to their specific issues,” says Dr. Boyd.

• Avoid pushing your own ideas. “Allow them to talk without being interrupted, and especially don’t put any more pressure on them (e.g., telling them that you think they need the police or a therapist),” says Tom*, a third-year undergraduate at Ripon College in Wisconsin. “Ask what you can do to help.”
• Don’t try to investigate the situation. It’s not important for you to find out exactly what happened or to delve into the details beyond what your friend wants to share.
• Avoid questions that might feel blaming (e.g., “Were you drunk?” or “Did you say no?”). “Being reminded that I wasn’t the one at fault felt reassuring,” said Taylor*, a second-year undergraduate at Wake Technical Community College in North Carolina.
• Don’t speculate about what you would have done in the situation (e.g., “If someone tried to do that to me, I’d fight them off”) or project emotions onto your friend (e.g., “You must feel like a whole different person”). Let your friend lead the conversation, and respect what he’s feeling.

Try statements like…

Avoid pronouns that assume the gender of the perpetrator or that make other assumptions about the experience. “I think one of the most important issues is breaking down the stereotype that only women are abused,” said Lena*, a second-year undergraduate at Tarrant County College in Texas.

• Make clear that you’re not making presumptions about your friend’s experience based on his identity. In particular, avoid assumptions about your friend’s sexual orientation or gender identity. “Drop in phrases or words that don’t put them on the spot but that signal your openness to hearing a more complex narrative, about, for example, ‘people of all genders,’” says Dr. Boyd. “Pay attention to what’s going on for the person in front of you.”
• It’s not your role to define the experience for your friend. Some people don’t use the word “rape” or “assault” to describe what may seem to you to be sexual violence, or relate to the terms “victim” or “survivor.” “You want them to feel like you’re connecting with their experience, not trying to impose your views or language on them,” says Dr. Hopper.

“As a friend, you want to relate to them in a way that gives them power, including by giving them choices and respecting whatever choices they make on whatever timeline,” says Dr. Hopper.

• Your friend might be interested in working with the police, pursuing disciplinary action, or working with other university resources. It’s up to him to decide. While it’s not your job to steer him to the police or school administrators, providing information about his options can be a great way to help. Figure out what resources your school has, such as hotlines, therapists, heath care providers, disciplinary processes, chaplains, or survivor advocates. “Since I was assaulted, I have learned that it wasn’t my fault and that therapy does help,” said Josh*, a second-year undergraduate at the College of the Desert in California.
• Talk with your friend about what makes him feel empowered and safe. Everyone’s different, so whether your friend feels like watching TV, working out, or flirting with someone at a party, you should ask and see how you can help. Sometimes people want to spend time on their own, sometimes people want to be social. It’s not your job to judge, but to be supportive. 

Look after yourself

“Supporting someone through the healing process can be stressful, hard, and exhausting. That’s why it’s important for supports to take of themselves,” says Bella Alarcon, a bilingual clinician at the Boston Area Rape Crisis Center who facilitates a support group for partners, friends, and family of people who’ve experienced sexual violence. Paying attention to your own needs isn’t selfish. “If you’re exhausted and overwhelmed, you’re not going to be able to support the survivor,” says Alarcon.

Be mindful of your own needs, and make sure that you’re getting support.

• “It’s okay to set limits and boundaries. If you need a break, it’s okay,” says Alarcon. If you’re finding a conversation with your friend overwhelming, say so. Try language like, “I really want to be here for you, but I’m finding it hard to handle this conversation. I want to be able to support you as well as I can, and I think I can do that better if I take a break for a few minutes.”
• Reach out to university resources for support. Consider speaking to a trusted mentor, a dean, a survivor advocate, or a health professional about how you’re doing. Respect your friend’s privacy by not sharing their story with peers or classmates.
• “Be kind to yourself and take care of yourself: Take a bath, go to the gym, have a cup of tea, go out with friends, have fun, have a good cry, take a deep breath, or get your own counseling,” says Alarcon.

*Names changed

Strategies developed by the Communication and Consent Educator program at Yale University.

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