Question 1

What is therapy and how does it work?

Accepted Answer

Therapy is a structured, confidential conversation with a licensed clinician aimed at changing something specific — a pattern of thinking, a way of reacting, a relationship that keeps breaking. It works by making those patterns visible and then giving you skills to interrupt them. At Mountainside we use CBT and DBT, both of which teach concrete skills rather than relying on insight alone.

Question 2

How do I know if I need therapy?

Accepted Answer

A useful test is interference: if worry, low mood, anger, or avoidance is affecting your sleep, work, or relationships, and it has not lifted on its own, therapy is reasonable. You do not need a crisis or a diagnosis to qualify. Our Denver mental health resources page lists the signs clinicians actually look for, and the consultation is free.

Question 3

What should I look for in a therapist?

Accepted Answer

Three things: a license in good standing, specific training in a method that fits your problem, and a working relationship that feels honest rather than merely pleasant. Specialization matters more than most people expect — general talk therapy and trained DBT are different products. Our guide to finding the right therapist in Denver covers what to check.

Question 4

How do I find a good therapist in Denver?

Accepted Answer

Start from the problem, not the directory. Decide what you need treated, find clinicians with real training in the matching method, then use free consultations to compare. Verify the license, ask how many clients with your concern they have treated, and notice whether they will say when they are not the right fit. We walk through the whole process on our finding a therapist page.

Question 5

What’s the difference between a psychologist and a therapist?

Accepted Answer

“Therapist” is the umbrella term for any licensed clinician who provides talk therapy. “Psychologist” is a protected title requiring a doctoral degree — a Ph.D. or Psy.D. — with training in assessment and evidence-based treatment. Every psychologist is a therapist; not every therapist is a psychologist. Our Denver team includes licensed psychologists alongside an LCSW and an LPC.

Question 6

What’s the difference between a therapist and a counselor?

Accepted Answer

In practice, very little — both provide talk therapy, and in Colorado both are licensed and regulated. “Counselor” usually refers to a Licensed Professional Counselor (LPC), who holds a master’s degree; “therapist” is the broader word covering LPCs, Licensed Clinical Social Workers, and psychologists. What matters far more than the title is the clinician’s specific training. Meet our team to see how ours differ.

Question 7

What’s the difference between a psychiatrist and a psychologist?

Accepted Answer

A psychiatrist is a medical doctor who can prescribe and manage medication. A psychologist holds a doctoral degree in psychology and provides assessment and therapy but does not prescribe. Many people work with both at once. Mountainside provides therapy only — we do not prescribe — and we are glad to coordinate with your prescriber. See our treatment approach.

Question 8

Do I need a referral to see a therapist?

Accepted Answer

No. You can contact a therapist directly, and no doctor’s referral is required to book with us. Some insurance plans ask for one before they will reimburse, so it is worth checking your own policy. Because Mountainside is an out-of-network practice, no referral is needed to start — just request a free consultation.

Question 9

How long does therapy usually take to work?

Accepted Answer

It depends on the problem and the method. Focused CBT for a single issue such as a phobia or insomnia often produces noticeable change within a few months of weekly sessions. Work involving long-standing emotional dysregulation or trauma takes longer, and our DBT skills groups are designed as a six-month to one-year commitment. Your therapist will set expectations honestly at the start.

Question 10

How often should I go to therapy?

Accepted Answer

Weekly is the standard starting point, and it is what most evidence-based protocols assume — skills need regular practice and review to take hold. Some people move to every other week as things stabilize, and comprehensive DBT clients attend individual therapy and a skills group in the same week. Sessions at Mountainside are 45 minutes; frequency is agreed with your therapist, not fixed.

Question 11

What happens in a typical therapy session?

Accepted Answer

You and your therapist review how the week went, identify what got in the way, and work on something specific — a thought pattern, a skill, a conversation you are dreading. Sessions are collaborative rather than a monologue, and in CBT and DBT you will usually leave with something to practice. Each session is 45 minutes, in our Denver-area office or by secure telehealth.

Question 12

Is therapy really worth it?

Accepted Answer

It is a real investment of time and money, so the honest answer is that it depends on fit and follow-through. Evidence-based approaches like CBT and DBT have decades of research behind them, and the people who benefit most are the ones who attend consistently and practice between sessions. A free consultation is the cheapest way to test the fit — book one before committing.

Question 13

Can therapy help if I don’t have a diagnosis?

Accepted Answer

Yes. Plenty of clients arrive with no diagnosis at all — they are burnt out, grieving, stuck in a relationship pattern, or simply not coping the way they used to. A diagnosis is a tool for describing symptoms, not a ticket for entry. That said, if you plan to seek out-of-network reimbursement, your insurer will usually require a diagnosis on the superbill.

Question 14

What are the different types of therapy?

Accepted Answer

The main evidence-based families are cognitive and behavioral therapies (CBT, exposure-based treatments), acceptance and skills-based therapies (DBT, mindfulness-based work), trauma-focused treatments, and insight-oriented or psychodynamic therapy. Family and couples therapy work at the relationship level rather than the individual. Mountainside specializes in DBT and CBT — our treatment approach explains how we combine them.

Question 15

How do I know when I’m ready to stop therapy?

Accepted Answer

Good signs: you are meeting the goals you set, you are using skills without being prompted, and sessions have shifted from crisis to maintenance. Ending well is part of the work — most therapists taper rather than stop abruptly, and many clients return later for a short course. Bring it up directly; a good therapist will treat it as progress, not rejection.

Question 16

What’s the difference between inpatient and outpatient therapy?

Accepted Answer

Inpatient care means staying at a hospital or residential facility with 24-hour supervision, and is used when someone is not safe outside it. Outpatient therapy means you live at home and attend scheduled appointments. Mountainside is an outpatient practice: individual sessions, skills groups, and telehealth. If you are in immediate danger, call 911 or Colorado Crisis Services at 1-844-493-8255.

Question 17

Can I switch therapists if it’s not working?

Accepted Answer

Yes, and you should. The quality of the working relationship is one of the strongest predictors of whether therapy helps, so a poor fit is a clinical problem rather than a personal failing. If another clinician on our team would suit you better, we will help you move across without starting over. See the full team.

Question 18

What questions should I ask a therapist before starting?

Accepted Answer

Ask what training they have in the specific method they are proposing, how they will measure whether it is working, what a typical course looks like, what happens between sessions, and what they charge. It is also fair to ask what they would do if you are not improving. Our guide to choosing a therapist expands on each of these.

Question 19

How do I prepare for my first therapy appointment?

Accepted Answer

Write down what brought you in, what you have already tried, and what you want to be different in six months — that is more useful than trying to summarize your whole history. Note any medications and previous treatment. For telehealth, find a private space and test your camera beforehand. Our page on preparing for a first CBT session has a full checklist.

Question 20

What should I expect in my first therapy session?

Accepted Answer

The first session is an intake assessment. Your therapist will ask about your history, your current difficulties, what you have tried before, and what you want to change, then talk through a plan. It is a conversation, not an interrogation, and you set the pace on what you share. You will leave with a clear sense of next steps.

Question 21

Is everything I say in therapy confidential?

Accepted Answer

Yes, with narrow legal exceptions. What you say is protected by state law and HIPAA, including in telehealth sessions, which we run on an encrypted, HIPAA-compliant platform. Your therapist will explain the limits explicitly in the first session so nothing about them is a surprise later. The exceptions are set out in the next answer.

Question 22

What are the limits of therapist confidentiality?

Accepted Answer

A therapist must break confidentiality only in specific circumstances: imminent danger to your own life, a serious threat to someone else, or suspected abuse or neglect of a child, older adult, or at-risk adult. Records can also be released by court order or with your written consent. Outside those situations, nothing leaves the room — including from a skills group.

Question 23

How do I talk to my family about going to therapy?

Accepted Answer

Lead with what you want rather than what is wrong: “I am working on how I handle stress, and I would like your support.” You are not obliged to share the content of your sessions. If family reactions are part of the difficulty, that is worth raising in therapy itself — we work with couples and families, and our teen program includes a multi-family component.

Question 24

Is it normal to cry in therapy?

Accepted Answer

Very. Therapy is often the first place someone has said a thing out loud, and the body tends to respond. Crying is not a loss of control or a sign the session has gone wrong — most therapists read it as the work reaching something real. There is no expectation either way, and plenty of productive sessions involve no tears at all.

Question 25

Why do I feel worse after therapy sometimes?

Accepted Answer

Because sessions surface material you normally keep at a distance, and processing it takes energy — this is common early in trauma work and in exposure-based CBT. It usually settles within a day or two. If it does not, or if it is escalating, tell your therapist: pacing is adjustable, and in trauma-informed treatment that adjustment is part of the method.

Question 26

What is emotional dysregulation?

Accepted Answer

Emotional dysregulation means emotions arrive faster and harder than you can manage, last longer than the situation warrants, and drive behavior you later regret. It is not a diagnosis in itself — it shows up across BPD, PTSD, ADHD, and mood disorders. DBT was built specifically to treat it.

Question 27

What causes emotional dysregulation?

Accepted Answer

Usually a combination: a temperament that is more emotionally sensitive from the start, plus an environment that repeatedly dismissed or punished those emotions rather than helping name them. Trauma, chronic stress, sleep deprivation, and neurodevelopmental differences such as ADHD all amplify it. The useful point is that the skills can be learned later even when the sensitivity does not change.

Question 28

How do I manage my emotions better?

Accepted Answer

Start by naming the emotion accurately and separating it from the urge it produces — feeling furious and sending the message are two different events. From there, reduce vulnerability through sleep, food, and movement, and build a small set of skills you can use under pressure. This is exactly what the emotion regulation module of DBT skills group teaches.

Question 29

What are emotion regulation skills?

Accepted Answer

They are the DBT skills for changing an emotion’s intensity or duration: identifying and labeling what you feel, checking whether it fits the facts, acting opposite to an unhelpful urge, and reducing vulnerability by attending to sleep, illness, food, and routine. They also include deliberately building positive experiences, so difficult emotions have something to compete with. Learn more about DBT.

Question 30

What is distress tolerance?

Accepted Answer

Distress tolerance is the ability to get through a painful moment you cannot fix or leave without making it worse. It is not about feeling better — it is about surviving the next hour without self-harm, a destroyed relationship, or a decision made at your worst. In DBT it is a taught skill set, including TIPP, distraction, self-soothing, and radical acceptance.

Question 31

How do I stop emotional outbursts?

Accepted Answer

Work upstream rather than at the peak. Identify the reliable triggers and early physical cues, lower your baseline vulnerability, and rehearse one concrete crisis skill so it is available before you are flooded — cold water and paced breathing both work by changing physiology fast. Repeated outbursts that damage relationships or safety are treatable; see anger and impulse-control treatment.

Question 32

What are healthy coping mechanisms?

Accepted Answer

Ones that reduce distress without creating a new problem: paced breathing, movement, naming the feeling, reaching out to someone, structured problem-solving, and deliberately delaying a decision until the intensity drops. The test is not whether it feels good in the moment but whether tomorrow is better or worse for it. Therapy replaces the harmful ones rather than simply banning them.

Question 33

What are unhealthy coping mechanisms?

Accepted Answer

Strategies that work fast and cost more later — drinking, substance use, self-harm, bingeing or restricting, compulsive avoidance, and picking a fight to discharge tension. They persist because they genuinely relieve distress in the short term. Treatment focuses on installing something that works quickly enough to compete, which is why crisis skills are taught before anything else.

Question 34

How do I deal with overwhelming emotions?

Accepted Answer

In the moment, change your physiology rather than trying to argue with the feeling: cold water on the face, intense exercise for a short burst, slow exhalations, or paired muscle relaxation. Then delay any consequential decision. Afterward, look at what set it off. If this is a weekly occurrence, that is a treatable pattern — a free consultation is a reasonable next step.

Question 35

What is mindfulness and how does it help mental health?

Accepted Answer

Mindfulness is the practice of noticing what is happening right now — thoughts, sensations, urges — without immediately reacting. It helps because it opens a gap between a trigger and your response, which is where every other skill has to fit. In DBT it is taught as a drill you rehearse, not a mood you summon, and it underpins the other three modules.

Question 36

How do I practice mindfulness for anxiety?

Accepted Answer

Keep it short and concrete. Anchor attention on one thing — the out-breath, your feet on the floor, sounds in the room — and return to it each time your mind moves, without treating the wandering as failure. Two minutes done daily beats twenty minutes done occasionally. Our anxiety treatment combines this with CBT so the worry itself is also addressed.

Question 37

What are grounding techniques for emotional overwhelm?

Accepted Answer

Grounding pulls attention out of the emotion and back into the present through the senses: name five things you can see, hold something cold, press your feet into the floor, or describe your surroundings out loud in plain detail. It works best when practiced before you need it. These are core distress tolerance skills in our DBT skills groups.

Question 38

Can therapy teach you how to manage emotions?

Accepted Answer

Yes — that is precisely what DBT is for. Rather than only exploring why you feel as you do, DBT teaches a specific curriculum of skills and then has you practice them between sessions until they hold up under real pressure. At Mountainside that runs as individual therapy alongside a weekly skills group. See our treatment approach.

Question 39

Should I take medication or go to therapy?

Accepted Answer

It is genuinely not either-or, and the decision belongs with you and a prescriber rather than with an article. In general, therapy targets the patterns driving the symptoms and the gains tend to persist after it ends; medication can lower symptom intensity enough for that work to be possible. Mountainside provides therapy only and will happily coordinate with your prescriber.

Question 40

Can therapy work without medication?

Accepted Answer

For many people, yes. CBT and DBT both have substantial evidence as standalone treatments, and plenty of our clients have never taken psychiatric medication. Whether it is enough on its own depends on severity, how long things have been difficult, and how much the symptoms interfere with doing the work. That is worth reviewing honestly rather than assuming.

Question 41

Is therapy better than antidepressants?

Accepted Answer

Neither is universally better, and comparing them that way tends to mislead. For mild to moderate depression, structured therapy performs comparably to medication and its effects are more durable once treatment stops. For severe depression, the combination usually outperforms either alone. The right answer depends on your presentation and history — discuss it with a prescriber alongside your depression treatment.

Question 42

Can I do therapy and take medication at the same time?

Accepted Answer

Yes, and it is a very common arrangement. Many of our clients see a psychiatrist or their primary care doctor for medication while doing DBT or CBT with us. With your written consent we can communicate with your prescriber so that treatment is coordinated rather than running on two separate tracks. Bring your current medication list to your first session.

Question 43

When should I consider medication for anxiety?

Accepted Answer

It is worth raising with a prescriber when anxiety is severe enough that you cannot engage with therapy or daily life — persistent panic, sleep that has collapsed, or avoidance that has narrowed your world. Medication is also considered when a solid course of therapy has not produced enough change. Many people start with therapy alone and add medication only if needed.

Question 44

When should I consider medication for depression?

Accepted Answer

Common triggers for the conversation include depression that has lasted months without lifting, significant loss of function at work or home, disrupted sleep and appetite, or any thoughts of suicide. Severity matters more than duration alone. A prescriber — a psychiatrist or your primary care physician — is the right person to assess this. If you are in crisis, call or text 988.

Question 45

What are the side effects of anxiety medication?

Accepted Answer

That depends entirely on the class of medication, and it is a question for the prescriber or pharmacist who knows your history — we are not able to advise on it. Broadly, different classes carry different profiles, some effects settle within the first weeks, and some medications should never be stopped abruptly. Ask for the specific risks and the discontinuation plan before starting.

Question 46

Can a therapist prescribe medication?

Accepted Answer

No. In Colorado, prescribing is done by psychiatrists, primary care physicians, psychiatric nurse practitioners, and physician assistants. Psychologists, clinical social workers, and professional counselors provide assessment and therapy but do not prescribe. Every clinician at Mountainside falls into that second group — meet the team — so medication is managed alongside our work, not by us.

Question 47

What’s the difference between a therapist and a psychiatrist for medication?

Accepted Answer

A psychiatrist is a physician who diagnoses, prescribes, and monitors medication, and who may or may not also provide therapy. A therapist provides the therapy itself and cannot prescribe. Many people work with both, which is why we ask for consent to coordinate. If you only need medication management, a psychiatrist is the right starting point rather than us.

Question 48

What are daily habits that improve mental health?

Accepted Answer

The unglamorous ones with the strongest evidence: a consistent sleep and wake time, daily movement, regular meals, daylight early in the day, and genuine contact with other people. DBT groups them as reducing vulnerability — they do not treat a disorder, but they change how much a difficult day costs you. Build one at a time rather than all five at once.

Question 49

How does exercise affect mental health?

Accepted Answer

Regular physical activity has a measurable effect on depressive and anxiety symptoms, and short bursts of intense movement are one of the fastest ways to bring down acute distress — DBT teaches this as part of the TIPP skill. It is not a replacement for treatment for a moderate or severe condition, but it reliably raises the floor. Consistency matters more than intensity.

Question 50

What is the connection between sleep and mental health?

Accepted Answer

It runs in both directions. Poor sleep worsens emotional reactivity, concentration, and mood, and mental health conditions in turn disrupt sleep — which is how people get stuck in the loop. This is why sleep is treated as a target rather than an afterthought. Chronic sleeplessness responds well to CBT-I; see our page on insomnia treatment in Denver.

Question 51

How does nutrition affect mental health?

Accepted Answer

Mostly through stability rather than any single food. Long gaps without eating produce irritability, poor concentration, and heightened emotional reactivity that are easy to misread as a mood problem. Regular meals and adequate hydration are part of DBT’s vulnerability-reduction skills for exactly this reason. If eating itself is the difficulty, that is its own treatable condition — see our services.

Question 52

What are signs of burnout?

Accepted Answer

Exhaustion that sleep no longer fixes, growing cynicism or detachment from work you used to care about, and a sense of reduced competence. It often arrives with irritability, poor concentration, and physical symptoms such as headaches or disrupted sleep. Burnout is not a clinical diagnosis, but it overlaps heavily with depression and anxiety — worth assessing properly.

Question 53

How do I set healthy boundaries?

Accepted Answer

Be specific about the behavior rather than the person, state what you will do rather than what they must stop, and keep it short. Expect discomfort the first few times — that is not evidence you did it wrong. DBT teaches this directly through interpersonal effectiveness skills, including a structured script for making a request. Skills groups give you a place to rehearse it.

Question 54

What is self-compassion and why does it matter?

Accepted Answer

Self-compassion means responding to your own difficulty the way you would to a friend’s — without either harsh criticism or denial that anything is wrong. It matters because self-attack reliably makes shame worse and shame drives avoidance, which is what keeps most problems in place. Loving Kindness and mindfulness practices are part of our treatment approach for this reason.

Question 55

How do I build a mental health routine?

Accepted Answer

Pick one anchor you can do on your worst day, attach it to something you already do, and keep it small enough to be boring. Track it for a fortnight before adding a second. Routines fail when they are designed for your best week. If motivation itself is the obstacle rather than the plan, that is a symptom worth treating, not a character flaw.

Question 56

What are signs I need professional help for my mental health?

Accepted Answer

Symptoms lasting more than two weeks without lifting, difficulty functioning at work or home, withdrawal from people and activities you valued, changes in sleep or appetite that will not resolve, relying on substances to cope, or any thoughts of self-harm. That last one warrants immediate support — call or text 988. Our Denver resources page lists the full set.

Question 57

How do I practice self-care when I’m overwhelmed?

Accepted Answer

Shrink it. When capacity is gone, the answer is not a new routine but the smallest viable version — water, ten minutes outside, one message to one person, going to bed. Self-care at that point is triage, not improvement. If overwhelm is the baseline rather than a bad week, skills training is a better answer than willpower; a free consultation costs nothing.

Question 58

How does therapy help with relationships?

Accepted Answer

It makes your part of the pattern visible and gives you something to do differently. Most recurring conflicts are driven by a predictable sequence — a trigger, an interpretation, a reaction — and therapy interrupts it at a point you can actually control. DBT’s interpersonal effectiveness module teaches this directly, and we also work with couples and families. See our services.

Question 59

What are healthy communication skills?

Accepted Answer

Describing the situation factually before interpreting it, saying what you want rather than hinting, listening without preparing your rebuttal, and being willing to acknowledge the other person’s position without abandoning your own. DBT packages these into a structured skill called DEAR MAN, which is deliberately teachable rather than intuitive. It is rehearsed in our DBT skills groups.

Question 60

How do I set boundaries in relationships?

Accepted Answer

Name the specific behavior, say what you will do in response, and follow through consistently — a boundary you do not enforce teaches the opposite lesson. Keep it brief and avoid negotiating in the moment. Guilt afterward is normal and is not a sign you were wrong. DBT teaches boundary-setting as a skill with a script, which makes it far easier to use under pressure.

Question 61

Can individual therapy help my marriage?

Accepted Answer

Often, yes. Changing how one person handles conflict, requests, and repair frequently shifts the whole dynamic, and individual work is a realistic option when a partner will not attend. It is not a substitute for couples therapy when the issues are shared — we offer couples sessions at $200 each. A free consultation is the place to work out which fits.

Question 62

What is interpersonal effectiveness?

Accepted Answer

It is one of the four DBT skill modules: getting what you need from other people while keeping both the relationship and your self-respect intact. It covers making requests, saying no, negotiating, and deciding how hard to push in a given situation. Most people find it the most immediately useful module. Read more about DBT at Mountainside.

Question 63

How do I communicate my needs without conflict?

Accepted Answer

Open with a factual description rather than an accusation, state the request plainly and early, and say why it matters to you instead of why they are wrong. Pick a moment when neither of you is already escalated. Conflict is not always avoidable — the goal is that it stays about the issue rather than becoming about character.

Question 64

How do I deal with a toxic relationship?

Accepted Answer

Start by getting specific about the pattern and its actual cost, because clarity is difficult to hold on to inside the relationship. From there the options are changing your own responses, changing the terms, or leaving — and therapy can help you evaluate all three without pressure. If there is any threat to your safety, that changes the priority entirely; contact Colorado Crisis Services at 1-844-493-8255.