The usual stress or something more? When to consider therapy – and what it’s really like

So, you think you may need therapy – or maybe you aren’t sure. After all, most of your days are what many Singaporeans would call “normal lor”. 

But there are times when you boil with internalised rage, like when someone blocks you on the escalator, or blasts loud videos on the handphone. At home, you’re this close to doing something to get back at your noisy upstairs neighbour and those darn pickleball players. 

Then, there are the big stressors, like the hoops you have to jump through to get your kid into the school of choice. Also coming right at you are the logistics of juggling your elderly parents’ medical appointments and your work commitments. Or perhaps things haven’t been all rosy between you and your partner. 

Taken altogether, it’s enough to make even the most optimistic of us feel like everything is crashing down. But, you also wonder: Isn’t that part and parcel of life? Isn’t everyone around you dealing with problems like you are? When should you seek therapy?

WHEN DO YOU NEED THERAPY?

“It’s normal to feel sad, anxious, or stressed – these are part of being human,” said Andrea Chan, the group head of TOUCH Counselling & Psychological Services. 

But when these emotions persist, intensify or interfere with your daily life, it may be time to seek professional help, said Justyne Ho, a counsellor from SAMH Insight Centre. “If the feelings last for weeks or months without relief, or if they become overwhelming and disproportionate to the situation, this signals a need for attention.”

It may also be time to see a professional when your “existing coping skills, support network, and personal circumstances” start to fall short when you’re dealing with a stressful situation, said Ong Jie Li, a senior clinical psychologist from Institute of Mental Health.

And you won't be alone in reaching out. SAMH Insight Centre has noted “a significant increase in individuals seeking mental health support”, said Ho. More specifically, the centre has upped its total counselling sessions by about 30 per cent, and the number of active clients by about 23 per cent from 2020 to 2024. 

The counselling hotline managed by TOUCH has also received more calls since the pandemic, said Chan, from a monthly average of 103 in 2022 to 132 in 2025 (up to Sep 30). 

“While the stigma surrounding therapy still exists, there is increasing acceptance and recognition of therapy as an essential form of self-care as more people realise that therapy can be beneficial for everyone – and not just those with severe issues,” said Ho.

WHAT EXACTLY IS THERAPY? IS IT LIKE IN THE MOVIES?

You might have seen it depicted in the movies or on TV: The all-knowing therapist listens, jots down a note or two, and tosses out a life-changing one-liner to the client lying on the couch. And just like that, the problem is solved and the plot moves on. 

What about in reality? “Therapy in practice differs significantly from the usual popular portrayals in shows,” said Ong. “Instead of lying on a couch, clients usually sit in chairs or sofas. And instead of giving advice and solutions to problems, therapists typically ask guiding questions that allow clients to derive their own insights.”

As for the “emotionally intense sessions producing instant breakthroughs” that you see on screen sometimes, Ong shared that “therapy usually takes months or even years to gradually address problems in a non-linear manner”. So sorry, no overnight epiphanies here. 

“Unlike in Hollywood portrayals,” Chan added, “therapy in Singapore is typically practical, evidence-based and confidential – with a focus on helping individuals to process their emotions and build resilience in their everyday lives. The goal is to gain clarity, develop coping strategies, and improve overall well-being. Therapy methods may differ from therapist to therapist.”

HOW ARE LIFE COACHES, COUNSELLORS AND SOCIAL WORKERS DIFFERENT?

Essentially, a life coach focuses on goal-setting and personal development, but is not typically trained to address mental health conditions, explained Ho. “They can support you in achieving personal or professional growth.”

On the other hand, a counsellor can help you work through emotional, relational or situational challenges through talk therapy and coping strategies, said Chan. Social workers can also counsel and do more; they can connect you to social services or financial assistance, she said.

Psychotherapists and psychologists, said Chan, use psychological methods to assess and treat emotional or behavioural issues, including anxiety, trauma or depression. “A psychiatrist is a medical doctor, who can diagnose and treat mental health disorders. They are licensed to prescribe medication, if necessary.”

WHAT IF YOU FEEL AWKWARD SHARING YOUR FEELINGS?

“It is completely normal to feel awkward at first, especially when discussing sensitive issues,” acknowledged Ho. 

To help yourself, you can start by writing down your thoughts or feelings before your session, she suggested, which can help you express them more clearly. 

“You can also let your therapist know that you’re feeling awkward, and they can help guide the conversation in a way that feels comfortable for you. The therapist’s role is to make you feel safe and supported, so it is okay to be open about your discomfort,” said Ho.

“If you notice a reason for feeling uncomfortable, such as feeling judged or misunderstood, or too directive or passive,” said Ong, “it would be best to bring it up to the therapist as early as possible, so that it can be jointly addressed within a session.”

WHAT IF YOU’RE STILL UNCOMFORTABLE WITH THE THERAPIST?

“It’s common to not ‘click’ immediately,” said Chan. “But if you consistently feel misunderstood, judged, or unable to open up after several sessions, it may be a sign that the match isn’t right.”

Ho recommended attending at least three or four sessions before deciding “as building this relationship takes time, and it is important to give the process a chance to develop”. 

But if the discomfort persists after attempts to address it, especially if it involves “factors that are difficult to change, such as gender preference, religious or cultural disconnect, or if there were inappropriate or unprofessional behaviours, it would be recommended to consider changing therapists”, said Ong.

WHERE CAN YOU GO FOR THERAPY?

“There are various pathways to access mental health support,” said Ong, citing the following avenues. “Each has its distinct characteristics that may suit different individuals’ needs and circumstances.”

Helplines or textlines

• Pros: Immediate access, anonymous, and a good first step for those hesitant about formal help. Some are available 24/7 such as the national mindline 1771; you can call, WhatsApp or webchat with trained counsellors who offer basic counselling services, and can refer you to support services relevant to your needs.
• Cons: Limited extent of support (single sessions, typically) to be considered therapy.
• Fees: Free.

Privately run counselling centres

• Pros: Direct access to a comprehensive range of therapists, from counsellors to clinical psychologists, as well as therapeutic approaches. Flexible scheduling.
• Cons: More expensive than restructured hospitals, due to the lack of government subsidies.
• Fees: Varies.

Community mental health centres

• Pros: Trained mental health professionals who offer a community-based approach. More accessible than hospitals.
• Cons: Requires liaison between medical teams for cases that involve medications.
• Fees: Varies significantly but are generally cheaper than restructured hospitals.

General practitioners (GPs)

• Pros: Familiar healthcare setting. GPs can assess the severity, provide referrals and prescribe basic medications.
• Cons: Consultation does not include therapy.
• Fees: Varies.

Polyclinics 

• Pros: Access to trained psychologists. Also, polyclinics are integrated with the national healthcare system.
• Cons: A general practitioner’s referral is required.
• Fees: Subsidised rates, so generally cheaper than private centres.

Restructured hospitals

• Pros: Psychologists who can treat moderate to severe or complex clinical conditions, and provide integrated care with the multidisciplinary team of the hospital.
• Cons: Psychologists are assigned by the hospital. Available only through an internal referral system.
• Fees: Depends on subsidy levels but is generally cheaper than private centres.

CAN YOU STOP THERAPY AFTER THE STRESSFUL EVENT IS OVER?

Ho likened the inaccurate impression that therapy is a reactive tool to a fire extinguisher you only grab when there is a crisis. “It is understandable but it frankly limits the true value of therapy.”

Just as you’d go for regular health check-ups, therapy can serve as a mental check-up, said Chan. “It helps individuals gain deeper self-awareness, strengthen emotional resilience, and prevent issues from escalating.”

Usually, there is already “fuel” in the form of deep patterns and vulnerabilities that make us more likely to struggle when stressful situations arise, said Ong. And “the specific problem – whether it's work stress or family conflict – is just the spark that lights the fire”. 

“So, there are good reasons to continue therapy even when things seem calm,” Ong continued. “First, to work on those underlying patterns that make you vulnerable to future stress; and second, to properly process similar problems from your past that might resurface later. It's like strengthening your emotional immune system during the good times, so you're better equipped when challenges inevitably come up again.”

Having said that, it’s not mandatory to attend therapy regularly, said Chan. “What’s important is that individuals feel supported when they need it most, and are empowered to navigate future challenges.”