Wednesday, May 7, 2008

What counselor should I find and should I go to counseling?

Recently a fellow blogger emailed and asked me some questions. Here is my response. Please note however, I am a student of counseling. So these aren't responses from a professional. But they are just what I've learned along the way both in my own life and in my study.

Q: what is the difference between a counselor and a therapist? and even a psychologist or psychiatrist for that matter?

Here's my cliff notes version.
  • Counselor and therapist - Basically these are the same thing. It just depends on the person's preference doing the counseling. Any of the below degrees can be this.
  • Licensed Counselor or Social Worker - These are the people who do most of the counseling. They have an Masters degree in something: social work, psychology, counseling, family therapy,..... The important thing here is that they are licensed!
  • Psychologist - They get a Psy.D degree. They can do one-on-one therapy and psychological testing.
  • Psychiatrist - They get an MD degree, which means they go to medical school. They are not known for their counseling, but are important if you need any kind of drug for depression or other mental illness. Your doctor can also help you find one.
Q: What to look for in a counselor/therapist

When looking for a counselor you look for two things first are they licensed (or if they are a student interning are they under someone who is licensed).

Secondly, it is crucial that you find someone who "fits" you. Research shows that "fit" of counselor with client is the most important factor in counseling success. (I learned this in school and haven't had a chance to find where it came from yet.)

There are successful and helpful counseling from all the main degree's and techniques. But one of the strongest factors in how counseling goes, is how you "fit" with the counselor and the method. By "fit" I mean you feel safe with the person, you want to share with them, you have good "vibes" or if you really want someone who does dream work, your counselor does dream work. Or if you have goals for working on three things and getting out of therapy then you may want to look for a cognitive behavioral therapist or short-term therapy instead of psycho dynamic therapy which is long term. There are hundreds of types of therapies and most counselors today use more than one. So I won't even begin to write them all out here

Shop around! Seriously. If you are brave enough to go to counseling be brave enough to meet two counselors and not decide until you have met both of them.

Q: i grew up in a family where you keep your emotions and feelings within the family, even within yourself...therapy/counseling always came with a very negative connotation. i'd like to see a therapist again. i guess i feel tho like i don't have a "reason" to go.

Just a brief comment on family. Most of the time a families idolatry of privacy is cultural and self-protective. If you look at your culture way back in history there is a way to tell why. So your noticing that your family isn't very affirming of therapy is expected. All family systems have "rules" or "modes of operation" and not going to therapy is just one of those for your family. Everyone who becomes an adult has to decide which "rules" they will keep and which they will re-frame or change. It's part of you becoming an adult. And it's not easy for anyone. More on "seeing someone when you don't have a reason" below.

Q: Why do people go to therapy/counseling? the other is how do i go about talking to my parents?

People go to therapy/counseling for as many reasons as they go to church or become a member of a healthy club. It adds to their health: mental, physical, emotional, or even spiritual. Perhaps they want some tools to calm themselves when they are stressed, a healthier relationship with their partner, to learn social skills, anger management skills. Usually there is an "event" that brings most people to therapy. Some may have had an experience they want to "work on" like depression, a bad dream, abuse, a break up. Some people have counselors to help them fight mental illness or addiction.

You sound like someone who may be looking into therapy just for a season of life, not because you have a problem but because you just want a bit more support. It's helpful to have another pair of eyes and ears to watch for patterns that if changed would improve your mental health. It seems college is a time a lot of people do this. They also do it before other big life transitions like marriage, job change, kids...

Q: How do i go about finding a good therapist/counselor?

The best way to do this is to ask for referrals. If you are in school talk to your school counselor. If you are looking for a counselor ask someone else who has gone to counseling and see if they like their counselor. If you don't know anyone in counseling you can ask for referrals from a local Psychology or Social work school or if you are working on gay and lesbian issues many cities have a "Center" or place you can get referrals from. You can also look up counselors online. When you choose someone they will educate you, if you want, about how they view therapy.

Good luck on your search.


~Deb said...

I thought that a psychiatrist would be better than a counselor or a psychologist, being they have a masters and can prescribe medications. I found out that many of them are pill pushers. (From my experience at least.) I wish when I was going through all my anxiety and panic attacks, that I could find both. It's hard for people to get good counseling as well as get the needed prescriptions to help them with whatever they're going through.

Good help is hard to find! That I will say!

Let me ask you this: what do you think about the "sliding scale" system? How do they determine how much each person should pay - even if the people are on medicare or whatever - they still do the sliding scale deal. I always thought that was sort of unfair in a weird way, yet beneficial in others.

Your thoughts?

titration said...

A quick comment before I get myself to work. A psychiatrist has a doctorate of medicine (MD) and they are trained just like doctors are. Which means yes they are pill pushers because they are trained to look more at diagnosis and the physical more than medical.

What you need it a counselor who has a good relationship with a psychiatrist because usually your counseling appointments are an hour and then that person can help tell the psychiatrist what your symptoms are to help you get properly medicated. MD's aren't trained to counsel they are trained to diagnosis.

Hmmm. Sliding scale. I think this all depends on your state and the counseling practice or center you are going to. Sliding scales have helped me out so I don't mind. The scale is almost always based on your income.

I suppose overall I am a fan because the people who need help the most, have the least money and least power. Since we did away with insane asylums (for good reason) but didn't replace them America if FULL of homeless who have no access to mental health care.

titration said...

p.s. I meant physical AND medical more than emotions ....