What to Expect When you go to a Professional Counselor or Psychotherapist
It is very common to hit a rough spot in life when a skilled professional who is trained to help you sort out your thoughts would be the best course of action. Many people realize that they are well on the way to serious problems with their own personal suffering, threat of job loss, parenting issues or marital distress. Yet, the fear of seeking professional help is such that they find it impossible to make that call. Could part of their reluctance be ignorance, fear of the unknown or misguided preconceived notions about what seeing a “shrink” means? For less than what the cost of divorce might be, one can buy some pretty fine therapy and come out entirely better for it.
After practicing thirty years in the mental health field, I have worked with some excellent clinicians and some that were not of the highest caliber. I have seen many individuals who waited way too long to get started and have regretted that they didn’t come in sooner. I have seen people who were seeking care with their pastor, their chiropractor or the local psychic who have wasted thousands of dollars and precious time but who are no better off than when they started. Many educated, hardworking, otherwise caring and intelligent folks feel that if they can’t figure it out on their own, there is no help for them. Some feel that a professional counselor has nothing to offer that they are not already aware of. Lastly, some are terrified that if anyone really knew who they were deep down inside, there would be no hope at all.
Here are some facts that anyone considering professional therapy needs to be aware of:
There is protection of your privacy and your safety if you see a licensed professional. Most state licensing boards regulate professional therapy practice and sanction those who are a threat to their clients. For example, a good therapist never discusses individual cases in public or by name outside of their office. You will not end up on local talk radio or newspaper unless you are the one who calls in!
Therapists do not socialize or conduct business with their clientele. This would create what is called a “duel relationship,” which is not good for effective therapy. One of the powerful things about seeing a therapist is that you can leave it all at their office. You can rest assured that you won’t have to face them again at Thanksgiving or have them ask you to do repair work on their house or car.
Professional therapists have good boundaries. This means that they will not take advantage of emotional or psychological vulnerabilities that they discover in your treatment process. This includes no sexual or romantic contact whatsoever. You don’t have to worry about holding in your belly for your entire session or crying if it runs your mascara . It doesn’t matter what you look or sound like. You should be safe to be yourself and comfortable that your therapist has only your welfare in mind. Your therapist will feel pleased to help you with your personal challenges no matter what you bring into the session.
All professional counselors are trained in psycho-diagnostics, therapeutic methods, and professional behaviors designed to help rather than harm regardless of which branch therapeutic training they come from. This could include professional counselors, licensed clinical social workers, licensed marriage and family therapists, psychologists, and psychiatrists. While each has similarities in the essentials of practice, they vary in terms of expertise. For example, in most states, one must be medical clinician to prescribe psychotropic medications. Marriage and Family Therapists have more training in Marital or Couples counseling than psychologists or professional counselors.
I have been up close and personal to each of these professions for many years. They all have a place in the helping world, and all are not equal. It is hard for a layperson to tell who is a good clinician to try. If you are from a small community, your choices for treatment may not be very wide. The guidelines for internet and telephonic practice are not yet well established in most professional organizations. Buyer, beware! As with many consumer choices, a personal referral from a satisfied client is the best.
Many individuals want to hire professional help but do not want a mental health diagnosis or claim filed on their medical insurance. It is perfectly legitimate for you to ask to be allowed to pay cash and not use your medical insurance. Many therapists are happy to do this because they save the cost of filing your insurance claim in order to get paid for treating you. If you do not have insurance that covers outpatient mental health, call anyway. Many providers can work out a pan that fits your budget or refer you lost cost or no cost resources.
Expertise does matter. Across many service areas, young providers who are fresh out of training and very current in their skills and the latest devices are best. Not so in the mental health world! I have gained so much experience and expertise in thirty years that not much surprises me in the consulting room. I usually know where to start, how to help and how things are going to turn out. I remember when I was a young therapist how many times I had to say “I don’t know but I will find out.” Now days, that doesn’t happen very often. Don’t assume that if you are young, you have to have a young therapist to “relate to”. I do an excellent job of relating to adolescents and young adults. I enjoy them and they feel safe and cared for by me. I keep up on what they read and what they play and remain culturally current for my clientele. Let stability of practice and quality by your guide.
Alarm bells should go off if your therapist only works from a workbook, has an office in their private residence, doesn’t take a detailed background history, and doesn’t ask about your medical conditions or substance use. If they are friending you on social media and talking about their person life and their clients, run! If you see records lying about with other client’s names on them in plain view consider it as a sign of sloppy practice. If the therapist doesn’t have enough openings to schedule you regularly, their practice may be so full that you should seek someone who is not as busy. I once heard of a therapist who saw fifteen clients in a day for individual session. I can’t imagine any professional, even a night watchman, who can work those kinds of hours and offer anything close to professional quality of performance.
Often therapists in a small practice will answer their own phones and you can interview them on the spot. Ask them if they work with people who have issues similar to your own. Ask them how long they have been in practice and what hours are available for appointments. If they have a receptionist, you can interview them as well. If you don’t like the support staff, look somewhere else for help. The staff often reflects the tone of their boss.
Your first visit will involve filling out paperwork, often with checklists, consents and questions about your family, work and health history. The therapist will make a record of your case and consult with you in a private setting. They may ask a lot of questions about what you have written. They will ask you about new ideas that your history suggests they inquire further about. They should listen to what your personal goals for treatment are and work with you on a plan to reach what those goals are.
Smart executives and business owners know that if they do not invest in the best professional guidance for their business and develop a profitable set-up, they are doomed to failure. They may have the budget to obtain that expertise in house on the payroll. As individuals, couples, parents and heads of families, why wouldn’t one want to keep what matters the most (ourselves and our loved ones), in prime condition? Coaching, guidance, counseling or psychotherapy, seek out the best and be careful out there.
Mary Mihelich Ventonis, PhD January 30, 2012
