Tag Archives: therapy

What Therapy is Not

Last month, I tried to convince you to go to therapy. Call me biased, but I truly believe it can be helpful when you engage in the process. However, I also know that we are often bombarded with media portrayals of therapy and therapists that can give lots of wrong information about what actually happens during the process. Hopefully, I answered some of your beginning questions in my previous post; this time, I want to talk about what therapy is NOT.

1. Therapy is not a quick fix: Sometimes, people have the expectation that after one session of therapy, you will feel better. Though you may experience some relief simply from getting things off your chest, your problems are not likely to be resolved after just one session. It takes time to build skills and strategies that will help you work toward your goals. Be patient and trust the process. Most therapists will check in periodically to ensure that you feel you are still working toward your goals and making progress. I often have people ask me how many sessions I think they will need- this is a really hard question to answer because people are so different and have different needs. It might be helpful to just acknowledge that you can’t be sure exactly how many sessions you will need, but you can pay attention to your symptoms and notice when you are starting to feel better.

2. Therapy is not done to you. Your therapist does not have a magic wand or fairy dust. Therapy doesn’t happen “at” you. In order for it to work, you have to put time, energy, and interest into the process. For some people, that might mean homework, reflecting during the time you are not in session, and practicing new skills. Your therapist can’t fix you! Their job is to provide you with some perspective and resources to live the life you desire. Your job is to put in the work, enact the skills and focus on the strategies provided to reach your goals.

3. Therapy is not boot camp. Your therapist doesn’t set a goal of seeing how many times they can make you cry in an hour. It is not our intention to make you feel bad. We don’t want to push you beyond what you are capable of. However, negative feelings can sometimes be a part of the process. Our job is to be there as support, help you to understand and explore what you are feeling, and hold you accountable to the goals you’ve set for yourself. Sometimes, that means you won’t like what we say, but you should always have the sense that you can trust your therapist’s intentions are in the right place.

4. Therapy is not a friendship. The best therapeutic relationships are ones where there is a deep sense of mutual care and respect between therapist and client. However, they should not be confused with friendships. Therapy is a professional relationship where the focus is on you and your needs. That means there should be certain boundaries in place: therapists don’t share about their lives the way a friend would; we don’t spend time with clients or talk extensively outside of the time spent in therapy; we don’t take on people as clients if we interact with them socially in other circles. There is a reason for this: therapy should be a protected space and you should feel free to share anything and everything about your life. If you interact with your therapist in other ways, it could complicate the safety of the relationship. This does not mean that you don’t care about your therapist and they don’t care about you- it just means that there are rules for keeping the relationship healthy.

5. Therapy is not a cure all. Sometimes, people feel completely better after going to therapy. For others, there might be a longer term diagnosis that does not totally go away. For those folks, the goal is to build skills so that they can manage their symptoms and live a happier, healthier life. Because we are humans, we have symptoms- sometimes we might feel anxious, sad, overwhelmed, or frustrated. The goal is not always to get to a place where you have no symptoms at all. Sometimes, the goal is to get to the place where those symptoms don’t take over your life or stop you doing the things you want to do.

So, hopefully this helps you to manage your expectations. Therapy is a wonderful experience, and it can be a little different when you try it for the first time. If you are ready to start the process, go to http://www.PsychologyToday.com to get started.

Thanks for reading and make Well Choices!

Advertisements

So you think you want to go to therapy?

One of the things I intentionally do is talk about therapy and how helpful it can be. In faith communities and especially in black faith communities, mental illness and it’s treatment are still highly stigmatized. We tend to try to pray away our emotional concerns, or go to pastors and other faith leaders for a quick fix. While these are good steps, some issues also require the attention of a professional. So how do you know when it’s time to seek out a professional? Here’s a list of signs it might be time:
– if you’ve been tired, sad, nervous, overwhelmed, or “off” for more than a couple weeks and nothing seems to help
-if you notice you have difficulty sleeping, headaches, stomach issues, or problems with concentration that can’t be explained
– if you are feeling unhappy or unfulfilled in your relationships
– if you are having difficulty managing the different tasks in your life
– if you have frequent crying spells, find your self lashing out at others, or have noticed an increase in substance use in an attempt to cope

These are just a few; the reasons I hear most often. But I should probably provide a disclaimer here: I THINK EVERYONE SHOULD GO TO THERAPY. Everyone. EVERYONE! Whether your concerns are mild, moderate, or severe, therapy can be helpful for you. One of the great gifts of therapy is that it is an invitation to take a brief hiatus from the hustle and bustle of your life and dedicate an hour of time totally to yourself. You get the opportunity to sit with a person who cares about you, but who won’t share their opinions, tell your business, or insert their own desires in the way they provide support. I can’t think of another place in life where all those things come together. It’s a peculiar and wonderful space! Yet, I understand how scary it is to enter a room with a stranger and bare your soul in such a way. So, I honor that it is a big decision and thought it might be helpful to demystify the process.

First, do some introspective work.

Why do you want to go to therapy? What do you want to get out of it? Ask yourself: If I woke up tomorrow and things were all better, what would be different? What would be the signs that my life had taken a shift?

Your answer to this question is the beginning of your goals for counseling. It’s ok if it’s not crystal clear, but it’s important to have at least a sense of where you want to go. Once you have at least a vague goal in mind, it’s time to begin to search for a therapist. Some logistical questions to consider:

– if you have health insurance, does it cover mental health (behavioral health)? Do you have a deductible that requires out of pocket payments before sessions will be covered? How much is your copay per session? Call your insurance company (or check online) for a list of therapists who accept your insurance. This gives you a place to start.

– if you don’t have insurance, how much can you afford to pay? Frequency of therapy is variable- you can go weekly, bi-weekly, or even monthly, depending on what you need and how much you can afford.

– what characteristics of a therapist would help you to feel ready? Similarities in gender, race, or religious affiliation? Maybe you can check with a pastor or a friend to ask for a referral

-Do your research: Just like dating, or finding the right furniture, or buying a new car, it’s helpful to get some information before you make a decision. One of my favorite websites is PsychologyToday.com because you can search by a myriad of characteristics and specialty areas, as well as insurance provider. In addition, you can hear, in the therapist’s own words, what they believe about therapy and how they like to help people get better.

Once you decide on a therapist, take a deep breath, and give them a call. You may have to call multiple people- sometimes people aren’t accepting new patients, or maybe your schedules don’t align. That’s ok! Keep making calls until you find someone. Most clinicians will be happy to answer a couple of questions over the phone- how the process will go, what the first session will be like, how you can pay, or something of the sort.

At your first appointment, you will have paperwork to fill out, just like when you go to your medical doctor. Give yourself a few extra minutes to get all that done and arrive a little early to your appoinment. Generally the first session is focused on information gathering- there will be LOTS of questions- your therapist is just trying to get to know you! They may take notes, or have some papers they go through as you explain what’s going on with you. The goal is to get a good picture of how you’re functioning right now and where you want to go. This is also an opportunity for you to ask questions about how the process will go, how your therapist does treatment, and what you should expect. At the beginning, you and the therapist are getting to know each other and getting comfortable with each other. The role of a client will be different than any other relationship you’ve had, because you won’t really know a lot about your therapist. While this may seem odd at first, it’s actually a good thing, because it keeps the sessions focused on you!

A note: At the beginning (and often throughout the process), therapy can bring up a lot of emotions. It’s normal for you to feel nervous, sad, or overwhelmed. We therapists have a special tool for if those feelings come up: TISSUES!! We are not scared of your emotions, you will not be “too much” for us, and we can handle it. That’s why we went to school! Remind yourself that discomfort can be a part of the process, and that it can produce change if you stick with it.

Therapy can be scary, but working with the right therapist is so worth it! If you’ve been wondering about it or considering a visit, take the plunge and make the call! It is a great step to take for you and your mental health. You deserve it!

Thanks for reading, and make Well Choices!

Church or Clinic? Who’s the right counselor for me?

I get lots of questions about the differences between psychotherapy, Christian counseling, and pastoral counseling. Choosing to go to therapy can be a big step because of the pervasive stigma we have about mental illness, and beliefs that we are somehow weaker or less faithful if we need help. I have some thoughts, but check out this article from Counseling Today as well:

To whom shall I refer? | Counseling Today.

So, who’s the best person to go to when you have a concern? Here’s a general breakdown. For believers, often a first step is a pastor or minister. These folks are often well equipped at what we would call “pastoral care” or “soul care.” Many ministers have received training on how to help people experiencing grief, bereavement, or struggling with spiritual concerns or questions of faith. They might also be able to help you manage minor relationship difficulties or times of stress. Pastors and ministers can offer spiritual guidance, but often refer to a psychotherapist when there seem to be more severe symptoms or difficulty functioning.

When your struggles get to the point where they would represent a diagnosable mental health condition or are having an impact on your daily functioning, it’s best to go to a licensed mental health provider. Still, you have options. There are some mental health clinicians who are also trained in issues of religion and spirituality and work with clients with both of these worldviews in mind- these are called Christian counselors. Christian counselors hold the spiritual experience at the forefront of work with mental health concerns, and are able to seamlessly incorporate issues of faith into mental health treatment. They are often particularly interested in using biblical principles as guidance for the course of treatment. They might even be licensed or ordained ministers. This is a great option for folks with current mental health symptoms who believe that spiritual/religious beliefs are central to their concerns. Most¬†Christian counselors will identify themselves as such on their marketing materials. VIPCARE is a great resource in the Richmond area.

A related field is pastoral counseling. These folks have training and clinical skill, but may not be licensed mental health professionals. Most states don’t have a licensure category for Pastoral Counselors. Instead, they may serve as chaplains in various organization such as VA hospitals or other medical facilities. They may also have a national certification as a pastoral counselor and/or a certification in Clinical Pastoral Education. Ministers and pastors might also have some specialized training in providing pastoral counseling, which is a¬† brief, solution-focused counseling model where spiritual and religious concerns are brought into the treatment planning.They are also trained in a way that they could work with people from a variety of religious traditions, not just Christians.

Then, there are folks who a trained secularly. These counselors will have a state licensure such as social worker, psychologist, professional counselor, or marriage and family therapist. A licensed therapist may or may not be a Christian, or be able to understand your religious and spiritual concerns. All licensed therapists should have training which allows them to work with people with a variety of cultural and religious beliefs. Mental health professionals who don’t identify as Christian counselors could still incorporate your beliefs into your treatment possessing this level of cultural competency, and they may or may not understand your beliefs at a personal level. Still others might be able to help you integrate these concerns into your treatment despite their personal beliefs. With secular therapists, it’s ok to ask if they feel that they can help you incorporate spiritual concerns. Keep in mind that people don’t have to share your beliefs to understand and appreciate them. However, if you think that would help you to feel more comfortable in therapy, it’s fineto have that as a preference.

The bottom line is that whenever you are at the point where you’re seeking help, you reserve the right to ask all the questions you need to find someone who is a good fit for you. No matter who you go to, they should be able to explain to you how they believe people change and get better, and how they feel they can help you in particular to feel better.You also have the right to seek out another provider if one doesn’t seem to be a fit, though I encourage you to be open about your concerns, as it may be something that can resolved without starting all over. Here are some questions you might want to ask a therapist/counselor when beginning to work with them:

  1. Do you take insurance? What do you charge?
  2. How and when were you trained?
  3. What kind of therapy do you practice? How do you believe people get better?
  4. How will we incorporate my religious/spiritual beliefs into my treatment?
  5. What will we talk about? How will we decide what to talk about?
  6. What happens if I have a crisis?

These are just some questions to get you started, but you may have others, and that’s fine. You have the right to advocate for yourself and get what you need! The important thing is to find a therapist who can understand your world view, help you address some concerns, and ultimately feel better. Check out my Find a Therapist page if you’re ready to start your journey to wellness! Thanks for reading and make Well Choices!