What to expect at TRANSITIONS

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Review this web site.

Call and ask questions.

Read The TRANSITIONS Client Handbook.

 

The first half hour of the first session (90 minutes) is free, so you can have time to feel safe and comfortable about coming BEFORE you become financially obligated.

 

 

 

 

 

 

 

Every effort is made here to put all the issues before you, so you can make an informed choice.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Security includes good confidentiality in record keeping that includes denial of insurance/HMO access UNLESS client gives consent as an informed choice.

 

 

 

 

 

M.Ed., Ed.S. degrees in Counseling (B.A. High Honors, Phi Beta Kappa, in Psychology)                

N.C.C. refers to board certification as National Certified Counselor.                    L.P.C. refers to N.C. State licensure as Licensed Professional Counselor.

 

 

 

Refer to links below to see why I offer a sliding fee scale as opposed to managed care.

 

 

 

 

 

 

 

 

 

 

 

These conditions, including private entry, private waiting room, and private exit are met at both the Northbrook and Lincolnton offices.

 

 

 

 

 

 

 

I take the telephone calls from prospective clients.  If I am occupied or with a client, my confidential voice mail answers and invites you to leave a message so I can call back.

 

 

 

 

 

 

 

 

 

 

HOW WE WORK TOGETHER:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

These factors in a practitioner's background are important.  Most disciplines practice in the same kinds of settings - often with each other.  Thus, over time, the sharp edges of disciplinary uniqueness are rounded by the years of shared and over-lapping methodologies.

 

 

 

 

 

 

On some occasions, when psychiatric assessment and/or medicine management becomes necessary, I refer a client to a psychiatrist.

 

 

 

 

 

 

 

On occasions when in-depth psychological assessment and testing become necessary, I refer a client to a clinical psychologist for the evaluation.

 

 

 

 

 

 

Suspected head injuries and neurological disorders must be referred to specialists in neurology, neuropsychiatry, or neuropsychology for diagnosis and treatment.

 

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Counseling is my disciplinary background.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

At times, I may refer a client to a colleague in another discipline or specialty because it will better meet the client's treatment needs.   One example would be referring a small child to a specialist in Play Therapy.

 

 

 

 

 

 

 

 

 

 

 

Working with clients on spiritual issues, according to their needs and desires, is a favorite aspect of my practice.

 

 

 

 

 

The most knowledgeable physicians will readily refer their patients for counseling.  Also, I sometimes refer clients to their physicians when medication seems indicated as a complement to the counseling process.

 

 

 

 

 

 

 

 

 

 

 

 

When intensive SA intervention is needed at an inpatient level, these disciplines are essential.

 

 

 

 

 

These emerging disciplines and areas of study are among the most exciting aspects of healing work today.

 

 

Much of my post-graduate continuing education has been in these cutting-edge, holistic areas of study and treatment.

 

 

 

 

 

 

 

 

 

As with many practitioners, part of my background includes formal training and practice in clinical hypnosis.  When indicated, it can be helpful in client treatment.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Typically, I can schedule a crisis referral within 24 hours - usually the same day, and routine referrals will be seen within the week.

 

 

 

 

 

 

 

 

 

 

 

 

www.transitions-counseling.com :                     Where Your Help Begins OnlineSM

ON CHOOSING A COUNSELOR

An Irreverent But Totally Comprehensive Guide to Choosing a Counselor or Therapist

Probably the most infrequently asked question that comes my way from a prospective client is: "How can I know if you are the best counselor or therapist to meet my needs?" Yet, this is the ultimate concern that underlies any other question the caller may present. None of us wants to waste our time and money seeking professional support that provides little or no help in meeting our needs.

My goal in writing this is to help you make the best decision for yourself and/or others who may become involved in the counseling process. In the six years my web site has been online, I have hesitated in addressing this issue -- partly because the topic is covered in various ways on other sites. Unfortunately, some of the discussions put a (not quite truthful) "spin" or degree of bias slanted more in the direction of the credentials or of the philosophy of the provider, rather than addressing the reader's ultimate concern. Sometimes, the bias is obvious as the writer takes an authoritative posture in arguing that a provider with certain credentials (typically the writer's) is most qualified to help. The bias is less obvious in other circumstances as an apparently "objective" writer under-emphasizes the qualifications and potential helpfulness of disciplines or orientations other than their own. This bias, masquerading in the word-clothing of "professional objectivity," does not serve the needs of the reader. We all have biases. I do believe that a part of all professional training involves learning the ability to express bias in apparently objective terms! Whereas the "best" politicians are excellent at this, professionals in the helping disciplines learn to be even subtler. However, the best interests of the potential client can only be served by open and honest expression of the bias.

I can assure you that with a generation of time in this field, including training and experience, I do have biases -- and my responses to this topic will include the most honest reflection of those experience-based and observation-based biases that I can offer! Hopefully, this will result in your having the most useful knowledge to make a truly informed choice. Since there already are good discussions out there on this topic, it seems useful to take another angle from which to explore the question of how to pick a counselor or therapist. There are a number of factors to consider from the perspective of a would-be client, so why not explore this by looking, in turn, at each factor that should be considered? The perspectives and biases I share come from the experiences, study and observations resulting from my being in the roles of both counselor and client at different times in my life.

The Security Factor

First, above all else, the setting in which you pursue counseling must be a sanctuary where you can come to feel safe to disclose the most sensitive and personal issues of your life -- without fear of having the sanctity of your vulnerability, your privacy, or your confidentiality being violated. The kind of client vulnerability that comes with a good counseling relationship must be respected by the helper at all levels, with meeting the client's developmental and recovery needs being paramount. You must feel safe that you will not be taken advantage of - not personally, not sexually, not economically and not in terms of your privacy.

The number of helping disciplines is growing -- with some being traditionally recognized and well established and others being "new" to our culture and not so well established. Whether you seek help at a world-famous clinic or the local "village shaman," your first concern should be that you or yours would have a safe and secure counseling relationship. Don't be afraid to ask direct questions up front on everything from qualifications, to confidentiality, to fees. Established professional helping disciplines typically have at least one graduate degree in an appropriate academic discipline from an accredited institution. They also would have board certification and/or state licensure in their field and membership in at least one professional organization that has a strict code of professional ethics. If you are not already familiar-enough with the qualifications of your prospective helper, you should feel free to inquire in enough depth to confirm that their qualifications will be in keeping with your needs.

Confidentiality and privacy, as aspects of security, have been eroded in recent years by the influence of managed care (HMOs, PPOs, etc.) on the practices of the many counselors and therapists who have subjected themselves and their clients to working under that system. Typically, in behavioral healthcare, managed care violates client security across-the-board. HMOs violate client confidentiality and privacy by virtue of semi-public record keeping; they violate client interests by dictating bottom-line, self-interested treatment management; and they violate clients economically by ultimately creating more financial hardship for the client down the line. For details, refer to my online articles, THE RISKS OF MANAGED CARE and How Managed Care Wrecks Our Lives -- A Personal Odyssey. (Also, there are links on this topic on my Resource Links page.) In my opinion, it is not possible to ethically treat clients under managed care without violating their security needs on several levels. The counselor or therapist you choose should offer you fee-payment alternatives to managed care and insurance (for example, a sliding-scale fee) and an explanation of the risks of managed care.

A sense of security for many clients is enhanced by the structure and layout of the counseling facility itself. The ideal is a private entry to a private waiting room and a separate, private exit upon completion of counseling. Studies have found that a quiet, comfortably lit, den-like atmosphere is most commonly preferred by clients. You should have a choice of where to sit that enhances your sense of being safe. As I sit here thinking of editing out these fine details, I am reminding myself that the smallest sense of being out-of-place can be costly in terms of lost client growth and poorly spent fees. The first concern is that you feel and are safe as you begin this journey. Last, but most importantly, this includes how you feel in relation to your prospective counselor.

Your first phone contact with the counseling agency should leave you with the secure sense that you made a right decision in choosing where to get help. You should have answers to all of your questions before you assume any obligations as to scheduling or fees. Although large facilities often do not easily allow for this, some personal communication with the prospective counselor is most helpful in moving toward this feeling of confidence. Finally, while it is common for persons to feel somewhat anxious at the beginning of the first session, by the end of the session your comfort level with your counselor should be where you would feel positive about rescheduling for the next session. Feel free to disclose and discuss any reservations you may have about continuing. Since it can take two or three sessions before things "click" into place in terms of comfort and a sense of progress, the experts recommend at least two or three sessions before deciding upon whether this counselor/therapist in this setting will help you. For your sake, if you are not feeling a sense of progress by then -- or the counseling relationship does not yet feel right to you -- don't waste your precious time, energy and money. Try going to another counselor or therapist for help. Once your sense of security is established in the relationship of a private, confidential and competent professional counseling setting, the stage is set for your progress.

The Qualifications Factor

The helping professions, otherwise known as mental healthcare or behavioral healthcare disciplines, historically have tended to address the qualifications factor by establishing a hierarchy. Traditionally, the person in the discipline highest in the hierarchy, with the highest degree, was deemed most qualified to treat the client, regardless. While this approach approximates reality for clients experiencing the most severe psychopathology, in principle, there are many other considerations. (This is America . . . it's not uncommon for the person living on the top floor of the most urban condo to drive the most expensive, thoroughly off-road outfitted SUV . . . but why?) Over the course of my career, I have never seen more dreadful turf fighting than that found in the community of mental health disciplines -- with the client/public being the most victimized. As I approach "village elder" status in my lengthy, though humble, practice of my discipline, I feel compelled from my perception to "share it like it is." This is my informal thumbnail sketch of the mental health field and how you might navigate toward help in this area.

There is no best disciplinary or academic qualification for all persons seeking psychological support. Each professional discipline and qualification offers unique advantages for certain potential clients or patients. Further, those advantages are tempered by each practitioner's length and quality of experience and additional post-graduate training; by focus or expansion of orientations and specialties; by changes in confidence and competence; and finally, by the attitude or spirit the professional brings to the helping relationship.

Historically, the mental health discipline hierarchy was established by precedent and political power -- not by "who's better qualified" to provide the most competent help. The first discipline to arrive acquired the top of the hierarchy, with the next discipline following in kind, and so on, in a process that continues today. Medicine was here first and the domain of psychological healing was first inherited by medicine. Freud established psychoanalysis in our culture as the most recognized early prominent theoretical approach to treating mental illness. Physicians (M.D.s) who specialized in the treatment of mental illness became known as psychiatrists. Many, not all, psychiatrists were psychoanalysts. Non-psychiatrist psychoanalysts were called lay analysts. Today, few psychiatrists are practicing psychoanalysts and psychiatry has moved back toward a more medically-focused, evaluation and medicine-management role -- with some psychiatrists continuing to do some types of psychotherapy and many others referring out counseling and psychotherapy to other practitioners. Though psychoanalysis has contributed much to human understanding, it was primarily theoretical, as opposed to being research-based and much of this domain remains unsupported by research. This did not stop psychoanalysis from initially wielding control of the mental health hierarchy, with its classic image of the authoritative practitioner sitting behind the recumbent patient on a couch. However, the 20th Century brought many changes in this field. Mental health-related disciplines and models of practice in our society continue to develop and expand at a rate that seems to lag only slightly behind technology.

As knowledge in behavioral science and healing continued to grow, it became obvious that it could not be entirely subsumed under the domain of medicine. How people and animals behave, think, feel and relate was a field unto itself -- and yet, pathology in those functions certainly had a critical part in the practice of medicine. How would we integrate this growing knowledge base coming from fields like psychology, neuroscience, sociology, anthropology, education and human development? Especially in those early heydays of reductionistic thinking, we compartmentalized our growing knowledge into disciplinary pigeonholes -- and each one seemed to hatch a therapeutic discipline. However, since knowledge and methods overlapped, it was a sad situation in the pigeon coop, for each pigeon sought to be master of his domain.

Over the course of the 20th century, psychology emerged as a comprehensive discipline in its own right. This discipline studied and did research on the origins and development of human and animal behavior, specializing in sub-disciplines like cognition and emotion, social psychology, personality, physiological psychology and neuropsychology, learning and human development, psychopathology, and so on. As research and theory in psychology emerged into the healing arena, professional psychology developed as a discipline to take its place along-side psychiatry (or under it from the perspective of some psychiatrists). Professional, helping psychology (in contrast to experimental or research psychology) then began to divide again in its emphasis.

One aspect identified more with the medical model and specialized in studying and practicing the discipline from the perspective of psychopathology, including its development, diagnosis, and treatment. The discipline of clinical psychology emerged. Like physicians in the medical model, practice approaches emphasized evaluation, diagnosis and treatment from an authoritative perspective: the knowledgeable doctor healing the patient. Today, practitioners in this discipline may work at the Master's degree level (in my state, under supervision, as Licensed Psychological Associates) or at the doctoral level as Ph.D. or Psy.D. clinical psychologists. Licensed practitioners in this discipline are especially trained to evaluate and treat persons suffering from the most serious psychopathologies. Where organic (brain and nerve function) involvement is suspected as a potential source of the problem, a patient may be referred to a neuropsychologist (a subgroup of clinical psychology) or a neurologist (a specialist in medicine), and these specialties often work together.

The other aspect of the psychology practitioner discipline split was more interested in the whole continuum of human development, from birth to the grave, and psychopathology was studied more in the context from which it fit within the whole continuum through normal to extensional human experience. Learning and education in the process of human development, along with study of the best helping methods -- both for enhancing development and for facilitating recovery from interrupted development -- were emphasized. In the development of this orientation, it was discovered that the helping relationship was crucial to human development and healing. As a result, the authoritative practitioner model was de-emphasized in favor of a client-centered facilitator practitioner model as the most effective approach for most people. This aspect of psychology became known as counseling psychology and its practitioners, de-emphasizing the authoritative (potentially alienating) mystique, called themselves counselors. Over time, one aspect of this group focused on practical applications in training practitioners for particular settings. The discipline of counseling emerged with a focus in education and developmental settings, emphasizing group as well as individual treatment approaches in refining the counseling relationship approach. Counseling has expanded into rehabilitation and clinical settings and emerged across the whole continuum of relationship work --including marriage/couples, family, multiple family and even treatment intervention at the societal level.

Depending upon the institution of their training and their focus, counselors may have Ph.D., Psy.D., or Ed.D. degrees in counseling psychology from a Psychology Department (counseling psychologist title) or they may have M.A., M.Ed., Ed.S. (between Master's and Doctorate), Ph.D. or Ed.D. degrees in counseling -- often from a Counselor Education Department at a college or university. Masters-level preparation, in many counseling programs today, involves significantly more work than that required for the masters degree in many other fields. It is typical for counselors to sub-specialize in areas like: mental health counseling, marriage and family counseling, school counseling, career counseling, etc. Rehabilitation Counseling training bridges back into the medical area and is typically taught in a department or college of Health-Related Sciences. Some states now have licensure reflecting sub-specialization in these areas.

As psychiatry and psychoanalysis came into their own in a culture of growing social consciousness, the field that came to be known as social work matured into a full-blown professional discipline. From its "friendly visitor" origins in the early 1800's, in which volunteers offered rudimentary social work efforts to lessen the burdens of the poor, this discipline evolved as a process of various social movements over two centuries. It put a scientific focus on the causes and potential cures of human suffering -- both from the perspective of within the family and society at large. This growing body of knowledge was developed as an applied approach to helping persons who were suffering within the microcosm of family and the macrocosm of society. The branch of clinical social work field evolved from within the psychiatric/clinical setting -- often training from a psychoanalytic core model. This discipline developed therapeutic methodologies from within social institutional settings, doing the organizational tasks required to bring about change -- both within the individual and at the social level. Today, social workers serve in various settings from government-funded agencies and institutions to private practice. Training can be at the bachelor's level (B.S.W.), the master's level (M.S.W.) and the Doctoral (D.S.W.) level. Social workers functioning at a clinical level generally have the M.S.W. degree, which actually requires significantly more preparation than the average Master's degree.

Many therapeutic helping methods developed in the above disciplines were adapted into some specialties within the clergy professions. Some, but not all, professionals of the cloth are well trained and qualified (sometimes licensed) as pastoral counselors. As such, they are able to address individual or family crises and conflicts within the context of the religious orientation of their clients. Some qualified pastoral counselors work out of a church setting, while others are in private practice or functioning as hospital chaplains. At this point, I hasten to add that an unfortunate number of ministers/pastors, not qualified in a counseling field, have taken on a professional counseling role for themselves. Qualifications in preaching do not make one a counselor. In fact, the required relationship skills (speaking/judging versus listening/reflecting) tend to fall on opposite sides of the continuum. Over the years, I have worked with more than a few individuals, couples and families who have been re-traumatized at the hands of well-meaning clergy who were not qualified in pastoral counseling, nor any other specialty of counseling.

While we are on the topic of religious issues in counseling, let's discuss the aspect of spirituality in terms of your choice of a counselor or therapist. All ethical and well-trained professionals in the field will refrain from pushing their particular religious views on their clients. However, spirituality (which I define here as how we seek to answer our ultimate questions) often is a critical aspect of the counseling process. If this is the case for you, it may be important for you to find a professional who is experienced, comfortable and qualified in addressing spiritual issues. You may -- or may not -- want to work with a counselor who adheres to the religious doctrine in which you were raised.

Physicians, particularly family physicians, are often the first line of support in mental health intervention. Good ones will take time to listen and identify the psychological aspects underlying or accompanying physical illness and will refer when counseling intervention beyond standard medical practice is indicated. Some physicians will attempt treatment with medication initially and refer if the pharmaceutical approach doesn't work. The most knowledgeable physicians will refer, as well as medicate, as studies have demonstrated that the combination works best for many people. If you are shy about seeking help on your own and you are comfortable talking to your family doctor or other specialist, your best approach may be to confide in him or her initially.

Finally, there are other important disciplines that are less well known as mental health-related in the performance of their professional work. Some are identified mental health disciplines. As an example, there are psychiatric nurse practitioners -- a therapeutic discipline emerging from the nursing profession. For that matter, members the nursing profession function in a number of settings in which their duties may include counseling/consultation related responsibilities. Some have branched into specialties, like nutritional counseling, holistic work, or lifestyles training. Over recent years, the addictions field has evolved to a level of offering specialization within some mental health disciplines, from addictionologists in medicine to substance abuse counselors - who may be specialists from another discipline, or stand on that credential alone. In different states, substance abuse counselors still have varying degrees of professional (or paraprofessional) training and experience - often with a successful history of their own recovery. Those who are best qualified and trained can play a critical role in helping the recovery of addicted persons from all walks of life.

Other disciplines are valuable adjuncts to the counseling/psychotherapy disciplines and as in the above disciplines, members who know their capabilities and their limitations can be helpful to you in your healing process. Music therapy has emerged as an increasingly valuable discipline and it has practitioners at the Bachelor and Master levels. There are other kinds of credentialed art therapies, along with a growing body of research to support these approaches to healing the human mind and spirit. The discipline of massage therapy (including other physical therapies) has proven to be a valuable adjunct to counseling. Almost all of the disciplines (naturopaths, acupuncturists, chiropractors, etc.) that identify themselves as holistic or complementary medicine have at least some training that supports the mental wellness continuum and they will refer (hopefully) when counseling challenges exceed the limits of their training. (Conversely, with research developments in psychoneuroimmunology, a growing number of counseling/psychotherapeutic professionals have studied and developed competencies in holistic approaches/alternative medicine. Hopefully, they will refer appropriately to these growing disciplines when they reach their limits of knowledge and skill.)

Finally, there are a variety of "hypnotherapists" out there, as hypnotherapy has many valuable applications in appropriate circumstances. Many of the counseling/psychotherapeutic disciplines described above have members who are trained to do therapeutic hypnosis and some specialize in this. Some of these skilled practitioners have additional credentials ("initials") relating to their training in hypnosis, while some do not. Beware. Persons who are not otherwise professionally trained in a mental health discipline acquire some fancy-sounding hypnotherapy credentials in weekend/week-long workshops. You would not want a non-physician, surgeon-imposter cutting into your body on the basis of learning a few surgical techniques over the course of a weeklong workshop. Why would you want a "techniques-only" person of limited psychological training "cutting into" your precious psyche?

Attitude: A Mutual Process

For success in any kind of counseling process, attitude is critical - both on the part of the counselor and on the part of the client. It is a mutual process, where each attitude is reflected in the other. I have shared a great deal on this web page about the importance of post graduate experience as a good indicator of competence, but no amount of experience is of much value if the counselor is "burned out." It is essential that you will experience a sense of enthusiasm and commitment from the counselor from the very beginning of the relationship. Ideally, you would pick up on this before you commit yourself to a situation in which you are financially obligated.

There are other ways in which you may determine the level of counselor commitment to meeting your needs first. Willingness on the part of the counselor to take a reasonable amount of time, exploring your initial questions with you before you schedule a session, is an indicator of that commitment. So is a web page that addresses your questions in detail. (I had to say that.)

Attitude can be reflected in an individual and on an agency level. How quickly is the counselor able to see you, if you are in a crisis? A professional who overbooks and doesn't have available time for emergencies may be more connected than popular - especially in these days of managed care. An example of good attitude in such circumstances would be a readiness to refer you to another qualified professional so you can get the help when you need it - not at the convenience of the person or agency making the appointment. Larger agencies - especially public ones - can be quite impersonal in this respect. The overwork and understaffing in such agencies can put a strain on morale and promote burnout.

I cannot think of anybody who entered a mental health discipline for the money. One can become far wealthier (or should I just say wealthy) on far less education while pursuing another discipline. People enter a mental health discipline because they love the work it brings. Unfortunately, the burnout brought on by some of the things I have mentioned (especially recently by overwork and decreasing income in agency and managed care settings) has compromised the attitudes and competencies of a growing number of counselors and therapists. While the rest of the nation sees economic good times, the psychotherapy field is in a deepening state of economic depression. All this candidness is not meant to discourage you in seeking help, but to encourage you to hold out in your search until you find somebody who responds with appropriate care and enthusiasm in meeting your treatment needs.

Counseling professionals love to work with clients who are invested in personal change and recovery. While it is normal for many clients to exhibit some "psychological defenses" in resistance to the challenge of personal change, those who are serious eventually demonstrate a commitment to overcoming them. The more enthused a client is in pursuing growth and recovery, the more enthused the caregiver will remain. On the other hand, if the client makes a practice of not showing up for sessions, writing bad checks, unnecessarily canceling at the last minute, etc., he or she is doing more than creating inconvenience. Such a client is wasting time another client could use and stealing from the livelihood and professional fulfillment of the counselor - and that can sour the best of professional attitudes! So, your first step in pursuing counseling lies in becoming sure that you want to pursue this course. Sometimes, we know counseling is our best recourse - or even essential - but we refuse to acknowledge that we have not yet moved beyond "wanting to want" to pursue it. It's okay to have misgivings, or even great apprehensions, but it is essential to make the commitment and follow through to show up for the session. While some aspects of the healing process may be frightening and painful, nothing will be as frightening and painful as remaining in your present situation. So, make the commitment for yourself, then find a professional who promises at least an equal commitment to being there for you in the process.

The Myth Factor

Those of us who are not practicing in the field (and a good many of us who are) have been influenced in our thinking about what to expect when it comes to seeking counseling or therapy of some kind. I still frequently hear the word "shrink" applied to those who work in the mental health disciplines, and occasionally, new clients express surprise at not finding the psychoanalytic couch upon entering my office. There are many social forces reinforcing old ideas of this work and continuing to add to the myths that surround this work. I believe many aspects of the myths contribute to the anxiety some clients feel when they first enter the office - and much of the relief as they complete their first session now knowing how it really is. So, let's explode some of the mythology in this field right here . . . and if you encounter a professional who seems invested in perpetuating some of these myths, you will know in which direction to run!

Much of what has been discussed so far, especially in terms of qualifications, dispels some of the mythology about who can help you. Unfortunately, the media (television and movies) are the biggest culprits when it comes to creating false impressions. The most common image of a portrayed character that comes to my mind is of a doctor (usually a psychiatrist) who inappropriately entangles himself/herself in the client's life - or in the life of a family member. The theme is usually sexual and/or power-oriented and we tend to discover that the "nut" is really the mental health professional! First, that kind of involvement in a client's life, or a family member's, is not only considered inappropriate - if the involvement is sexual, it may be considered criminal in many states. The great majority of mental health professionals, while of varying degrees of competence, do not act out in this manner. There are disciplinary measures (revocation of licensure and board certification, prosecution) reserved for those few who do violate in this way.

Second, the majority of practitioners in this field are trained at the master's degree level in their discipline, while many doctoral-level professionals develop their highest competencies in research and in educating new professionals.

When mental health professionals are portrayed in the media today, it is usually in a humorous or satirical manner. I admit, I have fallen out of my chair laughing at the therapists portrayed in Ally McBeal, but these characters hardly even come close to most of us in this work. (Maybe, a few - but neither my personal colleagues nor I would fall into this category.) Those of us who are good at our work respect, and deeply value, our clients. This theme of respect brings to mind another aspect of current myth building in our field. While Dr. Laura has gained popularity with her broadcasting work, her disrespectful communication to her radio "clients" does not even approach what one should expect in a real counseling session, where an atmosphere of respect and sensitivity prevails. In spite of her frequent chastisements to others about being honest, she portrays herself as some kind of therapist - when actually, her doctoral credentials are in physiology! This perpetuates the myth that any kind of doctor will be an expert on just about anything! Physiology is to psychology as muenster is to monster. If she believes in following the fine values she espouses, why doesn't she have a broadcast disclaimer that her doctorate is not in any kind of therapeutic discipline?

The emergence of Dr. Phil represents only a slightly more valid media example with regard to what the public can consider as being representative of a  therapist.  The cognitive-behavioral methods he generally employs are among the most effective of today's treatment approaches. While he can be more confrontive and caustic than many therapists, he authentically uses his unique personal qualities, including his warm country-charm  - along with his considerable professional expertise in these methods - to help his television "clients" resolve their problems. But, essentially, it's a TV show - not counseling. It is important to recognize, however, that a considerable amount of preparation goes into selection and on-air treatment planning for each client.  As a result, the viewer may be given the impression that just about anybody can  can expect the kind of "quick fixes" often seen on his program.  There are pre-program consults and evaluations, then professional follow-up is often arranged after programming to ensure the continuity of on-air treatment gains.  This leaves only the essence of the intervention process to be viewed on-air - and then, it's with Dr. Phil doing mostly talking and little listening.  In many "real-life" counseling settings, clients need considerable time to share their experiences and the tempo of the therapeutic modalities involved do not allow for the sound-byte approaches of today's on-air viewing practices. The work of Dr. Phil and his staff, in my opinion, offers a glimmering of some therapy settings.  Who you see may or may not be similar in style and quality to Dr. Phil. It is important to remember that every competent professional will have his or her unique personal and professional qualities that are brought to the therapeutic relationship.  Your primary concern is that those qualities work for you. 

Another trend we see today is the proliferation of initials after people's names. The myth is that initials mean expertise. It is a good idea to find out what those initials mean. Though we have outlined some of the initials that pertain to academic preparation above, additional initials may pertain to certification and/or licensure in various areas. In the past, initials after a name usually meant years of training and preparation; passing a qualifying exam, acquiring experience. As given in the hypnotherapy example, above, now that may not be true. A person with weeks or months of training in various workshops and/or unaccredited schools may add more initials after his or her name than a person with a couple of initials signifying a doctorate. Different initials from different sources carry different weight in terms of actual qualifications. Beware! A good adage is: Initials do not an expert make.

Finally, there is a prevailing myth that any kind of counselor or therapist is, well . . . just plain weird. To the perceptions of some folks, that may be true. The old psychological model of what constitutes healthy functioning is what we call "normal." The classic study of psychology focused on the concept of normalcy versus psychopathology. Back in the fifties, everybody wanted to be "normal." That meant "like most other people" and if you want a snapshot of what it looks like to function like most other people, take a look at all the happy people standing around you the next time you are in the checkout line. Wanting to be "normal" like that is what drives many honest people to drugs or depression. Counselors today, especially those who embrace the transpersonal aspect of the human development continuum, look beyond just healing and recovery. Life is about discovering who we are and learning to live up to our potentials. It's about learning and growing from our mistakes - and the mistakes of others that wounded us. It's about discovering answers - real spiritual answers that work for us, to the ultimate questions of life. It's about becoming naturally high and loving and responsible to those who share our lives. This is not normal. And a helping professional who seems weird in this way may be your best choice - even if it means that you will eventually tend to stand out in contrast to the sour-pusses in the checkout line.

The Most Critical Ingredient Of All

Of course, you are the most critical ingredient of all. The best counselor in the world cannot bring to the session what you already have. It is said that there is no greater courage than that found in our willingness to sacrifice what we are for what we can become. You are the one willing to resolve deadlocked conflicts; to pull back the curtain to expose painful memories; to expose old wounds for healing. And, when you wonder if you have the courage to go through all this for yourself, you hang in there because you know you must do it for those you love. I cannot think of a better way to close this discussion than to paraphrase an observation you will find in your Client Handbook:

Even though I have been in clinical counseling work for over twenty years, I increasingly feel a deep sense of respect and appreciation for each new client who decides to enter counseling with the courage and commitment to discover and make the changes that will give his or her life new meaning and direction. Having walked this road personally, as well as professionally, I know how challenging it can be. The shared trust and the opportunity to participate in, and witness, the growth of another is a sacred honor to me. My experience in this work has taught me that there is no tragedy so great, no shame so deep, and no pain so overwhelming but that the power of the human spirit can break through to the light. May it be so with you, as I trust it will.

Granville Angell, Ed.S., L.P.C., N.C.C.

Copyright 2000, 2004, by Granville Angell - All Rights Reserved

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    Granville Angell

    The ponds outside my office (view from walk)