Finding a Counselor

Lucile Guidry, Attaway, Denise

Until just a few years ago, mental illness was a shaming stigma to most people. The general opinion was that it indicated a moral or intellectual weakness within the person who was suffering from mental illness. Today, we know that science has found mental illness can be the result of a chemical imbalance in the system, or it can be genetic (in some rare cases) or even the result of severe traumatic impact to a person, such as an automobile accident, or traumatic injury or illness.

Seeking professional help for mental illness is becoming much more accepted, and the options for treatment are increasing. In fact, there is significant demand for more sources to assist individuals who suffer from mental illness. It is important to realize that mental illnesses are very painful psychologically and can even have some physical symptoms, which also may need treatment.

Selecting A Treatment Provider
The point of treatment is that it be effective in treating the condition and for the client/patient to be comfortable and trust their provider.

Just as medical doctors, counselors and therapists must
“…first, do no harm….”.

If a person becomes uncomfortable with a counselor or therapist, or if the trust is broken, it is perfectly reasonable to select another provider.

An axiom of therapy is that therapy gets worse before it gets better. This is very true. One of the most important aspects of therapy is that we get to know and identify things about ourselves, especially the things about ourselves that we don’t like—not always a comfortable thing. So, to that degree, it will be uncomfortable. A trained, experienced counselor makes this exploration of oneself less frightening. Several different types of therapists are available. Their "styles" may differ (depending on the type of therapy provided—talk, behavioral, etc.) , but all are required to adhere to the following:

  • Counselors and therapists are required to display their credentials -- all that apply, such as, diplomas, licenses, certifications, fellowships, etc. --  in plain view.
  • It is no insult to check these credentials out.
  • Counselors and therapists also are required to provide a written statement of ethics, services, fees and availability and list, again, credentials and areas of expertise.

Psychiatrists are medical doctors (MDs) specially trained in mental illness in addition to physical systemic disease processes. The most observable privileges psychiatrists have are that they can prescribe medication and admit patients to hospitals. Generations ago, only psychiatrists practiced mental health treatment. Now, it is not uncommon for a group of mental health professionals to include physicians, counselors, social workers and others in order to provide holistic services to their client patients.

Psychiatrists are medical doctors, so the American Medical Association (AMA) and state medical board are good places to start when checking their credentials.

Professional counselors are not medical doctors, although many often have doctor of philosophy degrees and most are nearly always master’s-level professionals. Here are some other characteristics of professional counselors:

  • They are trained thoroughly in mental health processes and treatments.
  • In some states a very small number of licensed professional counselors are also allowed by law to prescribe a limited number of medications to their client/patients. If this is the case, they will have a specific Drug Enforcement Agency (DEA) number and certificate.
  • Some counselors have extra credentialing and specialties just as physicians do. Specialty areas may be marriage counseling, adolescent counseling, child counseling, trauma counseling, etc.
  • They may be licensed or certified or both. They may be "fellows" of a certain discipline or type of therapeutic technique. If so, they should have the proof of these extra credentials clearly posted, as all professionals should in any field.

This category of non-physician therapists and counselors is often certified by different professional organizations and licensed in some states. Going directly to the state licensing board or the credentialing agency’s Web site or calling its toll-free number usually ensures accurate information. And of course, asking around if family and friends know of the individual also can help.

Social workers fall into a specific professional category and are very much like counselors. In fact, they often do provide counseling services. They may have any of the above additional credentials, except prescription privileges (unless they are also counselors with that special certification). For professionals to identify themselves as "licensed" social workers, they must be graduates of an accredited master’s-level or higher social work degree program and pass the credentialing test for licensure and certification and/or board certification.

Again, in such cases of non-physician therapists and counselors, they are often certified by different professional organizations and licensed in some states. Going directly to the state licensing board or the credentialing agency’s Web site or calling its toll-free number usually ensures accurate information.

Other mental health professionals -- such as pastoral counselors and even school counselors -- offer mental health services. Nevertheless, it is important to be sure that the counselor you choose is fully competent to provide the services you need.

Don’t hesitate to ask what the providers credentials are and with what credentialing group those credentials reside.

And remember, if the counselor is not a "good fit" for you, ask for a referral. No mental health professional wants to "not" help someone. They recognize that if the fit isn’t right, it’s not a personal rejection of them but is a sign of good mental health that the client/patient can identify a specific and realistic need within himself.

Cost of Treatment

The cost of mental health therapeutic services is extremely variable.

  • Non-profit and governmental groups may offer services at a reduced, "sliding scale" or no fee depending on the criteria for admittance to their program.
  • Health insurance covers services in many circumstances, depending on the policy.
  • Some providers and clients prefer “pay up front.” If no application for reimbursement is made (with employer or insurance company), then there will be no official documentation of the services outside the service provider’s office.

Finding the Right "Fit"

Finding the best counselor for each individual takes a little time, but it’s worth the effort.

If you know of someone you like and whose opinion you respect -- who sees a counselor -- they can give you a referral or suggestions on how they found their counselor.

You could, of course, just look in the Yellow Pages, but like any other service you find that way, you must be very careful.

You may want to ask your doctor, pastor or even a teacher you trust whom they might recommend.

Several Web sites are devoted to helping people find counselors. Some of these sites are very detailed and specific.

Googling "find a counselor" or "find a therapist" or "mental health counseling" will usually provide more information than you can go through: credentials, specialties, Web sites, etc. While Googling's not much different than using the Yellow Pages, it can be a good starting place to see what a broad spectrum of information is available

All mental health professionals must adhere to a strict code of ethics and are subject to law.

  1. Confidentiality is one of the most important. This means that everything you tell your counselor is not repeatable.
  2. Now, it is possible that a court order can be obtained to open specific parts of your files to a court case. This is nearly always in the case of harm to themselves or another person occurring. This is why all counselors and therapists are required by law to let the authorities know if a client/patient makes a real threat to their own or someone else’s life or safety.
  3. Otherwise, these records, like any medical records, are only released through specific, court subpoena.
  4. Many ethical points are actually law.
  5. But, in fact, most professional ethics codes are stricter than most laws.
  6. The main reason for this is that trust is the cornerstone of a healthy therapeutic relationship.
  7. The sanctions for unethical conduct can be loss of all credentials. It’s easy to see that a mental health professional has many good reasons to adhere to appropriate behavior.

Types of Therapy

There are several kinds of therapy for mental illness. Some people respond to one type, others do better with a different type.

Talk-therapy is the most well-known. It consists of intense conversations with the therapist and follows the guidelines for that particular method of talk therapy (rational-emotive, cognitive, psychoanalysis, etc).. There are several different methods within that type of counseling.

Behavioral therapy focuses on changing behaviors that are disruptive to life functioning into more adaptive and acceptable behaviors. The adaptive behaviors are reinforced with "rewards" and should eventually become more comfortable than the disruptive behavior.

Medication is most often used in conjunction with one or more other type of therapy to be most effective. Sometimes medication is short-term, but with some diagnoses, it is a lifelong commitment, just as insulin therapy is for diabetics.

Eclectic therapy is more of a group than a definitive type of therapy. Some therapists find that a little bit of several types of therapy work best for their client.

Controversial types of therapy -- including ECT (Electroconvulsive Therapy), Primal Scream, HUG, "Recovered (or Delayed) Memories," and others -- have fallen in and out of favor over the years. If you choose to work with a practitioner of one of these, research it carefully before committing to it.

The important point to consider, always, is the "fit" for you. Is this therapist a comfortable person to be with? Does this therapist's "method" just feel right? Do you feel safe? If you can say "yes" to these queries, then you will probably be able to work more effectively toward an enhanced level of mental health.

Below are some links that can help get you started on your search:

Therapists and Counselors: Network Therapy


American Counseling Association

American School Counselor Association

Marriage Builders


7/15/2008 9:31:08 PM
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