Psychological Matters

Thought: ". . . be wary and wise as serpents, and be innocent (harmless, guileless, and without falsity) as doves." Matthew 10:16b Amplified Bible Before graduate school education is complete, every mental health clinician is required to understand and is tested on the ethical guidelines of treatment. Yet, despite such training, too often you hear on the news about therapists who have abused their power. What went wrong? The relationship between therapist and client is an unusual one in that the counselor is seen as the expert.  This leads to a relationship where most of the interpersonal power is on the therapist's side. As a result, there are opportunities for the misguided, dysfunctional, or damaged clinician to hurt clients.  Being aware of and alert to signs of treatment relationships gone wrong will enable you to protect yourself better should such a situation occur. Due to the unique type of relationship between therapist and client there are some basic g...

Thought: "let the wise listen and add to their learning, and let the discerning get guidance-" Proverbs 1:5 You have found a good therapist and finished your initial appointment. You felt that your presenting issues were defined; treatment goals were established. Now what? Moving from the initial interview into the actual treatment phase is often an awkward stage of therapy. Your counselor should help you with this transition by telling you what is expected. My counseling style is insight-oriented therapy. In the first session, I inform my new clients that in future sessions they will have the freedom to talk about whatever comes to their mind or is a concern to them. I have found that no matter the topic, whether upbeat and positive or discouraging, it reveals how clients feel about themselves and the world around them. As a result, I don't lead sessions into a particular direction. I usually start each session with an open-ended question, such as "how are you doing...

Thought: “Then little children were brought to Jesus for him to place his hands on them and pray for them.” Matthew 19:13a The initial session with a minor is different from an adult's session in a couple of ways. First, one or both parents need to accompany the minor to the appointment since in most states children under the age of 13 cannot legally consent to treatment. During this first appointment, the parent(s) will also be the main source of the child's history considering that there are many details that children don't know, such as, the parent's marital history, any unusual issues during the pregnancy, labor and delivery of this child, and the child's early developmental history. Obtaining consent and gathering history may occur in the child's presence or during a separate appointment. Either interviewing style is appropriate and varies among clinicians. Treatment circumstances will also determine the interviewing process. There are some instances when t...

Thought: "Otherwise they might see with their eyes, hear with their ears, understand with their hearts, and turn and be healed." Isaiah 6:10b Your first appointment time has arrived. What is reasonable to expect from this interview? That is what the first appointment is: an interview. During the first 45 to 50 minutes the counselor will listen to why you are seeking help, the history of the issue(s), and your hopes and expectations of treatment. This information will determine the course and method of therapy. The style of first appointments varies from clinician to clinician. Some therapists have a specific set of questions that they ask every first-time client. Others will start with an open-ended question and let you lead the direction of the appointment. The purpose of either method is to understand your emotional or psychological difficulties and to establish some treatment goals and objectives. By the end of the session you should have a sense that the therapist has an ...

Thought: "Reckless words piece like a sword, but the tongue of the wise brings healing." Proverbs 12:18 At this point in the process of finding a good therapist, you have obtained the names of several clinicians from reputable sources. Many of them have credentials you haven't seen before, such M.D., D.O., Ph.D., Psy.D., Ed.D., LCSW, LLP, and MFCC. What do these degrees mean? Mental health specialists fall into one of four categories: Psychiatrists (M.D. or D.O.): These individuals are medical doctors who have specialized in the diagnosis and treatment of mental health disorders instead of another specialty, such as cardiology or dermatology. They have medical training and are licensed to prescribe medication. They assess individuals from a biological angle and provide medical treatment. Psychologists (Ph.D., Psy.D., Ed.D., or LLP): These therapists have intensive training in psychology. They have studied human behavior and personality development. They provide counseli...

Thought: "let the wise listen and add to their learning, and let the discerning get guidance-" Proverbs 1:5 It happened again last week. A new client came into my office for her first appointment. She had been referred by her primary care doctor's office, but was hoping to start medical treatment. She didn't know I only provided "talk therapy" and not medication. I worried that she may have wasted an hour of her time only to have the end result be another referral to a different specialist. Fortunately, this error only occurs a couple times a year, but even one time is too many. How could this have been avoided? I would like to use this article to help you be more informed as you seek psychological help. Identify your primary reason for seeking treatment. Has there been a change (or changes) in your overall psychological and physical functioning? What symptoms you are experiencing? When did these symptoms start? Are you looking for counseling (...

Thought: "Plans fail for lack of counsel, but with many advisers they succeed. A man finds joy in giving an apt reply--- and how good is a timely word!" Proverbs 15: 22-23 Probably the most common question I'm asked is for a name of a good therapist. My friends and family figure I must have contacts since I work in the field of psychology. I consider this a very important question and am glad to give recommendations. In the 1960 and 70's there was an explosion of new counseling models. Each specialty group thought it had found a better way to treat emotional problems. Was this assumption true? Whose treatment techniques were the most effective? Research studies began with the belief that one clinical model would rise to the top as the most effective treatment style. The results were surprising. No treatment modality was better than another. Instead, the studies found that the personality characteristics of therapists influenced treatment outcomes. Counselors who were ...