Therapeutic Help For The Journey
Figure Out Solutions to Your Challenges
What are some of the common issues that people seek out therapeutic help for? Many programs and books suggest that exploring counseling is a good idea but they don't tell you HOW to do it. I've included this section to assist in making this process easier to figure out.
FAMILY- RELATIONSHIP ISSUES
¨ Parenting/step-parenting – Parenting a child with Attention Deficit/Hyperactivity Disorder
¨ Family relationship enhancement
¨ Adult children of alcoholics/other dysfunctional families
¨ Aging parents
¨ Codependency (a term to describe imbalanced or unhealthy support to/of others), boundaries
ADDICTIONS/COMPULSIONS (one’s own, or dealing with a loved one’s)
¨ Drug abuse
¨ Compulsive exercise
¨ Food (including compulsive overeating, dieting, anorexia, bulimia, food obsessions)
¨ Sexual addictions
¨ Compulsive shopping/spending
TRAUMA—PHYSICAL, EMOTIONAL OR SEXUAL (past or present)
¨ Sexual abuse
¨ Sexual harassment
¨ Child abuse
¨ Domestic violence
¨ Elder abuse
¨ Coping with chronic pain/illness
¨ Support for specific illnesses, and for caretakers of people with those illnesses
BALANCING INTENSE EMOTIONS
¨ Anger management
¨ Stress management/relaxation skills
Types of Help Available and Costs
What types of therapeutic help are available? What are the differences between them?
Some common types of therapeutic resources available include:
¨ Individual counseling: one counselor with one client (generally for 1-hour sessions)
¨ Couples/family counseling: one counselor with one couple/family (generally for 1-hour sessions)
¨ Therapy groups: one (occasionally two) counselor with 4-12 clients (generally 1.5-2 hour sessions)
¨ Self-help support groups: leaderless or members rotate leading; (generally 1- 1.5 hour sessions)
¨ Psychoeducational classes: taught by therapist or other healthcare professional (generally last 1.5- 2 hour sessions), 4-12 weeks
¨ Employee Assistance Programs: If you have benefits through your own or your spouse’s employer, you may have access to their employee assistance program (EAP), which typically offers a limited number of counseling sessions at no charge.
Some differences among these are:
¨ Individual, couples and family counseling allow you the most time to focus on your individual situation and concerns.
¨ Therapy groups, self-help groups and classes may help you feel less alone with your problem/feelings, allow you to learn from others’ experiences and help others by sharing yours, and can be a rich resource for building support/friendships that may extend outside the group.
¨ Psychoeducational classes focus on information and skill building.
¨ Therapy and self-help groups are more likely to focus in-depth on members’ feelings and personal histories.
¨ Employee Assistance Programs are adequate to meet some people’s needs; in other cases, the EAP counselor will refer the client on to other resources after they have used up their allotted EAP sessions. If you’re not sure what you want to focus on, the EAP sessions may help you clarify this before proceeding to a private counselor.
¨ Some people find it helpful to use a combination of therapy, classes and/or support groups while working on a given issue in their lives.
¨ Therapy groups typically cost less than individual, couples, or family sessions.
¨ Psychoeducational classes are less expensive than therapy (about $10 per class) and are offered through hospitals and other community resources; most of these make their catalogs available to the public at no charge (see Kaiser Permanente’s Health Education catalog for a listing of our current offerings).
¨ Self-help groups are generally free or based on voluntary donation.
¨ Low-cost or free therapy is available in some settings, including county and other government-funded services, agencies that receive charitable contributions (United Way, churches, etc.), and those where student interns provide the counseling services.
¨ Some private therapists offer sliding scale or low-income slots; some of these allow clients to determine what they can afford within the sliding scale, while others define the price based on the client’s income.
¨ Therapists who have the title “Doctor” (whose degrees are either have Ph.D., Psy. D and MD) often cost more than those with master’s degrees. In Oregon, only those with doctorates can call themselves “psychologists;” those with Masters degrees usually refer to themselves as “therapists” or “counselors.” Fees vary, but usually range between $75 and $150 an hour.
Finding and Choosing a Therapist or Resource
How do I find the right therapist or resource to meet my needs? How can I get recommendations or find out who is available?
Personal recommendations from friends or those you trust (health care professionals, etc.) can be very helpful. In addition, there are a number of free information and referral phone lines, where you can anonymously get assistance in finding the resources you need. While there are some variations between them, these services typically provide general information, and will also help you select an appropriate mental health resource based on your needs. A number of these services are listed below. These are examples of what to explore in your city. The American Institute of Preventative Medicine's Mental Health Fitness Guide listed below is excellent.
What other things should I consider before I choose a therapist?
You may want to consider:
¨ Practical considerations (location, office hours, price range/insurance, etc.)
¨ Any personal preferences: age, gender, religious affiliation, etc.
¨ Specific topic area(s) you want to focus on and professional expertise (addictions/compulsions, life transitions, sexual trauma, family/relationship problems, mood disorders, etc.)
¨ Licensure (see below)
¨ Therapeutic “style” (short term vs. long term, directive vs. non-directive, etc.).
Should I see a licensed therapist? What’s the difference between a social worker and a professional counselor? How can I better understand what their credentials mean?
The “L” that begins many credentials (LCSW, LMFT, LPC, etc) generally indicates “licensed,” and typically reflects state licensure; other credentials (MSW, MA, Ph.D., etc.) indicate the kind of graduate degree the person has earned. Many different kinds of degrees can qualify a person to be a counselor, including doctorates; masters in psychology, education, or social work; nursing degrees, and degrees in pastoral counseling.
There is a difference between licensed and unlicensed providers. At this time, it is legal to practice counseling in the state of Oregon without any training or licensure, so anyone can advertise themselves as a counselor. This makes it especially important to be a cautious and informed consumer. One advantage of going to a licensed provider is that this indicates they have met a certain standard of knowledge, training and experience as defined by the state. It also means that there is a governing board, who can be contacted in case of complaints against the counselor and, if the charges are serious enough, the board will investigate, and may revoke the license. If you are considering going to a licensed provider, you can call their board to find out if any complaints have been filed against them and, if so, what the board’s conclusions were after investigation.
Another advantage to seeing a licensed provider is that most insurance companies will only cover a state-licensed provider. (Be aware, though, that just because a provider is licensed, this doesn’t guarantee that your insurance will cover them.)
On the other hand, there are good counselors who are not licensed, so if you find an unlicensed counselor who seems like a good “fit” for you or has been recommended, this can be a perfectly viable choice. In any case, it is best to use the recommendation of someone whose judgment you respect in selecting a good counselor, rather than relying on credentials or insurance coverage alone as a basis for selection.
What questions might I ask the therapist to help me determine if he/she is a good “fit” for My needs?…someone I feel comfortable with?
¨ How long is a typical course of treatment for this kind of problem?
¨ Have you worked with this kind of problem before? What is your understanding of what causes it, and what cures it?
¨ What type of approach would you take to helping me with this problem?
¨ After talking to a potential provider, ask yourself: Is this someone I could feel comfortable confiding in? Do they listen carefully? Do they treat my questions and concerns with respect, and provide clear answers that I can understand?
¨ What is most important is how comfortable you feel with the therapist’s personal style and approach. Be aware that you may not be able to completely evaluate this “fit” until you have a session or two with the therapist.
What if I’m considering joining a therapy group? What questions might I ask?
¨ Is this a time-limited group? If so, how long does it run?
¨ Does the group have a topic/focus, and if so, what is it?
¨ Is there variety in ages, gender, etc. in the group? (If not, consider if you would be comfortable, especially if you would be the only person of your gender, age group, etc.)
Used with permission from © 2004, Kaiser Permanente Northwest Health Education Services, Freedom From Diets Program, Optional Sources of Support Guide
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