When Help Is Needed: Choosing A Therapist
By Fr. Bogdan Djurjulov
Relationships are powerful for many reasons. From them we can derive strength, confidence and security. Relationships can be agents of healing and can come from family, friends, your pastor or a professionally trained counselor.
St. Paul, in his relationship to God clearly expresses a deep sense of confidence and security by saying “I can do all things in him who strengthens me” (Phil. 4:13). We know that God is always with us and often we converse with Him in the privacy of our own hearts. We know, too, that God is among us in His identification with others; that God works through other people and healing is a corporate experience and involves, me, others and God. It’s not something I have to tackle alone. Perhaps there have been times when you have thought or said what St. Paul has said “I do not understand my own actions. For I do not do what I want, but I do the very thing I hate” (Romans 7:15). It is usually at times like these that our prayer life gets more active and the answer comes to us - talk to someone. There are times in our lives when we need someone who can be really objective with us. Asking for help is not always easy. Sometimes we need outside counsel to help us see what we can’t see alone.
SEEKING HELP DOES NOT MAKE US WEAK
It’s no secret that even Christians at times need a little more help than a good friend-to-friend talk can provide. For whatever reason an outside objective view may be necessary to help us sort things out. Perhaps you’ve considered a therapist or counselor to help you sort things out - maybe it was suggested to you by your doctor, family, friend or pastor. Any variety of things can trigger the need to seek help. Seeking help does not make us weak. On the contrary, admitting we need help is a big step towards finding resolution to the situation. We may not like the reality we see, but paradoxically it won’t change without moving in the direction of confronting it. The power to change is in the acceptance of the reality - like it or not; it’s there. It’s like needing to fix a flat tire before you can move on. If not fixed, it makes other things worse too.
WHO’S OUT THERE
Choosing a therapist can be a confusing ordeal. There are many kinds of psychotherapists and counselors to choose from. There are psychiatrists who are medically trained doctors with special training in psychiatry, and psychologists who usually have a Ph.D. in psychology. Psychiatrists can prescribe medication, psychologists can’t. There are social workers who hold the Master of Social Work degree (MSW) as well as social workers who are certified and are designated as CSW’s and those who belong to the Academy of Certified Social Workers, the ACSW’s. You will also find many therapists who specialize and address certain types of issues like marriage, family, addictions, sex, adolescent issues, hypnosis, neurolinguistic programming, etc. Often these counselors will hold at least (but not always) a master’s degree in their respective fields and frequently have a doctorate. Each of these people often have special certification in their field of expertise. An alcoholism counselor may have the title of Certified Alcoholism Counselor or C.A.C. These certifications speak to a counselor’s competence as well as having been examined by a regulating body of professionals. Of particular interest here is the Pastoral Counseling field. Pastoral counseling is a form of counseling, but with a specific focus as the title implies. Like the others, it is done in a one to one relationship or in group form and is a ministry that assists pastors and their families in working through problems in relationship to self, others and to God. It has a theological focus which sets it apart from traditional secular psychotherapy.
The average therapy session lasts anywhere from forty-five to fifty minutes and the fees can range from $25 to even $120 and more per session. Psychiatrists generally charge the most. Many clinics and private practice charges are covered by insurance companies (ask to be sure). Most county mental health agencies, pastoral counseling centers and some therapists offer a sliding fee scale for counseling based on earnings and ability to pay. Some centers use intern trainees who are clinically supervised to lead counseling sessions, but are not fully credentialed or licensed yet.
SELECTING A THERAPIST
Certainly the Yellow Pages has a long list of them (and not to be discounted), but the best recommendations come from people you know; a friend, your pastor or doctor. The Orthodox Christian Association of Medicine, Psychology and Religion (OCAMPR) for example can be a good source for a referral. Metropolitan Theodosius has himself endorsee this organization. Persons in this organization are interested in the connection between the above disciplines. For information on OCAMPR in your area write to OCAMPR, P.O. Box 958, Cambridge, MA 02238. Your local mental health agency may be able to help or refer you to a clinic or therapist in private practice. Pastoral counseling centers can also help direct and counsel you. For specific concerns related to alcoholism and drug abuse, your local affiliate of the National Council on Alcoholism and Drug Dependence can help. Call 1-800-NCA-CALL (1-800-622-2255).
ASK QUESTIONS
Assuming it is not an emergency situation, plan to interview one or more therapists before you set up an initial appointment. Ask about the therapist’s training, background and approach to counseling, fees and expectations. Describe the kinds of issues you want help with and be certain s/he is experienced in dealing with those issues. Try to set up an in-person interview before you commit to anything. Some therapists will let you come in for an initial half-hour session at half their regular fee. Others will not honor such a request. Some prefer the full hour to get your Feelings during your first session. Ask yourself if you feel comfortable with the therapist and does the therapist appear comfortable with you. Is the therapist casual, informal or stiff? Does the therapist nave a good sense of humor? Is s/he flexible? Does what the therapist says to you make sense? Does it go contrary to your value and belief system? Does the therapist treat you with respect and dignity. Is your time with the therapist interrupted with phone calls and other annoying intrusions or does the therapist make it clear s/he is in session and not to be disturbed? These and other questions should be asked of yourself.
Don’t hesitate to see several therapists before choosing one. Don’t think you have to stay with a particular therapist simply because you have started with one. If you are asked to see several different therapists in the same counseling practice, ask why - what’s the rationale? Remember, the therapist works for you!
HOW LONG DOES IT TAKE?
When you finally decide on someone, plan on giving it at least four to six sessions before you decide whether or not to continue. Usually it takes at least that long to begin uncovering areas of concern and plan more specific treatment. Don’t quit just because you are given some feedback you don’t like to hear. If it’s a relationship issue that emerges, the therapist may ask the other(s) to get involved. Think about what was said and keep the door open. therapy helps us to see things about ourselves we can’t see by ourselves. It helps us look for alternatives.
For the average person, six months to a year is normally enough time to work through problem areas. How long it really takes is purely an individual issue. Much depends on the nature of the presenting concern as welt as your own participation.
After all things are considered and you feel ready to end, then do so. Have an aftercare plan set up, keep your options open and keep in touch. Whom you choose to tell about your counseling experience is entirely up to you.
AFTER THERAPY
The integration of your new learning will take time to put into action in your daily life. Our Lord has graciously given us the potential to change; to grow in His likeness. Changes in ourselves also affect others. Others will often notice changes in us even before we see them in ourselves.
OUR CARING COMMUNITY
Our Orthodox Tradition has always emphasized a holistic perspective concerning our growth in Christ - body, mind, and soul. Our spiritual growth is a combination of man; things working together to make a whole. The Greek word synergie points to the whole being greater than the individual parts. Guided by the Holy Spirit, understanding can come from our efforts.
FOR DISCUSSION:
1. Where do medicine, psychology and religion meet when it comes to getting help for physical, emotional, and spiritual needs?
2. What role does prayer have in the healing process?
3. How would you describe the “caring community”?
4. How do we help someone who doesn’t want it?
5. Discuss a person’s struggle to trust or to have faith in him or herself, in others, and in God - as opposed to the temptation of hopelessness.
6. How can we offer compassion without becoming overly manipulative and protective?
7. How do we sometimes “enable” unproductive and even abusive behavior to continue?
8. Finally, talk about what it is like to ask for help.