Dear Mrs. Web Personal Advice Column -- Welcome!

Dear Mrs Web, at times, recommends that her readers seek professional guidance for the problems they encounter. However, not all counselors, therapists, counselors, and other mental health workers are appropriate.

When choosing a counselor/therapist first ask around for recommendations. The best recommendations are from satisfied customers. Find out what the practitioner did and what they liked. The most important factor for successful counseling is the fit between the counselor and the client.

Set up a half-hour interview. Most practitioners will not charge for a brief interview. They are just as interested in looking you over. Evaluate all your visits with the following criteria: Did you like them? Did they put you at ease, and answer your questions? Did you understand them, and did they seem to understand you? Were they too stiff and formal or too relaxed? Did you like their surroundings? Were they attentive? Did you ask them for information about themselves and were they forthcoming? Are they committed to repairing marriages or do they see marriages as disposable? Did they offer you a Disclosure statement? Are they licensed in their counseling or psychotherapy? What are their fees? How do they handle insurance? Did you feel valued in your meeting?

Let us talk about faith and worldview. Look for practitioners who share your values, faith, and outlook. If you organize your life and worldview around a faith, you need to have a practitioner who respects your faith. I have found few atheistic practitioners respectful of faith and belief. In my experience, I have found them either hostile to religious belief or even they even worse, seeing religious belief and practice as a form of mental illness. During the initial interview, ask a practitioner what faith he practices, if any. Working with a therapist does not fall under the same guidelines as employment; questions about their religious practice are not out of bounds. Do not necessarily choose by denomination. An orthodox Protestant has less in common with a liberal Protestant than with a conservative Catholic. Remember that larger religious congregations and denominations often offer counseling services.

Ask about the practitioner’s track-record in marriage and non-marital relationships. A practitioner with a number of marriages under his belt has a very different view on marriage than one who is in a single, successful long-term marriage. Ask about the practitioner’s perspective on divorce. Listen carefully. Ask the practitioner how he works to keep marriages together. How he helps reconciliation to occur. What is her perspective on marriage? How she works toward helping couples develop healthy marriages.

If the practitioner is in a life changing process such as divorce, remarriage, or is suffering from a chronic illness these issues may affect your therapy. Dear Mrs Web remembers seeing a well-recommended therapist years ago about a difficulty with a parent. Out of the blue one day the therapist asked Dear Mrs Web whether it wasn’t time to dump her Dear Mr. Web and move on in life? Dear Mrs Web then realized that the therapist’s impending divorce had bled into her work. She was able to ignore the inappropriate suggestion, but was thankful she knew the therapist’s home life situation or she would have given more credence to the remark than it deserved.

As previously mentioned, for people with faith, finding someone who is respectful is important. For others, find a therapist who leads the kind of life you admire. A family therapist with a stable, intact family will have more to impart to you than one whose life is in tatters. Find a therapist who leads a full life and has other interests. Therapists who are totally therapy-minded often are unable to sit back and take the broad view needed by good therapists. Therapists who have overcome great tragedy can often help us in our own tragedies.

Find someone who has a few years on them. A wet-behind-the-ears newly-minted 28-year-old psychologist probably needs to marinate a bit in life being able to offer any effective pronouncements about your life.

Are you a parent? Do you have issues with your children? Will your children be a focus of your counseling? There is no one less valuable than a therapist who has not raised children attempting to guide your in your parenting. They are clueless about the passion and cauldron of the parent/child relationship. Ask the therapist how she succeeded in her parenting, and how she failed. What she would do differently. You don’t need details, but a broad idea of how this individual is valuable and can help you learn. If you are a hands-on parent, why would you work with a daycare maven? If you homeschool, don’t work with someone ignorant about the subject and takes the bulk of her work as referrals from the local school counselor.

Do not be shy. Dig a bit with them. Tell them why you are seeking help and ask them what particular skills and experience they would bring to your problems. Find out their areas of expertise. Be sure they are not a Johnny-one-note. Sometimes therapists specialize in one area, sexual abuse, alcoholism, or anorexia, or example, and all of their client’s problems are filtered through these important but narrow specialties. I prefer generalists who see the world broadly and can call on a number of treatment and perspectives.

In most states, all of the following are licensed. You can find out from your state licensing board if any legal actions are pending against them:

Psychiatrists - these are medical doctors who have advanced training in severe mental illness and emotional disorders. In these days of managed care one would use a psychiatrist to implement and oversee a major psychiatric drugs for people with schizophrenia, bipolar disorder and other illness requiring medication. People with depression that is not lifted through the medications used by their primary care doctor may see a psychiatrist for more intensive medication management.

Clinical Psychologists - individuals in most states with five years of doctoral training in psychology, or education. Often have one or more subspecialties. Clinical psychologists often administer tests used as instruments to diagnose and evaluate how people think and how well they function. Some clinicians also do talk therapy.

Clinical Counselors – licensed with two or three years of training and master’s degree. Trained across a broad base of disciplines. Educated to recognize and diagnose emotional problems, devise a plan of action and execute a treatment. Trained to have strong interpersonal skills.

Pastoral Counselors - licensed in some states with clinical training beyond their graduate or doctoral degrees with an emphasis on the psycho-spiritual aspects of life.

Marriage and Family Therapist - Individuals at a master’s and doctoral level who have received specialized training in family, works at the master’s or doctoral levels.

Clinical Social Workers – licensed with two or three years of training and masters degree. Trained in systems theories. Educated to recognize and diagnose emotional problems, devise a plan of action and execute a treatment.

Advance Practice Nurse Specialist - works under the auspices of a psychiatrist, manages medications, and does physicals and psychiatric evaluations.

Clinical Nurse Specialists - nurses with a master’s degree who has had advanced training in caring for psychiatric patients.

Peer Counseling – Available in some locations in specialized groups such as bereavement, Toughlove, suicide survivors, cancer survivors, parents of…, children of… AA, AlAnon. The list is endless.

Your local minister, priest, or rabbi A variety of levels of pastoral care abilities.

The level of education does not necessarily translate into clinical ability. Neither is state licensure, which just tells you that the licensee has done the hours, nor passed the test. No clinical quality assurance here. Board certification is a help, because it means that the practitioner has met national criteria. Post graduate training can be an indicator of the directions and interests of therapist and often these courses are more demanding as far as the skills. A somewhat better indicator.

Like most activities, psychotherapy is learned best by doing, and the capacity to support oneself as a psychotherapist over a number of years suggests, although it does not prove, that the practitioner is doing something right. Avoid the trendy, there are therapists who are on the cutting edge of whatever is trendy and in the news. These people are usually one half-inch deep.

Most therapists undergo their own therapy as a requirement, some continue in psychotherapy or supervision with other therapists to understand their reactions to their client’s issues, sharpen their skills and to practice effectively. Finding out whether they are in supervision is important and indicates a therapist who is interested in keeping their own personal issues out of your counseling hour.

Dear Mrs. Web does not recommend analytical psychotherapy as a way to solve relationship or family issues. Instead, she recommends working with good listeners, clear communicators, and people that will help with problems-solving. Someone who knows when to be the blank wall for you to bounce against and when to step forward and help find solutions, make suggestions and give information.

Best,

Dear Mrs. Web

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