What To Expect From Counseling

Deciding to go to a counselor can be a big decision. While it may be a hard decision to make, it may also be one of the best decisions you can make. It is important to find a professional counselor who is respectful of your Christian beliefs and values as well as one who is clinically competent. The information in this handout is designed to help you in finding the right counselor and knowing what to expect from counseling. If you have additional questions after reading this information, please call ACCFS. We are glad to assist you in any way we can.

Finding A Counselor

How do you find a good counselor in the first place? Below are some suggestions you may find helpful.

• It is usually best to go to a counselor that is recommended by someone you trust or by someone who would have information about qualified counselors in your area.
• Your local elder/ministers can help you find a good counselor in your area as well as provide you with spiritual guidance and support. They can also assist you in interviewing a counselor to see if s/he will be a good match for you.
• Apostolic Christian Counseling and Family Services maintains a database of counselors and specialty clinics located across the country. If you call the ACCFS office, someone will assist you in locating a professional counselor in your area.
• Your family physician may be able to help you find a competent counselor in your area as well as provide you with a referral to that counselor.

Understanding The Counselor’s Qualifications

Because of different kinds of degrees and state licenses, there are several types of counselors. Below is a broad outline of the types of helping professionals.

Psychiatrists: Have been through medical school and thus hold a MD or DO degree and completed a 4-year residency after medical school focusing in psychiatry. Psychiatrists approach mental illness primarily through a medical and biological model and therefore tend to utilize various types of medications (such as antidepressants, etc.) as a treatment strategy. Most of the appointments with psychiatrists will focus on medication management. While psychiatric training includes different types of therapy, psychiatrists do not generally provide therapy. However, they do have a basic understanding of the principles of therapy used by different mental health care providers.

Psychologists: Hold a Ph.D. or Psy.D. in clinical or counseling psychology. They specialize in treating mental disorders through counseling techniques and often do psychological testing. Psychologists most often work on a biopsychosocial model of mental disorders. That is, they look at how a person’ s emotional functioning and relationships have created problems and then seek to correct the problems. Psychologists cannot prescribe medication.

Social Workers: Hold a master’s degree in social work. Their main goal is often to understand the client’s home, work and social environment and then to help the person to function better within that environment. Social workers often focus less on diagnosis and/or testing than psychiatrists and psychologists do.

Master’s Level Counselors: Hold a master’s degree in counseling, psychology, human development, marriage and family therapy, etc. There is wide variability in the backgrounds and education of master’s level counselors. Most often they will work in a group practice under the supervision of a licensed psychologist. They will tend to have a clinical specialty (e.g., eating disorders, marital counseling, addiction), but they may also do general counseling (e.g., stress management, grief and loss).

A Note on Licensure: Almost without exception you will want to work with a counselor who is licensed in your state or who practices under the supervision of someone who is licensed in the state. Making sure that the mental health professional you see has the proper credentials will help to ensure that you will be treated competently.

Questions To Ask About A Counselor’s Qualifications

1. What type of degree do you have and what field is it in?
2. Are you licensed by the state?
3. Do you have any certifications? If yes, by whom?
4. How long have you been in practice?
5. What are your clinical specialties? What kinds of clients do you see most frequently?
6. Are you trained or skilled in treating _________________? (fill in your particular concern)

Expectations In Counseling

When going to a counselor you should have certain expectations for how you will be treated. At the same time your counselor will have expectations for your participation in therapy.

You Should Feel Free To:

1. Actively set your goals for counseling.
2. Contribute to and refine the treatment plan used by your counselor.
3. Ask any questions about your mental health condition and the therapeutic techniques being used to address it.
4. Express your opinions (both positive and negative) about your counselor’s suggestions.
5. Ask about all treatment choices that are available to you.
6. Give or withhold your permission, in writing, for your therapist to communicate with anyone outside the therapy relationship.
7. Ask for a referral if, at any time, you do not believe you’re getting the help you need.

Your Counselor, In Turn, Will Expect That You Will:

1. Arrive for your appointments on time.
2. Be open and candid. You have a responsibility to give your counselor the information needed so that you can receive the best possible care.
3. Let the counselor know when the plan of treatment no longer works for you.
4. Ask questions about your care so you can better understand your counselor’s role in that care.
5. Follow the plan and instruction for care, as agreed upon between you and your counselor.

Understanding The Counselor’s Approach To Therapy:

Every counselor has a different style. For example, some counselors are very structured in their counseling whereas others are quite open-ended. The following questions can help you learn about a counselor’s approach to therapy.

1. How do you come up with the goals for counseling? How will you involve me in developing those goals?
2. Do you give homework between sessions?
3. Would you describe your counseling as structured (i.e., well defined goals) or unstructured (i.e., open ended)?
4. Do you have clients take tests to help you understand their issues? (This can be very helpful at times.)
5. How do you define successful treatment?
6. How long do you think counseling should take? (Don’t expect an exact answer to this question. This will vary widely depending upon the issues involved.)
7. Do you include family members, friends, etc. in the counseling?

Logistics:

Before starting counseling, you should have information about fees, scheduling, etc. The particulars vary widely across counselors.

1. How often do you schedule appointments (e.g., weekly, every other week)?
2. What is your hourly rate?
3. Do insurance companies typically reimburse your services?
4. Do you have a sliding fee scale available (if needed)?
5. What is your availability after hours? How do you handle emergencies during these times?

Phases Of Counseling:

Counseling has a beginning, middle and end. Because many people do not understand this, they often drop out of counseling too soon and do not receive the full benefit of therapy.

1.  Phase #1 — Assessment/Interview: At the beginning of therapy, the main goal is for your counselor to get to know you and to understand the problem(s) you want to deal with.

a) Sometimes the questions the counselor asks may not seem to be related to the reason you decided to come to counseling. This is often because the counselor is trying to get a good understanding of the context of your life.

b) Your counselor may ask you to fill out some questionnaires or psychological tests. These tools can be very helpful in determining a diagnosis and how to best treat your condition.

c) At times it will be helpful for your counselor to speak with others about your treatment. With your written permission (called a Release of Information) your counselor can speak with a past counselor, family members, a physician and/or an elder/minister.

d) Your counselor may suggest medication may be a helpful addition to your treatment. Often you can simply have your counselor work with your family physician to obtain a prescription. However, in some circumstances it is preferable to work with a psychiatrist.

e) Don’t expect things to change much after only a couple sessions. Counseling is a process where you work together with a counselor to overcome your issues. It is not a “quick fix.”

2.  Phase — #2 Treatment: The treatment phase consists of actively working to deal with the issues that brought you to counseling.

a) The treatment phase is usually the longest phase of counseling.

b) You should start to notice things changing in this phase. If you don’t feel like things are changing or you aren’t sure your counselor understands your problem, by all means talk to your counselor about your feelings!!

3. Phase #3 — Relapse Prevention and Conclusion: People going to counseling often overlook this phase.

a) Some people stop going to counseling (or stop taking their medication) as soon as they start to feel better. Unfortunately, stopping counseling or medication too soon can lead to a relapse. If you are feeling like you are ready to end counseling, talk to your counselor about it and come to a decision together.

b) By the end of counseling it is important to have a plan in place as to what you would do if your symptoms (or relationship problems) started to return. It is also a good idea to have a plan for “preventative maintenance” so that you are able to maintain your gains.

Understanding The Counselor’s Belief System

When possible, it is beneficial to be able to work with a Christian counselor who is committed to respecting your faith background. Unfortunately, there is no standard for what a “Christian counselor” is. Also, at times, due to distance or lack of availability of professional mental health services, a professional counselor who is not a believer will need to be contacted. Therefore, the following questions may be helpful in determining whether a counselor is an appropriate match for you. You can start with the question, “Are you a Christian?”

IF YES:

1. Do you believe the Bible is the inspired Word of God?
2. How does this impact your counseling? Do you integrate Biblical truths with the counseling techniques? Do you pray with clients?
3. What is your church affiliation?
4. What do you do when someone’s doctrinal beliefs differ from your own?
5. With my permission would you be willing to talk with my elder/minister about my counseling?

IF NO:

1. How do you deal with matters of faith and religious beliefs in counseling?
2. With my permission would you be willing to talk with my elder/minister about my counseling?

Conclusion:

• If you have a particular concern about going to counseling, contact your elder/minister and have him help you.
• Remember that with your written permission, the counselor can talk with your elder/minister, family members and/or physician.
• You are welcome to periodically call ACCFS for a telephone consultation to talk with a counselor about how your therapy is progressing. This can be especially helpful if you have concerns about how the counseling is going.

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