Question 1

When is it time to seek counseling?

Accepted Answer

People go to counseling for a variety of reasons. Here are a few:
 • Need help navigating a personal or family crisis
 • Healing from emotional trauma
 • Managing anxiety
 • Managing depression
 • Managing a life transition
 • Want to improve relationships
 • Feeling stuck and need help to move on
 • Dealing with unresolved issues of grief, loss, or abandonment
 • Have a problem to solve and need someone to talk it over with
 • Want to improve parenting and/or family relations
 • Self-improvement
 • Need help managing a mental or emotional issue, such as anxiety or depression
 • Increased self-exploration and self-understanding
 • Improved interpersonal communication skills
 • Want to understand and make peace with past experiences 
 • As part of a multi-pronged, team effort to deal with a physical or psychological health issue
If you are experiencing a depression that doesn't lift after two weeks, or if you are dealing with a problem that feels overwhelming, or that is interfering with your daily life, work, school, or relationships, counseling may be able to help.
 
However, if your physical health and safety are at risk, you should seek emergency care right away. Counseling may be part of your healing process once your safety is assured.

Question 2

Psychiatrist? Psychologist? Psychotherapist? Who do I talk to?

Accepted Answer

There are many different kinds of mental health practitioners. Most of them can provide counseling. They differ in educational background, types of training, scope of practice (what they can or can't do), state licensing requirements and regulations, and the focus or mode of treatment. 
 
Here are some working definitions:
 
Psychiatrists are medically-trained (have an M.D. after their name) and are authorized to prescribe medication for things like anxiety, depression, and bipolar disorder. They will work with you to find the right medication in the proper dose to effectively treat your mental health disorder.
 
Psychologists have doctorate degrees (Ph.D. or Psy.D.) and specialize in psychological research, testing, and interpretation. A Ph.D. is more likely to focus on research, teaching, and academics; a Psy.D. is more likely to focus more on applied psychology to help people and organizations assess, diagnoise, and improve their mental health and functioning.
 
Social Workers have a bachelors- or masters-level education (BSW, CSW, LCSW, MSW) and are often associated with hospitals, schools, agencies, and other institutions. They assess mental and physical health and safety needs and provide appropriate interventions, including counseling. Social workers may respond to crises, provide home visits, and assist people by helping them access social services, programs, and other community resources.
 
 (or psychotherapists) also have a masters-level education (usually MA) and provide psychotherapy to individuals, couples, and families. Rather than being out in the community like a social worker, counselors are more likely to provide services in an office setting (such as a community agency or in private practice). Their scope of practice and emphasis may vary depending on their program of study, specialized training, preferred psychological theories and treatment methods, and state laws, regulations, and licensure requirements. All of them can assess, diagnose, and treat mental illness, and provide mental health counseling in a clinical setting.
 
Oregon licenses two two types of counselors:
 • Marriage and Family Therapists generally focus on individuals' relationships. They may work with individuals, couples, or families. In California, where I trained as an MFT, this was the general can-do-any-counseling license. In Oregon, an MFT is more specialized, focusing on primarily on family systems.
 • Licensed Professional Counselors can provide a broad range of counseling to individuals, couples, families, and groups – mental health counseling, career counseling, and so on.
Other states may license similar providers under different titles, including:
 • Licensed Mental Health Counselor (LMHC)
 • Licensed Clinical Mental Health Counselor (LCMHC)
 • Licensed Professional Clinical Counselor (LPCC)
 • Licensed Clinical Professional Counselor (LCPC)
Life Coaches are not licensed mental health providers. This means that they don't have any specific education or licensing requirements, and they are not trained in assessing, diagnosing, or treating mental health conditions. Life coaches work independently to provide one-on-one encouragement and advice and may offer a variety of services (wellness check-ins, goal-setting sessions, etc.) to assist people in their personal improvement goals.
 
School Psychologists and School Counselors work under the umbrella of education. Most have a background and licensure in teaching/education and have received additional training in order to provide mental health services institutionally to schoools and individually to students. They may refer children and families to counseling or social services for more specialized care.

Question 3

How do I find and choose a therapist?

Accepted Answer

There are lots of ways to find a therapist. You may get a list of therapists or referrals from your doctor, school, employee assistance program, or from an online counseling directory, such as Psychology Today. Some directories are based on geographical area, special interest, or professional affiliation. You may also find a good therapist by word of mouth or a recommendation from an ecclesiastical leader, a trusted friend (you probably know someone who has a therapist), or even online friends in your social media network.
 
Once you have a list of therapists, you can narrow down your search by location, specialty, the kinds of therapy they do, populations they serve, and more. You might look at their directory profiles or websites to get more of an idea of what they're like and whether they'd be a good fit for you. 
 
From there, choose one or two and send an email or give them a call. If they don't answer right away (they could be in a therapy session), be sure to leave a message so they can call you back.
 
Most counselors offer a free phone consultation or an initial interview. You can use that time to share your story, explain what you'd like to get out of counseling, ask any questions you, and get a feel for whether you and the counselor would work well together. If you like this counselor and feel hopeful about working with him or her, congratulations! You've found a therapist! If you and the counselor you found don't quite click, that's OK, too. Don't feel obligated to work with them. Just try the next counselor on your list. There are plenty of therapists of all kinds, and the perfect match is out there.

Question 4

How long does counseling take?

Accepted Answer

A typical individual counseling session is 50-60 minutes. An initial intake and assessment session may take longer. Some individuals, families, and couples may prefer 90-minute sessions, so that there's enough time to discuss everyone's side of the problem and do the work to resolve it.
 
How long one spends in counseling – in terms of sessions or weeks – can really vary, depending on things like the nature and duration of the problem, how severe the symptoms are, what you bring to the table (history, strengths, insight, work in between sessions), your specific goals and needs, the type of therapy you will be doing, and the quality of the therapist-client relationship. How long counseling takes can also be affected by insurance limitations, an upcoming move or life transition, or other outside factors. 
 
I encourage my clients to plan on 8-12 sessions, and evaluate from there. Short-term therapy can be quite effective in that time, new habits can be formed, and it will be clear by then whether counseling is helping and whether there are deeper, more complex problems to resolve.
 
But ultimately, how long you spend in counseling is up to you. You can try it and decide it's not your thing. Maybe the time isn't right, or you aren't ready to dredge up the past. Or maybe you jump in with both feet, work really hard, and find relief fairly quickly. Or maybe you find that what you thought was a small problem runs deeper than you thought, and you'd like to do some long-term healing. Any of those paths are OK, and you can end counseling whenever you choose.
 
For most of my clients, they are ambivalent about counseling at the beginning. It's a difficult step to take, and things often seem to get worse before they get better. But as things improve and they start to feel better, they really enjoy the process. They enjoy the little victories and the greater sense of control and accomplishment as they see their lives and relatinships improve. Eventually, life is pretty good, and counseling is no longer a top priority. Sometimes, they run out of things to talk about, or even miss sessions. These are signs that counseling is at an end. At this point, I invite my clients to have one final "termination" session to reflect on the counseling process, the goals they've met, and the progress they've made. Then we tie up any looose ends, and say our good-byes. These are often happy events as we celebrate completing this chapter in their lives and look forward to the future.
 
Whether it's a few weeks, a few months, or even a year or more, counseling is a gift to yourself and can be an amazing journey of growth and change.

Question 5

How can I get the most out of counseling?

Accepted Answer

Here are my suggestions for getting the most out of counseling:
 • Want it – A desire to change is the first step.
 • Set goals – What do you want to get out of therapy?
 • Participate – Ask and answer questions. Take what is said to heart.
 • Be open – Speak freely and honestly.
 • Be curious – Try out new ideas and experiences.
 • Practice – Do the homework, and apply what you learn.
 • Take courage – Getting counseling is an act of bravery and hope. You can do this! 
Counseling is a gift to yourself: It is an opportunity to learn, to grow, to heal, and to develop new ways of thinking and being so you can improve your relationships and live a happier, more meaningful, and satisfying life. A gift like that is worth opening.

FAQs

Frequently Asked Questions

If you're new to counseling, you might have some questions.