The future of counseling, therapy, and coaching.
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The Future of Counseling
By David Joel Miller, MS, Licensed Therapist & Counselor.
The fields of counseling, therapy, and coaching are changing.
I had already seen some changes in the field starting to happen even before Covid. But because of the emergence of the new virus and the measures we had to take to cope with that virus, not only the field of counseling but society, in general, has undergone some significant changes. Reminds me of some of the other changes I’ve seen in my lifetime. People may bemoan the loss of a simpler life, but once you’ve installed running water and electricity in your home, there’s no going back.
Most of what I am talking about here applies primarily to mental health counseling and therapy. But some of the changes are starting to spill over both from and into substance abuse counseling and life coaching. Some of what I am observing may simply be the result of where I practice and the clients I see. But what I hear from other practitioners seems to convince me that the changes I’m seeing are spreading throughout the country and the fields of counseling and therapy.
Some of these changes started even before Covid.
There’s a common conception that therapy, the talking cure, was primarily designed for upper- and middle-class white people. However, many people of color or those of lower socioeconomic status have experienced counseling as something done to them rather than with them.
Recently, I have noticed an increase in clients who reported they were skeptical of counseling until a family member or friend talked them into it. Their previous experience with therapy had often been mandated and unpleasant. If you are forced to go for therapy with a school counselor who tried to convince you to change your behavior because you had gotten into trouble, it’s hard to look on counselors in the future as your ally.
There’s an increasing diversity among counselors.
When I went through the graduate program, it was unusual to have more than one or two male students in the class. Traditionally the helping profession was largely the province of social workers, who tended to be primarily female. Even among marriage and family therapists, it always seemed to me that the preponderance of the practitioners were female. However, the number of male counselors entering the field has recently noticed an increase.
Clients are becoming more diverse also.
During the last few years, starting even before Covid, I’ve noticed an increase in client diversity. It appears to me that there are a lot more African American clients coming to voluntary counseling. I’m also seeing a slight increase in the acceptance of counseling and therapy by people of Asian ancestry. As with all other innovations, it appears that the younger the person, the more likely they are to accept new alternatives.
Distance or remote counseling is here to stay.
When I first went to graduate school, the idea of doing counseling in any other way than a forty-five-minute session in an office would have been looked at as downright unethical. There were always a few radical therapists who might do “in vivo” sessions. They might take a client for a bus or train ride to help them overcome their anxiety. But in general, all sessions had to be done in the office.
At the beginning of Covid, I encountered a lot of clients who wanted to make appointments but only if they could have in-person sessions. As a result, many therapists were reluctant to try to conduct sessions by any means other than in person. But across the last three years, the acceptance of using technology as an alternative to in-person sessions has grown.
The use of distance counseling is now so common that beginning in 2023; counselors will need to take a continuing education class focused on the laws and ethics of distance counseling.
The business of therapy has changed.
How therapy is conducted, who conducts it, and how it’s paid for have all been changing. The things we call counseling, therapy, and coaching have diverse roots. Medicine, psychology, social work, systems theory, and self-help groups all contributed to this confusing thing we now call counseling and therapy.
Who does the work of talking with people, and what qualifications they need have been changing at an ever-increasing rate? Here in California, where I work and practice, marriage, and family therapists were first licensed in 1963. Before that, social workers were the only one of the three “sister professions” working in this state. The situation in other states has progressed in various orders.
Most of what we now call counseling or therapy stems from medical doctors following in the tradition of Sigmund Freud of attempting to solve thinking, feeling, and behaving problems using a thing called “the talking cure.” Some of the ways this work is done today have also been informed by the field of psychology and self-help groups, notably Alcoholics Anonymous.
The traditional model was one professional working with one client in a small treatment room, typically hidden from everyone else in an effort to maintain that thing we call confidentiality. However, recently that model has been seriously disrupted as insurance companies have funded treatment, group counseling and self-help groups have become more common, and technology has offered options to the one patient, one treatment provider pattern.
In an upcoming post, I want to talk more about how the business of counseling has changed and how I expect to see it continue to change in the future. Thanks for reading my writing, and here is wishing you a happy life full of meaning and purpose.
Does David Joel Miller see clients for counseling and coaching?
Yes, I do. I can see private pay clients if they live in California, where I am licensed. If you’re interested in information about that, please email me or use the contact me form.
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