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About David Joel Miller

David Miller is a California Licensed Marriage and Family Therapist, Clinical Counselor, faculty member at a local college, certified trainer and writer.

When talk therapy fails – other learning styles

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Lessons of childhood

Child learning.
Photo courtesy of Pixabay.com

Not everyone learns things the same way.

Therapy is often conducted as if everyone learned in one way and only one way. In traditional therapy, we copy Freud, the client talks and the therapist listens. Eventually, the client says something, and then hearing their own voice they have this insight moment and suddenly they know what is wrong and what to do.

If only it was that simple. Sometimes just talking does not help everyone.

Several other methods of counseling have been developed to help those who learn or communicate best in another way. Unfortunately, those other styles of therapy do not always get the respect they deserve.

The three learning styles and therapy.

Some people are good at learning by listening to verbal directions. Verbal learns can reach decisions from listening to themselves talk things out.  Some people learn best by seeing things, they are visual learners. Some people need to be guided through the motions to learn. We call that kinesthetic learning. Some people learn best through a combination of methods.

While talk therapy may work well for verbal learners it is not always equally helpful if you have a different learning style.

Some people can’t find the words.

What if you can’t find the words to describe how you feel? There are a variety of reasons why someone would not be able to communicate about their experiences or feelings in words.

Young children may have been the victims of abuse or neglect; they may have grief or loss that is troubling them. What they do not have is the words to talk about those problems. That does not imply that a nonverbal person is not troubled by their problems.

People with a disorder on the autism spectrum may not be adept at verbal communication. Those who dissociate or are disconnected from their feelings have the same issue.

One method of working on those issues is to employ art therapy.  Art therapy does not mean the therapist and the client sit around and color or draw pictures. There is a reason for the art and it is therapeutic. The child who could not explain something bad that has happened to them can often draw a picture of that experience or of the feeling that event created. Once the picture has been drawn they can begin to describe the things they pictured. Amazing insights can develop as a result of using visual methods to supplement the client’s vocabulary.

Sometimes you can express yourself best by moving.

kinesthetic learners need to move and feel the situation.  One technique that I have used in a group setting is to have a client who is unable to describe how they feel about their family create a “family sculpture.” They make up a list of family members that we display on a whiteboard. Then other clients are asked to play the roles of those family members and positioned around the room. The client tells each “family member” where to stand.

The group then asks the client why each person is standing where they are. Clients discover that they always felt that one person was closer to them than another or that two family members stay apart from the rest and excluded them. This becomes a topic to talk about and sometimes exercises to do at home to improve relationships with those family members they saw as distant from them.

Other clients may find dance therapy or physical activity to be helpful in learning to understand and regulate their behavior.

Why other therapies?

The intent here is not just to engage in fun activities with clients as therapeutic as that can be, but to help the client to grasp their thinking, feeling, and behavioral issues in a way that fits their essential learning style.

To apply these alternative therapeutic modalities the clinical counselor needs to be trained in assessment and diagnosis of mental, emotional, and behavioral disorders.

For more on Clinical Counselors and the things you do please look at past posts on LPCC’s and check out the CALPCC (California Association for Licensed Professional Clinical Counselors. website.

Two books that I find especially helpful in working with young children or less verbal adults are:

Windows to Our Children: A Gestalt Therapy Approach to Children and Adolescents by Violet Oaklander

The Healing Power of Play: Working with Abused Children by Eliana Gill

For the full list of recommended books check out the listings over on counselorfresno.com at Recommended Books 

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Do people really need to stay on anti-psychotic medications over the long haul?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Drugs

Medications.
Photo courtesy of Pixabay.com

Are psychiatric meds for life?

The conventional wisdom has been that one you were put on an anti-psychotic you were going to be on it for life. People who stopped taking their meds were at high risk for a relapse.

Now comes a blog post, from no other than the director of the National Institute of Mental Health, reporting that we may have been wrong about this.

You can read the full director’s report at the link below.

http://www.nimh.nih.gov/about/director/2013/antipsychotics-taking-the-long-view.shtml

Please do not read my post or even the Director of NIMH and stop taking your meds. Talk to your doctor first.

But consider that meds and meds alone may not be what you or others with a mental illness really need.

You might also want to talk a look at Aaron Beck’s book on cognitive therapy and schizophrenia. The link is below.

Schizophrenia: Cognitive Theory, Research, and Therapy

“Counselorssoapbox is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com.” We recommend only books we think are good and maybe occasionally make a buck.

So as with all other treatments, one size, one method is not the right approach for everyone.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

13 things your counselor should know – part 2

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Counseling questions

Counseling questions.
Photo courtesy of Pixabay.com

In a previous post, we talked about the first 6 things that a Professional Clinical Counselor should know. Today the rest of that list.

7. Counselors know the principles of the diagnostic process.

What would you think of a doctor who sent all his patients for cancer chemotherapy first and then checked to see what was wrong later? You wouldn’t want to be treated for something you did not have, would you?

That is why diagnosis is so very important. It is also controversial and sometimes the diagnosis on a client’s file is flat wrong. I have written in previous posts about why we professionals may get it wrong and there is room for improvement but one thing a good counselor is to be able to do is to diagnose.

We may change that diagnosis over time. You may turn out to have more than one problem or we may treat the thing that looks the worse first, then move on to another thing.

However it is done, a good counselor needs to be able to diagnose and they need to be able to explain that diagnoses to their client. The diagnosis drives the treatment. We should treat the problem and leave the other things in the client’s life alone unless they want to change them.

8. Counselors know about research and evaluation.

Counselors need to know how to read research and understand the information. Some stuff looks good on paper but does not work when we try it on clients.

I read a lot of research in preparing to write this blog. I will not say I “get” it all. But I can spot some really suspicious research.

Recently I looked up a new counseling theory; there are over 300 of those and counting. This new therapy had one study done by the author of the book on this new system and then his study included only 5 or 6 of his patients.

I do not call that evidence.

See why professional clinical counselors need to know how to evaluate research? Would you want them trying out something on you that might not work or might even harm you?

9. Counselors know professional orientation, ethics, and laws in counseling.

Interesting that the law that created Licensed Professional Clinical Counselors lumped all three of these things together. In another context, this might be three separate things.

What this is telling the prospective clinical counselor is that they should know about their profession and presumably related professions. Who does what, when, and why?

It is always really important to understand a little about the law. It is recommended that counselors have lawyers rather than trying to memorize all the things in applicable laws.

Clinical counselors also need training in ethics. Not that ethical principles are hard and fast rules, but the code of ethics for a profession are general guidelines for how to conduct yourself.

The big ones as you may have gathered from my past posts on ethics are avoiding things that would harm clients. You can read more about this topic by clicking on the law and ethics category in the list of categories to the right.

10. Counselors should know about psychopharmacology.

Professional Clinical Counselors do not prescribe medication here in California or anywhere else that I know of. That is fine with me, as I think that if you are prescribing meds you need to have attended a medical school and know about medicine.

Still, we Profession Counselors see a lot of people who are taking meds, psychiatric or others. We need to have an awareness of what the meds are that clients are taking, are they complying with their doctor’s instructions, and so on.

Some medication that is prescribed for physical health issues can cause symptoms that might be mistaken for a mental health condition. We need to know when to refer clients to an MD and when to send them back so their primary care doctor might be able to take another look at the meds they take and the side effects they are experiencing.

11. Addictions Counseling.

Clinical counselors are supposed to have knowledge about the field of substance abuse. In the future, I expect to see more LPCC’s working in the substance abuse areas. I say supposed to because while LPCC’s have some training in substance use disorders. Some is just not enough.

It is amazing how little training in substance use disorders mental health professionals get. A standard MFT program might include a one weekend class, Friday evening and all day Saturday.

Contrast this with 36 units, eleven full semester classes on substance abuse and related problems, which are included in the CAADE Drug and Alcohol counseling curriculum which I teach over at FCC.

More training is needed but look to LPCC’s as the branch of the mental health field that combines mental health treatment with substance use disorder treatment in the future.

12. Crisis or trauma counseling.

Would you believe that there are mental health professionals that are uncomfortable handling a crisis? Sorry, you other professionals. I do not have time to wait around to make a referral to a program when someone is suicidal. (I know most of you don’t do that either.)

Crisis and trauma are huge parts of what brings people to counseling.

Stress, acute or chronic is a significant factor affecting mental health. Professional clinical counselors are trained to help clients with issues in these areas.

13. Advanced counseling and psychotherapeutic theories and techniques.

Beyond the basics, there are times when you may need tools in your counselor’s toolbox beyond the everyday ones.

This concludes part two of the discussion of the 13 things every Professional Clinical Counselor should know and understand. As I tell my students, these things probably will be on the test.

For more on Professional Clinical Counselors, LPCC’s and PCCI’s check out the CALPCC website.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

13 things your counselor should know.

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Counseling questions

Counseling questions.
Photo courtesy of Pixabay.com

What are the 13 Core Competencies of a Clinical Counselor?

Professional Clinical Counselors study and are expected to know these 13 important “Core Competency” areas.  Quality counseling should include a lot more than giving you a diagnosis, prescribing or referring you for medications, and then listening to you talk.

As important as listening is for any health care professional, the meat of counseling contains a lot more substance than diagnosis and listening. Here are the 13 areas a professional clinical counselor needs to know to help their clients. It helps to know this stuff if you ever expect to pass your licensing exam.

1. Counseling and psychotherapeutic theories and techniques.

Theories are about what we think causes those things we call mental, emotional, and behavioral problems. Sometimes we professionals get trapped into thinking all we are treating are diseases and disorders and we lose sight of the person with the disease.

If you and your partner can’t get along that is a relational issue. To treat this we do not need to give you a diagnosis of a mental illness. Could someone with a serious and persistent mental illness have a relationship issue? Sure they can.

The theory maps out the terrain you will cover in counseling. As any hiker in the woods knows, around the next bend in the trail, there could be a patch of flowers or there could be a hungry bear.

Those two situations call for different actions. That is where the therapeutic techniques come in. We may use one tool for someone who is having difficulty making decisions because they have no clear goals and a different set of techniques if their indecision is the result of abuse and being told they would never be any good.

2. Human growth and development across the lifespan.

There are common, almost predictable, events at certain times in our lives that have a high propensity to get us off track. Knowing what might happen to a client at a specific age and why can help a counselor and the client in taking this journey we call therapy.

Teens and early twenties have a high risk of suicidal thoughts, so do elderly men. For teens the risk may have to do with school, launching a career, or a failed relationship. His risk may also be increased by drugs and alcohol. Being the victim of bullying increases these risks.

Seniors have a high risk also, especially elderly men who live alone. The challenge at that point is coping with the loss of the things that used to give life meaning, their partner, their job, their health. Being alone, having to give up things they used to love are risks here.

A good counselor adapts their treatment to the life stage of the client.

3. Counselors know about career development theories and techniques.

Professional Counselors are specifically trained in Career counseling. Your Therapist may listen to how sad your lack of a job makes you, they may give you encouragement and tell you to just go out there and keep trying.

The Professional counselor can help you explore the world of work, find a direction that is right for you, and gets you started on a lifetime career journey. They can also really help displaced workers find something new to do with their work lives.

Nothing so improves a client’s mood as having a job they enjoy and that pays reasonably well. Having a relationship can improve your mood, but having a job can reduce a lot of the stress and fights that are a part of so many relationships these days.

4. Group counseling theories and techniques.

Group counseling is not second-class services. I know there are still a bunch of therapists who don’t like doing group. Many are flat afraid of it. But hearing from other people who have problems and how they are overcoming them, that can be very powerful.

Group has been the standard treatment for Substance abuse since the beginning. We are seeing some wonderful things happening in mental health groups these days.

Clinical Counselors are specially trained in running groups. (Note to employers, this makes them very productive and worth the extra effort to get an LPCC hired in an agency or governmental settings.)

5. Assessment, appraisal, and testing of individuals.

Several other mental health professions specifically do not engage in testing. Professional clinical counselors do testing for their clients and can help you make sense of these results. Yes, there are limitations on the amount of testing they do, sometimes they need to refer clients out to a clinical psychologist, but LPCC’s can do a whole lot more testing that their “sister” mental health professions.

6. Multicultural counseling theories and techniques.

Culture includes a lot more things than just race and ethnicity. Military families and their dependents have a culture that needs to be recognized and treated in special ways. Clients who come from backgrounds of poverty, regardless of their race have different cultural experiences.

Recent immigrants and their children have a whole set of problems that make their emotional problems more difficult.

African-Americans may or may not have come from poverty but their experience has been different. Many find it difficult to define who and what they are. One African-American described this to me as a form of cultural amnesia. I know where my ancestors came from, more or less, but most African-Americans, their cultural memories dead-end at slavery. So what part of their culture do they keep and what do they reform?

There is some theoretical justification for trying to match the counselor and the client. Women who have been abused may prefer a female counselor. Men may prefer a male counselor unless the female one is really good-looking. Most counselors are women.

Matching the counselor and the client is not always possible. Hence the whole need for training in multicultural counseling.

Next time part two of this list.

For more on Professional Clinical Counselors, LPCC’s and PCCI’s check out the CALPCC website. 

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

You’re creating your bad days

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

People fighting

Bad behavior.
Photo courtesy of Pixabay

Bad days don’t just happen sometimes we create them.

There are days when bad things happen. There is an earthquake or a hurricane but that doesn’t always add up to a bad day. Sometimes in the midst of all the chaos that Mother Nature sends our way we can find the good in that day. Everyone lived, No one is seriously hurt, life goes on.

Sometimes the universe doesn’t send any calamity our way but we have a bad day anyway.

Ever had a day like that? Things should be going well. Nothing out of ordinary but somehow you hit every traffic light. At work nothing goes right, everything takes longer than it should and you hate every moment.

What if you were creating these “Bad Days?”

If you were to discover that you are creating these bad days would you be willing to do something new? You don’t necessarily mean to create bad days but if you are doing something that gives you this result, would you be willing to try something different?

If you have somehow learned to behave in a certain way and the result of that behavior, the actions you are taking, are creating those awful days then you have some choices. Anything you have learned to do can be unlearned.

You may have slipped into a habit that is causing all these difficulties. Habits are entrenched. We aren’t always aware that we are doing something in a habitual manner but if you start paying attention you can change those habits.

Your brain believes what you tell it.

What you tell yourself becomes the basis for your actions. You don’t have to say the words out loud but if you repeat that thought enough it becomes an automatic thought. Thoughts become beliefs and your brain does its maximum to make your beliefs a reality.

Your brain will make things go wrong if that is what you are expecting, it wants to please you. Say over and over to yourself that “I can’t do this” and all the energy will drain out of you.

Tell yourself that “I am going to have a bad day” and you create it.

On some level, we all know this stuff. You have heard about the power of positive thinking but you can’t bring yourself to disregard those feelings that you are having that today is going to be a bad day. The more you think that today will be a bad day the more likely you are to create one.

You can’t change this by lying to yourself.

You wake up and you are on edge. Things are going to happen at work today and you are expecting this to be a problem-filled day. Your appraisal of the situation is that today will, despite your best efforts, “Be a bad day.”

Being a Pollyanna and telling yourself that life is perfect when you, in fact, know that there are troubles ahead will not fix this one.

This is one reason people will say that positive affirmations do not work. They pick things that they wish were true, that they would like to have happen or qualities they wish they had, but they have picked something that is so beyond where they are that they do not believe this affirmation. The result of these unrealistic affirmations is that you feel more hopeless than before.

The words you use to describe your challenges matter.

Mostly our thoughts are words. Our memories are largely stories saved by using words. Our nervous system can store pictures or emotions but when you think, say to yourself “This is going to be a bad day.” You are telling yourself a story using words.

Change the words and you change the story.

If you were to tell yourself that today will be difficult, could you believe that? What if you say today I face challenges? These ways of expressing what is ahead are not rose-colored glasses but they are a lot more optimistic than saying you will have a bad day.

Telling yourself that today will be hard is not the same message as telling yourself that today will be a bad day. Especially if you also tell yourself that you will find ways to cope.

Move from telling yourself that “this will be a bad day” and try saying to yourself “this will be a challenging day” and watch failure turn to opportunity.

Difficult times you can handle, you will get through this and you may grow or prosper.

Try this way of changing your life story and see what happens. If you find a set of words that helps you please share that with the rest of us. I am always on the lookout for anything that will help move me along the road to happiness.

Your self-talk does predict the future. 

Remember Self-talk and affirmations change your life. 

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Want to contact counselorssoapbox or David Joel Miller, LMFT, LPCC

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Want to contact counselorssoapbox.com or David Joel Miller, LMFT, LPCC 

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CALPCC board meeting – Professional Clinical Counseling

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Just returned from the CALPCC board meeting. http://calpcc.org/

CALPCC stands for California Association for Licensed Professional Clinical Counselors. It is an honor and privilege to be able to hang out with a group of people who are so concerned about the future of the Counseling profession.

The things we talked about will affect those who work in the field and those who receive services from Professional Counselors everywhere. I try to balance posts on the counselorssoapbox.com blog between things that are of interest to clients, people in recovery from whatever challenge you have, and those who consider themselves professionals. Some people fit into multiple categories.

Today a quick summary and then in the future I plan to write some posts about things I learned and thoughts I have had as a result of this meeting. Today just the highlights of my thoughts, and while I can’t speak on behalf of the organization or the board, as always I have plenty of thoughts of my own.

CALPCC’s primary mission is to further the profession of Clinical Counseling here in California. Many of our board members are very active at the National level and beyond.

I see a difference between the processes of counseling, therapy, and coaching. My students know that while I am licensed as both a Marriage and Family Therapist and a Professional Clinical Counselor I see those functions as two different things and describe myself as a counselor first and a therapist second.

One size does not fit all

There are some disturbing trends in mental health treatment these days.

The first step for most clients is to get them on meds. If they need them that is all well and good, but sometimes the meds cause harm.  In this era of “there is a pill for everything,” it is hard to convince those who pay that clients might benefit more from some counseling than from a meds only approach.

Meds can only do so much, to help a person to have a life worth living; they may need some help learning new skills, like living without drugs or setting and accomplishing goals.

It is estimated that California will need an additional 5,000 mental health clinicians by the year 2019. Many of those clinicians will be working with the poor, the unemployed, and the addicted.

Professional Clinical Counselors are uniquely qualified to fill that need. They are trained in 13 separate “core areas.” Including career counseling – getting a job, addiction counseling, and many have extra training in working with non-verbal clients or those whose primary learning styles is a mode other than words.

As more Clinical counselors get their license some are asking about the prospects of going into private practice. I am working on a PowerPoint and a longer article on the topic of counselors in private practice. That old Business Administration degree keeps calling to me. If that topic interests you, send me an email or other communication and I will put you on a list to get the link or the article when it is finished. The same goes if you are interested in the book that is in progress.

If you are interested in the role of Professional Clinical Counselors consider visiting the CALPCC website. (Links to CALPCC.org or counselorssoapbox.com are always appreciated.)

If you are a student, trainee, or intern, consider becoming a member. The Unlicensed rate is a paltry $30 and includes some perks like accesses to the member’s only page, info on job opportunities, and a discount on your liability insurance. That discount alone will pay for the membership or come real close.

CALPCC is a small but growing group. Most of the work is done by the members and volunteers, not paid professional staff. So when you join, consider volunteering to help and serving on a committee. Member input and participation in CALPCC is welcomed.

At this time the job openings for LPCC’s and PCCI interns are thin. CALPCC is working on getting more government and insurance positions open to LPCC’s. I believe that as more people know the things that LPCC’s can do the more job openings there will be. (Yes Mental Health Directors and other employers, LPCC’s are trained to and may see children.)

I know there are some behemoth counseling organizations who advocate for all mental health professionals, but if you are or plan to become a Clinical Counselor or another professional counselor then you owe it to yourself to join a group that advocates for Professional Clinical Counselors, particularly if you live here in California.

As you might guess I am a bit tired from the long drive and the writing schedule for the counselorssoapbox.com blog is behind schedule. It is a long drive from Fresno California to almost anywhere. If you find any typos that did not get corrected in the proofing, be kind, please.

Please – please, leave a comment or question. Those responses help me know if the things I am writing are useful and what other topics you would like to see posts about.

Can you talk to your therapist on the internet? Online dual relationships

Online dual relationships.

Computer

Internet.
Photo courtesy of Pixabay.com

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Update.
This is an older post from 2013. As a Rural result of the COVID pandemic counselors and therapists have had to learn to do a lot more online, distance counseling work. This post reflects the thinking back in 2013 but I feel sure the use of the Internet in counseling will continue to grow, and change in the future.

Has the internet changed relationships between clients and therapists?

A member of an online group to which I belong sent in this question

“Is it ever proper for a life coach or therapist to invite their clients to an online group, or for a client and therapist to be in the same group, or work on online projects together?  Can that cause a lot of problems?”

How this affects life coaches and how it might affect therapists and counselors are miles apart.

This is a problematic area for therapists and counselors. We are taught to avoid “Dual relationships” with clients. Some of these issues are pretty clear, dating, sex, borrowing money, and so on. Some dual relationships are easy to see and clearly, can cause problems.

The goal of avoiding dual relationships is to avoid harming the client, once you see the client outside the office there are risks for the client and the therapist.

We do not want to do or say things outside the office that identify this client as a patient in a mental health treatment setting. Sometimes there is just no way of avoiding the client when we are out in the community, so in those settings, most therapists will not say anything to the client and wait for them to say something first. That way they do not identify this person as a patient.

The smaller the town the more the risk of a second relationship. I live in Fresno; my clients live in Fresno, so far no problem. They shop at the same grocery store as I do.  I do not need to stop shopping there but I do need to not make the first move to say hi and especially we do not talk about their therapy in the store.

Then let’s say I go visit a new church. I run into a client there. Now can I talk to them? Maybe. I do not think I need to avoid churches or schools or civic organizations because my client might attend. What I do need to avoid is getting into a close friendship relationship with a client.

What happens when we both belong to a local group, say, NAMI and then we end up on a committee together? This may begin to create problems. I need to remember what they said in therapy and keep that separate from what they told me at the group meeting.

In that kind of situation, I might consider not being on the committee or ending therapy with the client so we do not have two separate relationships going. At this point, no matter what I do there are ethical implications. Dropping a client to be on the committee is a problem, being on together is a problem, telling the client they can’t be in this group is a huge problem.

Therapists need to consult.

Once these problems begin, or that possibility crops up, we therapists should get an opinion from our colleagues, maybe from a lawyer, and we may talk this over with the client.

Some therapists try to avoid these things by not joining or attending meetings, but you can only go so far with that before you give up your right to have a life.

Some therapists have tried to avoid these problems by not being online or having a social media account. While this may prevent some problems it can create others.

The hard part is keeping all your separate roles or “hats” separate.

Lots of therapists teach classes. We may see current or former clients there. I do trainings, Mental Health First Aid for example. Good chance that a former or current clients could show up there. I do not cancel the class or throw the client out of the training because they have seen me for therapy, but it can be a challenge if they start asking questions and I know this is an issue we have worked on in therapy.

The internet has changed all that.

Millions of people all over the world are now connected. I can run into clients current and former and not even know it. So we need to work on making sure that while we all engage in those activates nothing I do might harm any client’s current past or even a potential future client.

So here are some suggestions for both therapists and counselors and clients on the multiple relationships that can form on the internet. Let’s get specific with this reader’s questions.

Is it ever proper for a life coach or therapist to invite their clients to an online group?

Therapists should not be maintaining email lists of clients and then start mailing anything to them. If they happen to subscribe to my blog or a list of trainings or classes I treat them just like any other subscribers, not like clients.

For a client and therapist to be in the same group or work on online projects together? 

If they join a group and I join, so be it. I do not suggest this as a rule but if they are interested in homelessness and so am I, then I might give them the information about an online group. What they do with that web address is up to them.

Working together on an online project sounds like something I would not do until a lot of time had elapsed between them being a client and the project. If I had a client who was a web designer I would not pull out his file and call him for some help on my website.

If someone who worked with me got a list of designers and called him, then next session I would need to discuss this with him and we would need to decide if we were going to end therapy or he would not be able to also be working for me.

Can multiple relationships cause a lot of problems?

Yes having multiple relationships can cause lots of problems. I do not let that keep me from writing a blog or teaching classes but I am always looking out for these possible conflicts and avoiding them whenever I can.

Therapists and clients do run into each other, in the community and on the internet. The rules are essentially the same.

Do not get into a second relationship that will harm the client. Do not do things to identify them as clients or to violate their confidentiality and treat you various roles professionally and appropriately.

About life coaches.

There is no licensing for life coaches that I know of. Some have taken classes, anything from a one hour webinar on up. Some join coaching associations and they may or may not have codes of ethics. But coaches do not get confidentiality and you get no privilege in talking to them. They can say and do what they want and they may engage in all sorts of multiple relationships. If they hurt you really badly you have to sue them. It is common for coaches to keep mailing lists of former clients and to keep trying to sell you things and they can use your name or story in their materials or trainings. While there are some good coaches out there, coaching is not meant to help you with emotional problems that might include a mental illness.

I am sure that this will not be the last time we need to look at how the internet, blogs, and social media are changing relationships and how that might affect clients and therapists, but at least it is a start.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Does a low IQ score matter? Mental retardation becomes Intellectual Disability.

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Could you be mentally ill?

What Causes Mental Illness?

Mental retardation becomes Intellectual Disability.

How much do I.Q. scores tell us?

There has been a lot of misunderstanding about I.Q. Scores, what they mean, and just how significant a low I.Q. score may be. Some of the things we thought we knew have been challenged recently.

One definition of an I.Q. score is “The number of marks you make correctly on a piece of paper divided by your age.” We expect younger people to get lower scores and older people to get higher scores. What this does not tell us is what those scores are really measuring and what difference does it make.

The conventional belief is that people with low I.Q. scores are less mentally able.

This presumes that there are no biases in the test. Most test manufacturers or publishers work long and hard to eliminate biases. Still, we know that culture matters. Most I.Q. tests rely heavily on words, so if you speak two or more languages, but as a result know fewer words in each language you speak, you might score lower.

The presumption in the past has been that the higher you score on the I.Q. test the smarter you were and the better you should do in life. For someone with a low I.Q. we assumed that learning things would be harder.

This does not explain how someone with a low I.Q. score might be very good at a skill like music or a sport while the person with a high I.Q. might fail at those same skills.

Clearly I.Q. is not the whole story.

The mean I.Q. score is set at 100. The way I.Q. mathematics works are that the majority of people get scores from 85 to 115. That range is considered normal. So mix children with I.Q. scores of 85 and 115 together in a class and the teacher might have difficulty telling which is which, without reference to their test scores.

But if you get a score of 84, now we say you have “Borderline intellectual function.” If the 30 point differences between “normal” don’t make much difference how does that one point difference between 84 and 85 make so much difference?

The truth is small differences don’t make that much difference.

What matters most is what people do with the intelligence they have. So just like the really heavy kid may be no good at football and the skinny little kid may be able to run really fast with the ball, so to differences appear in how people use the intellectual resources they have.

The trend in the DSM-5 to move towards dimensional diagnosis rather than categories has changed our thinking from classifying mental retardation based on I.Q. scores to looking at how that low I.Q. is affecting the person.

So if the person is having difficulty with adaptive functioning because of their intellectual disability they get diagnosed with an intellectual disability disorder. If they are doing a good job of functioning despite a low I.Q. score they just may not get a diagnosis.

I realize this will take a while for the popular culture to catch up. It is no longer your I.Q. score that matters but what you do with what you got.

This shift by therapists and the APA is also likely to cause ripples in all that special education and those government programs that are still using I.Q. scores as a basis for services.

All in all, I see good and bad in this. Good if it reduces stigma against people simply because of the score they got on one piece of paper and bad if as a result of new definitions some people who need help get screened out.

Only time will tell.

So till then stop saying people have mental retardation and look to see if they are having difficulty coping with their life because of an intellectual disability or are they just sad, anxious, or upset about life events like the rest of us.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Will four beers get you drunk?

Gallery

This gallery contains 1 photo.

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor. Are lite beers less intoxicating? Yes, four beers can get you “drunk.” And it does not matter if they are lite beers or not. The brand and the nature of … Continue reading