6 Top Reasons to Go for Counseling.

By David Joel Miller.

Reasons you may want to consult a counselor.

Many people avoid going to see a professional counselor until their life falls apart.

Counseling

Counseling or Therapy
Photo courtesy of Pixabay.com

There’s been a growing acceptance of preventative medicine for physical health issues. Still, some people believe that going to see the doctor or the therapist is a sign of weakness.

An increasing number companies provide E.A.P.’s (employee assistance programs) for their employees. There are plenty of good reasons to see a counselor before your problems become severe.

Avoiding counseling appears to me like walking around town with a broken leg. See the doctor, and that leg might heal, keep walking on that broken leg you may do permanent damage to it.

1. There are things you can’t talk to your family and friends about.

Your family and friends may be sympathetic but if you keep talking to them repeatedly about the same problems you can burn them out. People close to you may judge you for what you think or how you feel. A professional counselor can listen to you nonjudgmentally.

2. You don’t know what you don’t know.

Professional counselors can provide you with the information you may need. They talk to many people with similar problems. They may be able to fill in gaps in what you know and refer you to resources where you can find answers to your questions.

3. They can mentor you on life skills.

If you didn’t have a knowledgeable adult or older sibling in your life, a counselor could fill that need. Even when you have great role models, you may not have learned every lesson. Counselors can help you with skills to reduce or manage your anger. They can help you cope with your anxiety. If there are feelings you find it difficult to manage, a good therapist can help you learn the needed skills.

4. When you get counseling, they can tell you the truth.

The smartest people sometimes get extraordinarily dumb ideas. Top executives need to beware of yes-men and yes-women. The people close to you may not want to hurt you or offend you by telling you the truth. A professional counselor can help you do something called reality testing. They can help you sort out your thoughts and separate the good ideas from the fanciful ones.

5. Prevention is cheaper and faster than cure.

Dealing with emotional problems in the early stage can prevent them becoming huge problems.

6. Counselors can give you another perspective.

Successful athletes have coaches. You can’t see your own swing.  A good counselor can give you a fresh perspective on the challenges you face.

Two David Joel Miller Books are available now!

Bumps on the Road of Life is now available in both Kindle and paperback format.

Bumps on the Road of Life.

Your cruising along the road of life and then wham, something knocks you in the ditch.

Sometimes you get your life going again quickly. Other times you may stay off track

Bumps on the Road of Life.

Bumps on the Road of Life.
By David Joel Miller

and in the ditch for a considerable time. If you have gone through a divorce, break up or lost a job you may have found your life off track. Professionals call those problems caused by life-altering events “Adjustment Disorders.” Bumps on the Road of Life is the story of Adjustment Disorders, how they get people off track and how to get your life out of the ditch.

Bumps on the Road of Life

Please visit my Amazon Author Page – David Joel Miller

Casino Robbery.

The robbers wanted more than money; they planned to kill Arthur’s fiancé and her boss.

Arthur Mitchell was trying to start his life over with a fiancé and a new job. That all

Photo of Casino Robbery book

Casino Robbery.

ends when the casino robbers shoot Arthur, kill his fiancée, and her boss. Arthur would like to forget that horrible day, but the traumatic nightmares and constant reminders won’t let him, and someone is still out to get him. When he tries to start over by running a rural thrift store, someone knocks him unconscious, vandalize the store, and finally tries to kill him. His only chance to find peace is to figure out what the killers want from him and why.

Casino Robbery is a novel that explores the world of a man with PTSD who has to cope with his symptoms to solve the mystery and create a new life.

Casino Robbery is available now in both Kindle and paperback editions.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

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How long are assessments and treatment plans good for?

By David Joel Miller.

When do you have to do a new assessment or treatment plan?

assess

Assessments.
Photo courtesy of Pixabay.com

At 1st glance, it would seem like we ought to be able to come up with a specific number to answer this question. It’s a whole lot more complicated than that. Think of this like asking how long the food you buy at the grocery store is good for. The correct answer should be – it all depends.

For the counselor or therapist, this matters because redoing assessments and treatment plans can take a lot of time, time you would rather be spending with the client. For clients, this comes up when they must redo paperwork they have completed previously.

Three possible answers to these questions, the theoretical answer, the answer that pleases the funding source, and the program’s policies.

Theoretical reasons to reassess.

There’s a difference between an assessment, the form you fill out, and assessment, the process. Initially, the counselor does an assessment to gather information, define the client’s problem, and develop a plan for treatment. This process is documented by filling in an assessment form. The information should be used to develop a plan of care.

Assessment, the process, continues throughout treatment. Any time new information becomes available, the assessment, the diagnosis, and the plan of care, may need to be revised. If it’s a small piece of information, a note in the chart may be sufficient. If a whole new problem is discovered, it may require a new assessment.

Reassessing is primarily a matter of clinical judgment. As long as the client stays in treatment and nothing changes, the original assessment should still be valid. Presumably, a client in treatment should be getting better. At some point, it would be good practice to reassess to verify whether the original problem still exists and needs treatment.

Clients who leave treatment, and then return, should be interviewed, to see if anything has changed, and a new treatment plan is developed.

Funding sources have their assessment rules.

People who pay for other people’s treatment what to know they’re getting their money’s worth. Insurance companies, criminal justice, Medi-Cal, Drug Medi-Cal, Medicare, Medicaid, may all have varying requirements. A lot of the rules beginning counselors learn about how long assessments and treatment plans are good for come from the rules of the funding source their program works with.

Your program or agency’s rules about treatment plans and assessments.

Some agencies set their own policies and procedures for how long an assessment and treatment plan are good for. One agency locally creates treatment plans good for a full year, another creates treatment plans for 90 days, and does updates every 30 days. When an agency works with multiple funding streams, they frequently do their assessments and new treatment plans frequently enough to satisfy the funding stream with the shortest time requirement.

Thanks to the reader who sent in the original question on this topic. I hope it helps you understand why there’s so much variation in how frequently assessments and treatment plans are done and revised.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

Time for a change?

By David Joel Miller.

Feeling like you need a change but don’t know what to do?

Time to change.

Time for a change.
Photo courtesy of Pixabay.com

You have been plotting along, but things don’t seem to be getting any better. You may be feeling restless, irritable, confused and indecisive. There are times in most people’s lives they don’t like where they are, but they are not sure what to do about it.

Whether it is an unhappy romantic relationship or an unfulfilling dead-end job, the decision to stay or go can be a difficult one. If you’ve reached a point in your life where you feel you can’t stay stuck where you are, but you don’t see a way forward, here are some suggestions.

Enrich the relationship.

People start new relationships, romantic or occupation ones, full of enthusiasm. As time passes that relationship loses its luster and the job becomes boring. Couples who do not maintain their relationship can find it falling apart. Put some spark back in your relationship by doing more things together.

Add some new roles to your romantic relationship. Become activity partners. Do more things together. Set some couple goals. Some couples exercise together, cook meals together, read together, or they may even learn a new skill together.

On the job, learning a new skill, taking on additional responsibilities or transferring to another assignment can help you regain your interest and enthusiasm. Challenging yourself to grow in your work life prevents burnout and those trapped feelings.

Become open to new experiences.

One way to get unstuck is to open yourself up to novel experiences. Take up a hobby, begin an exercise routine, or learn to cook a new recipe. Do you have a special interest? Maybe like to read or garden? Consider joining a club focused on your interest. Joining clubs and organizations is a great way to make new friends and to vary the routine.

By being open to new experience, be very careful about making changes you will not be able to take back. It is common for people who are stuck to think the problem is their partner or their job. Using a new relationship as a parachute to get out of your current relationship, can result in emotional injury when you hit the ground hard.

Don’t overreact to an unsatisfying job situation by quitting your current job with no new job to go to. As you try new activities and learn new skills, keep your eyes open for jobs that might interest you or places you might want to work.

One reason you may feel stuck in your current situation could be you don’t feel confident in your skills. Take trainings when they are offered, take a night class or an online class to improve your skill. With more training and skills, you may find opportunities for advancement in the organization where you already work. The reason you are feeling trapped maybe you don’t yet have the skills needed to move forward.

Work on yourself.

When you are going through a rough patch, anxiety or depression, it is easy to blame the situation or the people around you. Sometimes the reason you are feeling stuck and confused is that there is work you need to do on yourself. New opportunities can’t present themselves until you develop the skills and attitudes you will need.

In couples counseling we often find the couple blaming each other for their unhappiness. Very shortly the couple separates, and one or both begin new relationships. Within a year or two, both new couples have turned unhappy. Happiness is an inside job. You need to be able to be happy by yourself before you can be happy in a relationship.

Develop distress tolerance.

Life has its ups and downs. Sometimes there are difficult patches. Don’t be too quick to make an impulsive change in your life. Sometimes the reason choices aren’t clear is because you are not yet ready to make that change. Sometimes discomfort lasts only briefly. Focus on the distress, and it becomes unbearable. Focus on living the best life possible, and the discomfort may fade away.

Use the calendar, not a watch.

Have you been feeling pressure, as if time was running out on you? Don’t be one of those people who has unrealistic high expectations for themselves. Life is not a destination but a process. In your rush to become successful, however, you define success, don’t lose the joys of the things you do accomplish.

A successful life is rarely the result of achieving great things at a young age. Don’t expect to be all you can be by a particular age. Ever hear of a musician called a one hit wonder? Longevity in any field is the result of continual practice and improvement.

Clarify your choices by seeking professional help.

One legitimate goal of counseling is to help you see your choices clearly and resolve your confusion. The counseling room is a good place to talk things out with an objective person. Whether you are currently confused, facing difficult choices or is a time for a change professional counselor can help you through the process.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

Thinking mistakes you are making.

By David Joel Miller.

Is your thinking full of bad habits?

Thinking

Thinking mistakes you are making.
Photo courtesy of Pixabay.com

It is easy to drift into bad habits. Do something a certain way a few times and that becomes the default setting for your brain. After that, you need to put conscious effort into responding in a different way.

Many times people drift into bad thought habits and from then on having unhelpful thoughts pop into your mind becomes your usual way of thinking. Just because this is the way you always think about things does not make those thoughts true. Your bad thought habits may be making your problems worse and interfering with your having a happy life.

There are 11 ways your thinking may be full of bad habits.

1. Thinking it is all about you, personalizing.

If you walk in the room and people laugh you might think they were all talking about you. When someone is short or curt with you, do you think they are being disrespectful? Many times in life when someone ignores us or is less than helpful it has nothing to do with us. One of the great lessons of growing up is that most of the time other people are just too preoccupied with their own life and problems to give you a second thought.

2. You magnifying mind blows things out of proportion.

When you think about what could happen, do you imagine the worst possible thing? If your mind can turn a minor inconvenience into the end of the world you have trained your thinking to be a magic magnifying mind.

You went on a date, you liked that other person and they said they would give you a call. But the next day comes and goes and no call. You are now convinced that they will never call, that you will never meet that special someone and that you will live the rest of your life alone. When they call an hour later you are now so bummed out from ruminating about this life alone you just don’t want to talk to them and you do not answer the phone.

There are lots of variations to this thought pattern. It rains for a few minutes and you are sure it will flood, you get stuck behind a truck and are sure you will be late to work and get fired. In each scenario, your mind leaps from a small problem to a happy-life threatening outcome.

3. Minimizing, discounting the positive.

You got ninety-nine questions out of a hundred right, but you are upset about the question you missed. Some people find it hard to take credit for the things they do well. The underlying thought here is that you should be perfect and that anything less is not acceptable.

If you can’t take a compliment, or you find it hard to accept credit for what you have done, you may have trained your brain to ignore anything you did well and focus only on the mistakes of life. This can result in a pretty bleak, discouraging way of looking at things.

4. Either Or, Black and White thinking, means you are either a winner or a loser.

High achievers are at extra risk for this one. If you have trained your brain to go for being the best at everything it can be hard to accept the size of the achievement that a second place might be.

Do not let your brain cheat you out of enjoying an accomplishment by insisting you have to be better than everyone else to be worthwhile.

5. Taking events out of context.

So you get the job but all you remember from the process is that you did not have a good answer for one of the questions. One criticism from your partner becomes they “never” like anything you do. You are on vacation for two weeks but the thing you most remember is the traffic jam on the way out-of-town that first day.

If when you think back on past events all you can remember are the rough spots you are falling into making too much of the small things and forgetting the big ones.

6. Jumping to conclusions.

He didn’t return my text right away so that means he does not want to talk to me. You feel a lump somewhere and don’t go to the doctor convinced you must have cancer and only days to live. Many people have developed the habit of jumping over all the possible good outcomes and landing in a pit of pain.

7. Overgeneralizing leads you to bad places.

“I did not get this job” becomes “I will never get a job.” That thought can get you so worked up that you stop looking for work. Believing because something did not go your way once that means you will never achieve your objective, can become the greatest obstacle to progress.

8. Self-Blame, believing you made a mistake so you are stupid, no good.

This mental and verbal self-abuse does not motivate you to work harder. Beating yourself up leads to feelings of helplessness and giving up. You shouldn’t accept this kind of treatment from others. Don’t abuse yourself this way.

9. Are you that good at mind reading?

Do you tell yourself, “When he does that it means — If she loved me she would know.”

Believing others should know what you want and need and then thinking less of them for not reading your mindsets your relationships up for failure. Believing that others should be able to read your mind and anticipate your needs without your voicing them creates misunderstandings.

10. Comparing up, that model or star is better than me.

Comparing yourself to others sets you up for disappointment. There are always people who have more friends on social media and who make more money. To feel better about yourself stop comparing. Especially do not compare yourself in your gardening outfit to someone walking down the red carpet.

11. Catastrophizing is thinking the worst possible outcome will happen.

Do you think “he is late, he probably got in an accident and died?” When things happen that are not to your liking is your first thought that this absolutely must not happen? Catastrophizing is looking for the worst possible outcome and then mentally rehearsing that thought in your head until it demolishes your sanity.

If you are practicing any of these bad thought habits work with someone on changing these unhelpful thoughts to more adaptive ones.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

What is “Conditions for Further Study?”

By David Joel Miller.

Are there more mental illnesses than we know about?

What is? Series

What is “Conditions for Further Study?”
Photo courtesy of Pixabay.com

“Conditions for Further Study” is a chapter in the DSM-5 which describes some possible mental illnesses that have not yet gotten full official recognition. These are not something a clinician can diagnose, or that insurance companies will pay to treat, not by these descriptions anyway.

You would think that by now we would have identified every possible mental, emotional or behavioral disorder, and come up with sure-fire treatments for each of them. Unfortunately, it doesn’t work that way.

Periodically a new disease comes along. It wasn’t all that long ago that no one had ever heard of AIDS or even HIV. The same thing, sort of, is happening in mental health. Researchers would like to be sure that when they tell you about the characteristics of and the treatment for a mental illness that everyone who was a subject in the research had the same disease.

Clinicians know that not everyone who has the same “diagnostic label” has the same symptoms. So you get a group of people who supposedly all have the same thing, say PTSD, and then you give them tests and assessments. For some things, personality characteristics like say introversion and extraversion, people will be on a continuum.

For other things like Posttraumatic Stress Disorder there will be clusters of people who all have similar symptoms and then clusters of other people who have different symptoms.

Lumpers and splitters.

Some people want only a few categories, like dogs and cats. Trouble with this is that Poodles are very different from Rottweilers. The house cat sitting on my desk is nowhere near like a Lion. So while we want to be specific about a mental, emotional or behavioral disorder someone might have, we also want to avoid creating several billion mental illness descriptions, one for each person.

Researchers and clinicians who notice these different clusters may become convinced that there are differences in symptoms that should be categorized as separate illnesses. For example, not all PTSD is alike. The PTSD that results from combat may show different features than the PTSD we see in battered women or abused children. Currently, they may all get a diagnosis of PTSD but there are different treatment approaches. Some clinicians have taken to referring to the form of PTSD that is the result of repeated abuse as “complex trauma” even though this is not officially a DSM diagnosis.

Are behavioral disorders a mental illness?

We see some similarities between drug and alcohol use disorders and some behaviors. Children and adolescents get some behavioral disorder diagnoses, things I sometimes refer to as “bad kid” diagnosis. But in adults not much in the way of behavior currently, meets criteria for a mental illness.

So far the only behavior that has gotten included in the Substance-Related and Addictive Disorders chapter is Gambling. Other behaviors, internet usage, compulsive gaming and pornography all have features that look like the loss of impulse control seen in Gambling.

Some of the major things that counselors treat are not diagnoses.

Anger is a huge reason for referrals to therapy, yet anger currently is not a specific diagnosis. While anger may be the reason for referral, currently it is seen as a symptom of some other problem, not a specific diagnosis. Despite the common practice of court ordered Anger Management classes Anger is not a diagnosis.

Suicidal behavior is not an official mental illness either.

Same problem with non-suicidal self-injury sometimes called cutting. Currently, the only place this fits is under Borderline Personality Disorder where it may be a symptom. This seems problematic. Does adding Non-Suicidal self-injury inflate the number of people with a diagnosis of Borderline Personality Disorder? Can you have one without the other? Shouldn’t someone who is thinking about killing themselves qualify for a diagnosis for that reason alone?

Disorders of special populations.

Several group-specific problems may be the focus of treatment but so far are not recognized as mental illnesses. This is a particularly acute problem for treatment of military personnel. Moral Injury is a situation in which you are required to do something that violates your sense of right and wrong. In civilian life, you may find ways to avoid this dilemma but in the military, there are few choices. Sometimes to do one good thing, following orders, you have to do something else that troubles your conscience.

Military sexual trauma is another non-DSM issue. In combat, you count on your comrades to keep you safe. Being raped by someone in your unit is a very traumatic incident. Having to continue to have good relationships with your abuser in order to stay alive is a tough situation.

Certainly, there are other problems, cultural or situational, that have not yet reached official disorder status but that require more research.

Do Conditions for further study make it to become a full diagnosis?

In each edition of the DSM, there are a number of proposed new diagnosis. Most do not make it as separate mental illness. After much research, they may get lumped in with existing disorders. Many of these proposed new disorders have long specific names. My observation is that the fewer words in the name the more likely it will get its own place in the DSM. Binge Eating Disorder made it. I have my doubts that Neurobiological Disorder Associated with Prenatal Alcohol Exposure will make it unless it gets a short name.  (More on Fetal Alcohol Exposure Problems is coming up in future posts.)

Currently, there are 8 “Conditions for Further Study” listed in the DSM-5. The DSM-IV-TR had 16, most of which disappeared in this revision.

What are those Conditions for Further Study in the DSM-5?

  1. Attenuated Psychosis Syndrome.
  2. Depressive Episodes with Short-Duration Hypomania
  3. Persistent Complex Bereavement.
  4. Caffeine Use Disorder.
  5. Internet Gaming Disorder.
  6. Neurobiological Disorder Associated with Prenatal Alcohol Exposure.
  7. Suicidal Behavior Disorder.
  8. Non-Suicidal Self-Injury.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

See Recommended Books.     More “What is” posts will be found at “What is.”

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

Therapy room secrets.

By David Joel Miller.

What do people get out of therapy?

Therapy room secrets.

Therapy room secrets.
Photo courtesy of Pixabay.com

 

People who have been to see a counselor or therapist, those who have gone long enough to see the results, know some secrets about the process that most other people never find out. Counseling should help you create the life you want, not confirm someone’s opinion that there is something wrong with you.

Going for therapy does not mean you are crazy or a mental case. Plenty of people see a counselor to work on their life skills. Being in therapy does not mean you are and will always be mentally ill. The point of counseling is to move you from being overwhelmed by life’s problems to a place where you can handle them.

Therapy should be about wellness, not sickness.

The really sick people don’t go for treatment even what they need it because they are afraid that getting treatment means they are ill. This is the equivalent of trying to not “give into cancer.”

You can learn that what you are dealing with is normal.

We hear in the counseling room from a lot of people that they thought they were the only one who felt that way or had that problem. Turns out that most of the lifes problems are common, so is suffering in silence. It can help a whole lot to know that what you are going though happens to lots of people at a particular point in life. It can also help to hear how others have solved this problem. This is one reason that group therapy is extra helpful.

Sometimes you just need to talk it out.

Family and friends find it difficult to just listen. They want to fix you or tell you what to do. It pains them that you are having problems and they just want to stop hearing your pain. Talking too much about life’s problems with family and friends can burn them out.

Sometimes all you need to do is just talk this problem through with an objective person who will not judge you or tell you not to feel what you feel. You partner can’t always be objective and hear you talk.

It helps to have someone listen to you.

They probably didn’t teach you about emotions in school.

Feelings are a taboo subject in many homes. You may have been taught that you should not have feelings or that it was not OK to express them.

Learning how to feel, recognize that feeling and then give it a name, can help you learn to regulate your emotions. If you have unrecognized feelings, therapy can help you learn to manage those feeling inside you.

Therapy can de-stress you.

Sometimes therapy makes you really face your problems. People come in depressed and after explaining their life to the therapist they decide that their life is a mess. Then they have a choice, do the hard work of changing things or leave things as they are, depression and all.

There may be gaps in your life skills inventory.

Mostly what you know about life came from living the one life you have had so far, yours. There are all kinds of life skills you need and it is hard to pick them up while rushing through your daily activates.

Your counselor can help you with the life skills you may have missed out on. Making friends, regulating emotions and getting things in perspective all require skills and practice.

It helps to have supporters.

You need supportive people in your life. Your therapist should be on your side. This does not mean that they will always agree with you or tell you that you are right. You need them to be honest if they are really supporting you.

They also should not try to make you dependent on them. You will need supporters after you are done with therapy. Helping you design a plan to create a support system is another thing your counselor may be able to do to help you get your life on track.

You can get a more objective opinion.

Friends tell you what they think you want to hear. Family members may want to influence you, get you to do things that are in their best interests or right for them but may not be good for you. A counselor can be really honest. They may slip up on that honesty, looking for a way to tell you things in a kind or gentle way, but know that at heart they want you to know exactly how things are.

You need to work on the things you are afraid of.

In the counseling room is one time you can really talk about the things you were afraid to tell anyone. This is the place to let your secrets out and know that this person will do all they can to maintain your confidentiality. Yes, there are a few things, like your being suicidal or abuse of a child they have to report, but most everything else they will keep to themselves.

If you have questions about this look at some of the other post on counselorssoapbox.com about what is and is not confidential. It also helps to ask your counselor and see how they answer this question.

Change is a process.

In the therapy room, you learn about the course of change. You can experience change a little or a lot at a time. We all move through our change process at our own rate. Sometimes you need to change a little and then change some more.

Prevention is important.

Sometimes it pays to go in and talk with an expert when you are faced with issues. This can help you to cope with a problem before it swamps you. Sorting things out can prevent your struggle becoming overwhelming.

This is one place you can really be you.

You do not need to worry about pleasing the counselor or if they will like you. This is a consulting relationship, not a long-term friend one. You should not need to worry about being judged. This is the one time you get to really “tell it like it is.”

Unpacking your baggage is painful and needs help.

Working through old issues, getting that baggage unpacked and sorted through, is something that happens often in the therapy room. This should be a safe place to work on those old hurts and pains that you can’t talk about anywhere else. This is one place you ought not get judged.

Counseling should be taken as needed.

You may need to attend every week or every few weeks. Some people go for a while, take a break and return as their life changes. This does not mean you are weak or can’t handle life. What it does means is you know how to make use of professional help as needed.

Counseling helps you find and accept you.

Working on me and trying to find myself are common themes in counseling. This is the time and place to explore your inner self and really get to know those parts of yourself that may be hard to stop and take a look at.

Your therapist is on your side.

Your therapist is an ally in your self-change and self-exploration. They really want the best for you and will do what they can to help you get there. If you don’t feel this then this is one of the first things you should talk about.

For more on this topic see:     Counseling and Therapy

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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

What is the ACA?

By David Joel Miller.

How many ACA’s are there?

What is? Series

What is the ACA?
Photo courtesy of Pixabay.com

These initial things don’t always mean what we think. Different groups of people mean different things by the same set of initials and the same group or condition may get more than one shortened reference. Currently, we are struggling with a sudden shift in the meaning of ACA. I will give you some possible meanings for ACA in a moment.

Context matters.

There is a lot of research out there and more being published every day. Sometimes I think that I read way too much of that research. Is there a treatment for excessive research preoccupation?

The convention in research is that the first time a writer uses a term in their article they give the full name of the condition, theory or test instrument they used followed by the abbreviation they will be using in parentheses. Thereafter they use only the abbreviation.

For example, older articles on Pervasive Developmental Delay used to read Pervasive Developmental Delay (PDD.) Thereafter the article would only talk about PDD. With the DSM-5, Pervasive Developmental Delay became a part of the Autism Spectrum Disorder (ASD.) There is now a new disorder Persistent Depressive Disorder (PDD.) Persistent Depressive Disorder is pretty much like the thing we used to call Dysthymia.

So if you see PDD in an article look back to the beginning of the article and see what the original term was that is being shortened to PDD.

So what is ACA?

In the mental health field, ACA has several meanings. Most likely these days ACA refers to the Affordable Care Act (ACA.) This is big here in America, right now, in that it expanded medical coverage to a lot more people. Unfortunate this does not mean that everyone here in the U. S. has medical insurance. There are still a lot of poor people who do not have medical insurance. We still have a long way to go to get everyone health insurance.

This does not mean those uninsured people do not receive medical care. They still show up in hospital emergency rooms and get free care there. The difference is that without insurance there is no provision for who will pay for that care and so the public gets the bill. Sure if you have no insurance they mail you a bill, but if you are homeless you are not likely to pay that bill.

The result of this system is that the uninsured are discouraged from seeking care if they have anything at all until they are dying and then the rest of us get that bill. This presumably saves money by avoiding preventative care and only having publicly funded care after there is a serious medical emergency. I will step off my large soapbox now and resume my place on the smaller soapbox.

ACA means something special to Professional Counselors.

The American Counseling Association (ACA) is a major organization in the counseling field. Most professional counselors, clinical counselors, mental health counselors and so on are members if the ACA (American Counseling Association.)

If you are a counselor you should be a member of the ACA and/ or its local affiliate. Here in California that would be CALPCC. Some people are members of both.

If you are a counselor that sees people with Behavioral Health coverage under the ACA (Affordable Care Act) you should especially be a member of the ACA (American Counseling Association.) I am still not sure why we call emotional and mental illnesses “Behavioral Health.”

ACA is also for people in recovery.

Adult Children of Alcoholics (ACA.)

American Council on Alcoholism (ACA.)    

Adult Children Anonymous (ACA.)

And that’s not all the ACA’s.

One internet source (http://www.acronymfinder.com/ACA.html) lists 241 different ACA’s. This includes groups in Australia, Austria, Alaska and Arizona. They also list groups of Accountants, Actuaries and other “A” occupations. Just reading that list has started to make my head hurt.

We will leave our discussion of ACA there.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

See Recommended Books.     More “What is” posts will be found at “What is.”

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books