The Future of Counseling

Counseling Questions

The future of counseling, therapy, and coaching.
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The Future of Counseling

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

The fields of counseling, therapy, and coaching are changing.

I had already seen some changes in the field starting to happen even before Covid. But because of the emergence of the new virus and the measures we had to take to cope with that virus, not only the field of counseling but society, in general, has undergone some significant changes. Reminds me of some of the other changes I’ve seen in my lifetime. People may bemoan the loss of a simpler life, but once you’ve installed running water and electricity in your home, there’s no going back.

Most of what I am talking about here applies primarily to mental health counseling and therapy. But some of the changes are starting to spill over both from and into substance abuse counseling and life coaching. Some of what I am observing may simply be the result of where I practice and the clients I see. But what I hear from other practitioners seems to convince me that the changes I’m seeing are spreading throughout the country and the fields of counseling and therapy.

Some of these changes started even before Covid.

There’s a common conception that therapy, the talking cure, was primarily designed for upper- and middle-class white people. However, many people of color or those of lower socioeconomic status have experienced counseling as something done to them rather than with them.

Recently, I have noticed an increase in clients who reported they were skeptical of counseling until a family member or friend talked them into it. Their previous experience with therapy had often been mandated and unpleasant. If you are forced to go for therapy with a school counselor who tried to convince you to change your behavior because you had gotten into trouble, it’s hard to look on counselors in the future as your ally.

There’s an increasing diversity among counselors.

When I went through the graduate program, it was unusual to have more than one or two male students in the class. Traditionally the helping profession was largely the province of social workers, who tended to be primarily female. Even among marriage and family therapists, it always seemed to me that the preponderance of the practitioners were female. However, the number of male counselors entering the field has recently noticed an increase.

Clients are becoming more diverse also.

During the last few years, starting even before Covid, I’ve noticed an increase in client diversity. It appears to me that there are a lot more African American clients coming to voluntary counseling. I’m also seeing a slight increase in the acceptance of counseling and therapy by people of Asian ancestry. As with all other innovations, it appears that the younger the person, the more likely they are to accept new alternatives.

Distance or remote counseling is here to stay.

When I first went to graduate school, the idea of doing counseling in any other way than a forty-five-minute session in an office would have been looked at as downright unethical. There were always a few radical therapists who might do “in vivo” sessions. They might take a client for a bus or train ride to help them overcome their anxiety. But in general, all sessions had to be done in the office.

At the beginning of Covid, I encountered a lot of clients who wanted to make appointments but only if they could have in-person sessions. As a result, many therapists were reluctant to try to conduct sessions by any means other than in person. But across the last three years, the acceptance of using technology as an alternative to in-person sessions has grown.

The use of distance counseling is now so common that beginning in 2023; counselors will need to take a continuing education class focused on the laws and ethics of distance counseling.

The business of therapy has changed.

How therapy is conducted, who conducts it, and how it’s paid for have all been changing. The things we call counseling, therapy, and coaching have diverse roots. Medicine, psychology, social work, systems theory, and self-help groups all contributed to this confusing thing we now call counseling and therapy.

Who does the work of talking with people, and what qualifications they need have been changing at an ever-increasing rate? Here in California, where I work and practice, marriage, and family therapists were first licensed in 1963. Before that, social workers were the only one of the three “sister professions” working in this state. The situation in other states has progressed in various orders.

Most of what we now call counseling or therapy stems from medical doctors following in the tradition of Sigmund Freud of attempting to solve thinking, feeling, and behaving problems using a thing called “the talking cure.” Some of the ways this work is done today have also been informed by the field of psychology and self-help groups, notably Alcoholics Anonymous.

The traditional model was one professional working with one client in a small treatment room, typically hidden from everyone else in an effort to maintain that thing we call confidentiality. However, recently that model has been seriously disrupted as insurance companies have funded treatment, group counseling and self-help groups have become more common, and technology has offered options to the one patient, one treatment provider pattern.

In an upcoming post, I want to talk more about how the business of counseling has changed and how I expect to see it continue to change in the future. Thanks for reading my writing, and here is wishing you a happy life full of meaning and purpose.

Does David Joel Miller see clients for counseling and coaching?

Yes, I do. I can see private pay clients if they live in California, where I am licensed. If you’re interested in information about that, please email me or use the contact me form.

Staying in touch with David Joel Miller.

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

For more information about my writing journey, my books, and other creative activities, please subscribe to my blog at

Seven David Joel Miller Books are available on Amazon now! And more are on the way.

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

For information about my work in mental health, substance abuse, and having a happy life, please check out

For videos, see: Counselorssoapbox YouTube Video Channel

Changes are picking up speed.

Changes are picking up speed.

Changes are picking up speed.

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

There have been a lot of changes over the last three years.

Over the last three years, my life has felt like someone took everything I knew and everything I do, put it in a box, and tossed it up in the air. I’m still waiting to see where all the pieces fall. I suspect you’re feeling a little unsettled, also.

Regardless of how you feel about things politically or how you were affected by Covid and society’s effort to adjust to a new virus, this experience has changed a lot of the things we do and has fundamentally changed some of us.

We can’t go back to the past.

No matter how much you miss the “good old days,” once things change, we can’t put them back the way they used to be. Trying to cling to the past can rip your arm right out of the socket. I know many “old people” miss the good old days. I know that’s not a politically correct term, but I think I get to say that because I’m one of those “old people.” I can see my seventy-fifth birthday approaching with the speed of a flying bullet. While I can keep up with some of the young folks these days, my philosophy tells me the best way to stay ahead of the Grim Reaper is to keep moving forward.

I’m not sure the good old days were all that good.

A lot of people are talking about the good old days, by which they mean four years ago before Covid happened. I’m old enough to remember when we didn’t have to deal with all this modern technology and its constant change. But then I remember using an outhouse instead of the bathroom and having television for only an hour or two in the evening if the weather was good. I also remember when getting polio meant paralysis or maybe the rest of your life in an iron lung.

You have to take the bad with the good.

Some days my cell phone can be a downright annoyance. People call me all day long. And there are those text messages, along with a trillion notifications about new emails. It can be frustrating. But I remember breaking down along the freeway and having to walk for several miles to find a phone. I sure like having a communicator device in my pocket when there’s an emergency. I just wish the technology people would stop changing things just for the sake of change.

Which direction is all this change going?

Predicting the future is never certain. I have a crystal ball, several of them, as a matter of fact. They look pretty, sitting on the shelf. But all of mine are far too cloudy to see much of anything, especially when it comes to the future. Still, I have some thoughts about what’s going to happen in the future. I’m going to briefly outline the changes I expect us to grapple with, but it’s also my intention to write some additional blog posts about these changes in more detail. My to-do list has been growing far faster than my ability to do.

The way we interact with other people will continue to change.

Across my lifespan, I have gone from a home with only one crank phone on the kitchen wall to a world where preschool kids are carrying around cell phones and tablets. The computer used to be a man in an office, down at the end of the hall, who added things up with a manual gear-driven adding machine. My first “modern” computer was one of those RadioShack TRS-80 model 2 with a whopping 64K of memory. Please don’t tell the technology police, but the desktop computer I’m using today, with its terabytes of external memory, may shortly be a candidate for a museum.

Does anyone besides me remember when you had to wait a week or maybe two for a letter to go from the Midwest to California? My mother would wait for a letter from my grandmother and then write a reply. We then had to take it to the post office and pay extra to have it sent “airmail.” Today people in other countries all over the world can call you instantly. Unfortunately, the scam artists and the telemarketers can also call you at virtually any time of the day or night. The ease of communication comes with its challenges.

The world of work is changing.

The term “remote work” meant something totally different only a few short years ago. For example, remote work might have involved a news reporter or correspondent sending in his dispatches from another country. If the company wanted you to work remotely, they put you on a boat or, more recently, an airplane and sent you there. Because of Covid, many people are working remotely either by computer and email or virtual communication.

A warning here to “Zoom.” You’ve done such a good job of allowing people to do simultaneous video and audio communication you’re in danger of the name of your company becoming a generic term for any video and audio conferencing platform. But then Coke had that problem when everyone wanted to refer to all soft drinks as a Coke. And I think most people still refer to all tissues as “Kleenex.”

The impact of Covid on the world work has not ended.

I think we’re in for some struggles ahead. Some companies and people are embracing remote work. Some worksites are marching to the flag of “everyone needs to get back in the office.” The issue of remote work is likely to reshape not just the way we work but the kind of work we do.

I see the same thing going on in education. I teach at a couple of different colleges and had to go through the frantic move to online education and now the move back. Some students and, more importantly, some schools, do better when education is delivered in the classroom. But some students do better when they learn online and online schools are flourishing.

There’s also the question of whether remote work and learning impair people’s social skills or do they require us to develop a whole new set of social skills.

We need to address the problem of burnout.

When the concept of burnout was first explored it was related to social work and was called “compassion fatigue.” We now know that it happens in a lot of other professions. If it’s caught in the early stages, burnout can be treatable. But most of the time, people simply soldier on until they can’t. I think we will see a loss of talent in several fields due to burnout from the stresses people experienced during Covid.

Creativity is changing.

The rapidly accelerating progress of technology is also impacting how we do many creative things. For example, video production and graphic design can be done far more easily from the kitchen table than they used to be done at commercial enterprises. The increase in e-books has opened the field of writing and publishing in ways we don’t yet even fully understand. And, of course, the chance to express your opinions by writing a blog, creating a podcast, or making a video is far more common than ever.

More to come.

Having said all this, I just wanted to let you know there will be more posts on these topics.

Also, I decided to separate my blog posts about mental health and having a happy life from the posts about my creative endeavors, including writing and making videos. You’ll see the links to my new writer blog ( and my YouTube channel below. I am making all these changes in preparation for the rapidly approaching new year.

Best wishes, and please be happy and healthy.

Does David Joel Miller see clients for counseling and coaching?

Yes, I do. I can see private pay clients if they live in California, where I am licensed. If you’re interested in information about that, please email me or use the contact me form.

Staying in touch with David Joel Miller.

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

For more information about my writing journey, my books, and other creative activities, please subscribe to my blog at

Seven David Joel Miller Books are available on Amazon now! And more are on the way.

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

For information about my work in mental health, substance abuse, and having a happy life, please check out

For videos, see: Counselorssoapbox YouTube Video Channel

It’s been a challenging couple of years

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It’s been a challenging couple of years

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

The last two years have been a time of overwhelming change.

As the end of 2021 rapidly approaches, I think it’s a good time to look back at all the things we’ve been through. I’m not a big believer in New Year’s resolutions, but I do think the holiday season is a good time to reflect on what’s happened over the last year and what direction I want to take for the year to come.

I lump the last two years together because 2020 and 2021 have been a blur in my head. I suspect these two years will blend together as we move forward. A lot of the things I think of as the sixties actually happened in the early nineteen seventies.

The pandemic certainly has affected everyone regardless of their feelings about Covid or the vaccine. What we have been through has changed a lot of people and changed the way we do things.

I’ve become convinced that some of those changes are likely to be permanent. I’ve made many changes in my life over the last two years. Some were because of Covid, and some for other reasons. Many of these changes were already in the works even before the pandemic. I want to summarize those events briefly here. Some of these I’ll write about in more detail in future blog posts.

Online education has become a viable option.

Over the years, I have taught five separate classes at two different colleges. Over the last two years, I have taught online classes for both colleges. Moving in-class material into an online format turned out to be quite a bit of work. Some students struggled with the online instruction. But a great many of them reported that it was preferable to the way we used to do it. I taught all but one of my online classes as an asynchronous class. Many said that they benefited from being able to do the work on their own schedule.

The feedback I’ve gotten from teachers who are working at the lower grade levels has been more mixed than my experience at the college level. Some students worked enthusiastically on their own and completed more assignments in less time than they would have in class. Other students struggled with discipline and fell behind. I’ve also heard multiple reports that students with anxiety disorders frequently turn off their cameras or refuse to attend online classes if they must be on camera. It will be interesting to see how the shift to distance education plays out.

I am now certified as an online teacher.

The early shift to online education was a rapid movement out of necessity. Then, as it continued over a longer time, the colleges began to emphasize distance education. Over the last two years, I have taken a series of classes and become fully certified to teach online courses. Personally, I prefer teaching online classes. It takes me a lot more work to create the materials. Still, it allows both the students and myself to go online and work on things whenever we have the time available rather than all of us having to make the long commute and fight for parking spots in order to be in a small classroom for the same three hours each week.

Both faculty and administration seem to be divided over whether we should continue to offer classes in the online distance education format. While some students will continue to benefit from the discipline of studying while a teacher stands over them, I think most college students would greatly benefit from the online format.

Counselorssoapbox is now a YouTube channel.

Part of the shift to teaching an online class was converting my PowerPoints and lecture material into a series of videos. I’ve learned a lot, and the quality of my videos continues to improve. One of the things I want to do in the coming year is become even more proficient at creating videos for the counselorssoapbox YouTube channel.

Some of my in-person trainings may become online classes.

In addition to academic classes of the last few years, I’ve done several in-person trainings for various groups. Putting on a training involves a lot of travel and leaves me tired for a week after. I have become increasingly aware of the number of online trainings or classes people are taking, many of which are taken for the knowledge rather than for college units or CE’s.

Over the last two years, readership on my blog has declined, while viewership on my YouTube videos has continued to increase. While I’ve been a lifelong reader, I find myself watching more and more videos. If there’s a topic you think I should cover in a video, please leave a comment.

The way we do therapy is changing.

When I first became a counselor, there was one predominant paradigm. Therapy should be done with one therapist and one client in their room behind a closed door. Many people avoided therapy believing that it was only for the seriously mentally ill. Today more and more people are going to see therapists for help with solving life’s problems.

Those who read my blog in the past are probably aware that I am engaged in a great many activities. For example, I do group supervision for a local nonprofit. Because of Covid, group supervision was moved to an online format. Although a few of the trainees reported missing the human interaction we had when we met in person, most report they prefer the online format for supervision. While a few long for a return to the days when we met in person, most enthusiastically want to continue meeting remotely.

It has been interesting to see the various reactions that beginning counselors and therapists have had to see clients online. While I think we were all initially skeptical most of us have developed the skills to work effectively using distance methods. For some clients, talking to their therapist over the Internet or by phone has made therapy more effective and more readily available.

More people are interested in mental health than in mental illness.

During the pandemic, I’ve done some work for several online counseling and therapy companies. This online practice of counseling seems to be moving in two separate directions. First, therapy that is paid for by an insurance company is becoming more medicalized. There’s an increasing emphasis on making sure the client meets the full criteria for a mental disease. I’m seeing more of an emphasis on having the therapist talks the client into taking medication. Insurance companies are also trying to reduce the number of therapy sessions the client may have unless they have been diagnosed by a psychiatrist or medical doctor and are on medications.

People who self-pay are more interested in reaching their goals.

To get treatment by a counselor or therapist paid for by an insurance company, you pretty much need to have been diagnosed with a mental illness. Most of the people who voluntarily seek counseling are looking at solving the problems of everyday living.

Several counselors have asked me whether it is okay to continue seeing the client who no longer meets the criteria for a particular mental illness but just really needs someone to talk to. My answer is that it’s not okay to bill medical insurance if the client no longer has a mental illness. However, I believe it is okay for a counselor to talk to a client each week if the client is paying and finding the sessions helpful. Sometimes this gets close to being coaching rather than counseling.

There’s a difference between being discouraged and being depressed.

They are having a problem finding a job; they would like to be more productive or better at reaching their goals. Medical insurance pays to treat someone who is depressed until they’re not depressed. Unfortunately, there’s a whole lot of distance between being not depressed and having a fulfilling, happy or contented life. As a result of working with clients who are not mentally ill but do want to have a more fulfilling life, I’ve shifted away from taking on more insurance clients and seeing more clients who are willing to pay for private counseling. If you live in California and think that talking with me might be helpful, don’t hesitate to get in touch with me. Besides being licensed in California as a Licensed Professional Clinical Counselor (LPCC) and a Licensed Marriage and Family Therapist (LMFT.) I recently took a class to get certified as a life coach. In future posts, I want to talk more about the differences in what those three professions do.

I’ve concluded there’s too much focus on illness and not enough on happiness.

Over the last ten years, I’ve written over 1900 blog posts. Many, but not all, of those posts, have focused on specific diagnosable mental illnesses and their treatment. I’ve also written a lot about substance use disorders and how those interact with mental illnesses, a condition known as co-occurring disorders or dual diagnoses. In future posts, I want to focus more on how to have a better, more productive life. If there’s a topic that you would like to see covered, please email me using the contact me form.

Were you wondering what happened to my fiction books?

Getting through the pandemic and making this career pivot derailed my plans for writing more novels. I have one nonfiction book and six fiction books, which continue to be available from Amazon. I’ve taken a couple of classes in fiction writing over the last two years and hope to get back to a series of novels I had planned to write, which got crowded out by learning to be an online teacher, learning to make videos, and all the other skills I’ve been developing over the last two years.

Increasing my emphasis on personal relationships.

Over the last two years, I have spent less time in the classroom, office, and consulting room. Instead, I have found it important to put more time and effort into maintaining my friendships and close relationships. As I have gotten older, a handful of close personal relationships have become increasingly important to me. I hope that all of you are putting effort into maintaining your relationships with those who are the most important in your life.

Sorry for the long post. Stay tuned for more to come.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now! And more are on the way.

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