Category Archives: Counseling and Therapy

Should your daughter’s therapist be talking to you?

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

child

Child.
Photo courtesy of Pixabay.com

When should your child’s therapist include you in the conversation?

Sometimes the therapist should be talking to the parent and sometimes not.  Which is which and what factors are in play?

The child’s age.

If your child is 4 then yes, most of the time the therapist should actively engage you in the conversation and in participating in the process of therapy. You need to be a part of what is going on. You are with the child 24 /7 and you will need to do things to maintain any progress that is made in therapy. Mostly, if the child is young, the parent needs to be involved. Most of the work will focus on helping the parent to manage this child’s symptoms in the home environment.

When your child is older will the therapist talk to you?

What if your child is 44? Sorry folks, I know that you parents think of this person as your child, you care about them and want to help them. But once they pass 18 they get privacy and confidentiality. Unless they are severely disabled and you are their only caregiver it is unlikely you will be included in the conversation at all. Even then most of the conversation will stay confidential between the client and therapist. Your child will need to tell you what you want to know or you will not get the information.

Between four and 18 years of age the “including parents” part gets iffier. The older the child the less that parent will be included in the therapy.

The more the parent pushes to know every detail of what the child is saying in therapy the more this intrusion can interfere with making progress. As the parent pushes more to control the therapy we therapists also get progressively more suspicious.

I love it when the parent cares about their child and wants them to get well. But the parent who insists on being present at every session and wants to know everything that the child says and the therapist does – what is up with that?

Is the parent the solution to the child’s problem or the cause?

Most therapists have stories of parents who seemed overly interested in what their child said in therapy. One reason this happens is that the parent is the cause of the problem.

Parents who are abusing their children are afraid the child might talk about that abuse. Some parents have their own secrets they want to hide, drug use, alcoholism, criminal activity, all manner of things.

Even if the parent is not the proximate cause of the problem, the family’s situation may be what is making this child depressed. Most parents want the conversation focused on the child and they do not want any discussion of the domestic violence or other problem behaviors that take place at home. Some parents do not want the therapist to find out that one parent has been missing for a few years in prison or that there has been a whole string of step-parents.

When parents are present, or when the child thinks the parent will hear what they say, they don’t talk about the embarrassing things.

Most kids do not talk about the pressures to have sex or the urges when parents are present. They know what their parents have told them about drugs, alcohol, and sex. They also know what the parents are doing in these areas and that what parents say and do are often at odds. So lots of embarrassing things get left out of conversations when the parent is present in the therapy room.

The fear that the parent will disapprove or the risk of embarrassment should the parent know what is going on might keep the child from talking about things that really need to be discussed.

Even that fear of failing algebra may not get talked about with mom in the room. The kid knows mom will just rag on them to study more rather than hear that this fear of failing algebra is giving them test anxiety and making it harder to finish the test.

Therapists help families through role changes.

During those late teen years, the parent’s role moves from protecting the child to teaching them how to make choices and learn from their mistakes. Parents, if your teen’s problems are severe enough to need the services of a professional then you probably will not be involved in the discussion until the teen has worked the problem out.

One thing a therapist should do is help the teen work up the courage to tell their parents what is wrong. Sometimes we even facilitate the teen telling the parents embarrassing things.

Many a child is surprised to find that when they do work up their courage and tell the parent this secret, the parent is more understanding and supportive than the teen expected.

Lots of problems could be worked out if a family could just talk about the issues in a supportive; “we are all in this together” atmosphere. But for family’s who can’t do this or have lost the ability to talk with each other, there are professionals that can help.

Related articles

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 therapy work even if you don’t believe in it?

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

Therapy

Therapy.
Photo courtesy of Pixabay.com

What is therapy and how do you know if it will work for you?

Interesting question, this came in as a search term and that always gets me thinking about what was on the reader’s mind and what did they want to find. As a therapist, I believe that therapy works, sometimes, for some people, but at other times people tell me that they went for therapy and it did not help them.

Why does therapy sometimes help and sometimes not? Maybe this depends on what therapy really is. I think there are ways it works and ways it doesn’t.

Let’s try some similar questions and see if it helps understand this dilemma.

Does gravity work if you do not believe in it?

Most of us would say a conclusive yes; gravity always works, at least here on planet earth. So if therapy is a force that produces change yes it should always work regardless of whether you think it will or not.

Do cars work whether you believe in them or not? If you just hang around them, but because you do not believe in cars, you never get in one, then no for you, they will not work.

If you think that therapy is a process of change; then for it to work you will need to do some work.  If you do not do the work, your disbelief will prevent the process from taking you anywhere. Disbelief will keep you stuck where you are.

We know that you do not have to be a therapist for what you to do to be therapeutic. We even talk about therapeutic environments. So if you have supportive friends who can listen to you and help you think and talk things out, that might be therapeutic.

The most effective therapy occurs when you believe that the therapist wants to help you and you feel comfortable talking about your problems. The short answer is that counseling works best if the client believes it will. But like gravity, counseling or therapy can work for you if you just temporarily suspend your disbelief and give it a try.

Related articles

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

What is a therapist? What do therapists do?

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

Therapy

Therapy.
Photo courtesy of Pixabay.com

Why this word therapy might be confusing.

When I used to tell people I was a therapist they kept giving me blank stares. I got the feeling that they did not understand what I do. Personally, I tend to call myself a counselor more often than I call myself a therapist despite the fact that I am licensed here in California as both a Marriage and Family Therapist (MFC45390) and as a Licensed Professional Clinical Counselor (LPC15.)

One intern asked me why in so many blog posts I seem to use the word counselor rather than the term therapist. I think there are two reasons, I think of myself as doing more “Counseling” and the word therapist seems to need more explanation than the word counselor to avoid misunderstandings.

Both of these words can involve activities outside mental health. Lawyers are referred to as “counselors” for example. There are other professions, financial and lifestyle workers who get to use the words counselors or therapists when appropriately attached to some other description. What we need to do is prevent the term from becoming so generic as to mislead people.

What about Substance Abuse Counselors?

Substance Abuse Counselors also do similar work but they are restricted in most places to only working on the substance use disorders. Mental health issues are outside their “scope of practice” meaning the things they can legally do.

Correctly used both counselor and therapist should be part of a license title rather than standalone names, as in Licensed Counselor, Licensed Clinical Counselor, Mental Health Counselor or Marriage and Family Therapist.

To add to the confusion many School counselors or School Psychologists are often not licensed and work on issues surrounding graduation requirements, getting into college or school behavior rather than treating mental illnesses that are more common than previously thought among school students.

So how did mental health practitioners come to use the title of therapists?

Originally this term was psychotherapists. Many mental health practitioners, Marriage, and Family Therapists, for example, practice “applied psychotherapy.” This is a reference back to the time when most mental health work was being done by psychiatrists who did some form of talk work with their “patients.” Most of this work was psychodynamic or Freudian type work. Today most therapists do briefer more directive work and do not choose to emphasize the “psycho” part of the psychotherapist name.

What about other kinds of therapists?

Two types of therapists,  occupational and physical, get confused with the psychotherapists that do mental health work.

Physical therapists, as the name implies, work on the rehabilitation of the body. So if you are in a car accident and lose a limb they could help you regain your abilities, adjust to a prosthetic limb or strengthen remaining muscles. This is my understanding and if there are physical therapists out there who would care to add to that understanding feel free to leave comments.

That same person, grieving and depressed over the loss of the limb might also see a rehab counselor who would help them with the psychological adjustment to living without that limb. That rehab counselor might also help with career counseling to find that person a new job they could do despite the loss of a body part.

In California rehab counselors as well as Career counselors might elect to get licensed as Licensed Professional Clinical Counselors providing they meet the requirements for that license.

There are also people who function as “occupational therapists.”

This one still confuses me a bit. Per the Bureau of Labor Statistics “Occupational therapists treat patients with injuries, illnesses, or disabilities through the therapeutic use of everyday activities. They help these patients develop, recover, and improve the skills needed for daily living and working.” Most occupational therapists have master’s degrees and work in the offices of physical therapists.

So when I tell someone that I am a therapist they sometimes ask if I know of an exercise that will help their shoulder mobility. No, I do not. That is not the type of therapy that I am licensed to practice.

So has that cleared up the confusion? Or have I just added another layer of mud to the waters?

The point is that you need to be sure that the type of counselor or therapist you are seeing is doing the type of work you need.

Best wishes on your journey to a happy life. (I think of myself as a happy life therapist or counselor but can’t find that listed in any of the statute books.) I do try to stay well within my scope of practice.

Related articles

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

What if you see your therapist in public?

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

Counseling and therapy

Counseling.
Photo courtesy of Pixabay.com

What should you do – What should the therapist do?

Counseling or therapy is a very special relationship. It is also very confidential. One problem is what happens if you see your therapist out in public.

Mostly what happens is up to you.

Professionals are trained to avoid saying anything or doing anything that would identify you as a client in treatment. What if we see you and you are with your wife or girlfriend? Do you want them to know you are or have been in therapy?

What if you are at work and we come into that workplace? Do you want your boss or coworkers to know you are in therapy?

Since we can’t be sure, the customary practice is to say or do nothing, just walk right on by. The professional should not do anything to identify you as a client.

You, on the other hand, are under no such obligation. If you chose to say hi then we can respond and say hi back. If you chose to introduce us it is up to you to decide how to identify us.

While we can talk with you if you initiate the conversation what we do not want to do is start another dual relationship with you.

We can shop in a store where you work; to avoid your workplace would penalize you for being our client. We do not want to ask for special discounts or deals you can’t or wouldn’t make to other customers, which would confuse the relationships and run the risk of interfering with the primary relationship, the one between therapist and client.

So if you see your therapist out in public and they do not say hi do not take this as they do not like you or they are rude. Believe that they are pretending to not know you in order to protect your confidentiality.

Thanks to the reader who asked that question.

Related articles

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 therapists like, fall in love with their clients? Why don’t they tell them?

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

Fall in love.
Photo courtesy of Pixabay.com

Unconditional Positive regard or dual relationship?

Do counselors fall in love with clients? Do they like them and if so why don’t they tell them?

The role of emotions, feelings between the counselor and the client are complicated. Learning to juggle all those factors and keep the relationship between therapist and client in bounds is something every professional has to work at.

Here are the factors in play.

1. Unconditional positive regard

This is one of those “core conditions” that counselors are taught they need to exhibit for their clients. This can be summarized as – yes I accept you the way you are, feel you have worth as a person, and have a belief in your ability to grow.

In short, the counselor is supposed to like the client as a person.  What we do not always like are the things this client is doing.

If a counselor finds themselves disliking this client, judging them or wishing they did not have to see them, those feelings are likely to get in the way of therapy. So we strive to always see the best in our clients.

2. The need to be genuine.

It does not help the client much if the therapist lies to you. If we find a particular client annoying we sometimes have to address that.

We might need to let the client know, gently if we can, that this thing they do or say, we find ourselves getting annoyed when they do that – do other people get annoyed with you when you do that? This truth-telling has to be done in a supportive way but sometimes the client needs to hear the things we see that they may be blind to.

3. Is this about the client or the counselor?

Psychoanalytically trained therapists talk a lot about transference, the times that the client relates to their therapist just like they used to relate to someone else in their life.

I am an old guy it a gray beard. Clients have told me this reminds them of their dad or grandfather. We then talk about how was their relationship with that person and how does that affect the way they relate to others in their life now.

Sometimes I see a client and they remind me of someone I went to school with. I have to ask myself, did I like that person? Does the way this client reminds me of that person from my past affect the way I treat this client. We counselors might call this countertransference, seeing the client through the counselor’s past experiences.

4. Counseling is a novel relationship.

In the therapy room, we have this close, emotionally intimate experience. We try to help the client experience emotions they may not have experienced before or have not had for a long time.

The office is a sort of laboratory to try out new ways of being and relating to people and feelings. But the relationship needs to stay in the room not get carried out into the community. We keep it confidential so we can’t become best friends and hang out at the client’s house.

5. Counselors need to avoid dual or multiple relationships.

I wrote in another post about the dangers of trying to have two relationships with a client. It can be tempting, here she is, crying and feeling really bad and looking really cute or sexy. But if the counselor lets themselves move over into that developing a romantic or friendship relationship there is a risk of messing up the therapeutic relationship.

Every year a certain number of counselors get into romantic or other dual relationships with clients. Mostly these end up badly.

The client comes in for therapy because of an emotional or mental problem. It is a short hop from trying to help the client to becoming a predator when counselors forget their need to be a helper and get into a relationship where they are getting one of their romantic needs met.

So yes, counselors do often like their clients, and sometimes some feel like they are falling in love with the client. Professionals should not talk about their feelings except to be helpful to the client and they should not act on those feelings by creating a second “dual relationship” with clients.”

The counseling relationship is a special one and the focus needs to stay on the client and their needs. The counselor needs to get their needs met at another time and place.

Thanks to the reader who asked about this for suggesting a topic for this blog post.

Related articles

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

counselorssoapbox.com posts you read the most

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Counselorssoapbox.com

Here are the top 10 mental health posts to date.

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

1. How much should you tell a therapist?         

2. Are you Hyperthymic?    

3. Do people really forget what happened when drinking? – Blackouts

4. Why can’t we forget the painful past?                 

5. Do therapists have to report a crime?                    

6. Is nicotine a stimulant or a depressant?     

7. What is the difference between Depression and Major Depressive Disorder?      

8. Levels or types of Borderline Personality Disorder        

9. Six ways to recover from Complex Trauma or Complex PTSD         

10. Which border is Borderline Intellectual Functioning on?         

Thanks for all the support and encouragement you have shown for counselorssoapbox.com I appreciate all of you who read this blog. I especially want to thank those who leave comments and likes.

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

4 Reasons counselors don’t say they like you

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

Counseling and therapy

Counseling.
Photo courtesy of Pixabay.com

Does my counselor like me? Why won’t they say they like me?

Counselors are reluctant to tell clients they like them and for some very good reasons. Most of the time I do like the clients I work with, but there are lots of reasons I don’t say so.

1. We want the client to learn to like themselves.

Many clients report they have “low self-esteem.” As often as I hear that expression you would think it was a specific diagnosis. It isn’t.

One reason for this low self-esteem problem is that too often all of us are looking to outside things to establish our self-esteem. If you need someone, anyone, to tell you that they like you, then your self-worth is dependent on doing and saying things so they will like you. This is a risky place to be.

I do not tell the client I like them. Most of the time I do not encourage them to even worry about what other people think about them. There is a huge danger in basing your self-worth on ratings or other’s opinions.

It is worthwhile to watch and see how you are affecting others. We call this self-monitoring. If lots of people are getting irritated with you, then you may need to take a look at yourself and see what you might improve. What you do not need to do is base your self-worth on what they think. Improve what you can and accept the parts of you that you can’t change.

What I do tell a client is that I think they are worthwhile people. They are the unique them just like everyone else on earth is a unique person. They do not need to do or be anything to be worthwhile. What they need to do is to do those things that will make them happy and that they can be proud of. If they do estimable things they can feel good about themselves regardless of what others think about them.

2. Counselors should not foster dependency.

Counseling is a helping relationship. It is not helping when someone else does everything for you. Rather than doing for clients, we want to teach them to do for themselves.

Rather than being in need of a friend, which increases the risk of becoming a needy person, you should become your own best friend. Once you learn to like yourself, you will find that you are much more likable to others.

Coming every week to see your counselor for another booster shot of self-esteem is not the same thing as recovering from whatever you chose to call your problem.

3. You need to develop an outside support system.

Counselors are professional people but we can’t be there every hour of every day.  Yes, professionals are a part of a person’s support system, but we should not be the whole thing.

If you are in recovery, and who among us is not recovering from something or someone, you need a strong support system that is positive and in your corner.

There are a few people who have become conditioned to use the psychiatric hospital and professional therapists as their one and only support. They are sometimes surprised to find they do not have to go on doing that forever.

Having a positive friend you can call in the evening before bedtime or when you are feeling a little low, beats the heck out of having to call the psych hospital every night before bed for some reassurance.

Providers who create peer lines, which are places people with problems can call and talk to other peers, find there are more people who can function without needing psychiatric hospitals. Those communities that rely on hospitals to provide all the services need more hospital beds.

Peers are an important part of the recovery process.

4. There is a danger of developing a second or dual relationship.

The counseling relationship is special. It should not get mixed up with any other relationship. Counselors who forget those boundaries are at risk to get into friendship, financial or even romantic relationships with their clients. That is very likely to harm the client.

If someone says they like you there is that natural tendency to say you like them back. For a week or vulnerable person, there is the risk of trying to feel that way even if that is not how you really feel. The net result is an unwanted unprofessional relationship.

These second or dual relationships harm clients and they can cost counselors their licenses. Best to avoid this from the start.

Hope that explains this odd behavior we counselors feel obligated to observe with our clients.

David Joel Miller, LMFT, LPCC

Related articles

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

How do you find a counselor for Depression or Dysthymia?

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

Counseling questions

Counseling questions.
Photo courtesy of Pixabay.com

Looking for help with your depression.

Reader question thought I should share this with all counselorssoapbox.com readers as you might miss it as an answer to an older post. This was a comment on the Dysthymia post.

“I have a question: How do you find a professional who specializes in the treatment of Dysthymia? Someone who is really good. Searching for such a person in Michigan. Medications, by the way, are a waste of time. They don’t work for me. Can you suggest someone for me? Thanks!”

Great question. Let me make some suggestions. I am out in California and do not know professionals back there in your area. But the process is likely the same everywhere.

1. If you have not done so see a medical doctor first, there are some medical conditions that can look like depression or Dysthymia.

2. If you have a history of substance abuse, alcohol, or drugs, get that treated first or concurrently with the Dysthymia  Even after people stop using they still have the old thinking and it does not change without help.

3. Interview the counselor you are considering seeing.  Picking a therapist is kind of like dating, you may find the right person the first time, but you need to get to know them a little before you make the commitment.  Progress in therapy is all about the relationship.

4. Look for someone who treats depression. The process is very similar in treating Depression or Dysthymia  If the depression comes from a recent bad event this is more like an adjustment disorder. If you are depressed because you lost your job you need someone who can work on career counseling. Dysthymia is generally more long-term and you may need to look at things you learned as a child that no longer are helpful. I prefer to work from a Cognitive Behavioral or Rational Emotive perspective. Narrative therapy can also work.

5. Avoid a counselor who advertises things that do not fit you. Men should generally avoid a therapist that advertises they use a “feminist” perspective. Don’t see a Muslim counselor if you are a Christian or vice versa. Most good counselors work with everyone and do not put that sort of thing in their advertising.

6. Expect to do a lot of work on yourself. A good therapist is like a good tour guide, they can tell you about the trail but you need to take the hike.

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

Why love and counseling don’t mix – ethical Loophole 4

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

Falling in love in recovery.
Photo courtesy of Pixabay.com

This time love is not the answer.

We thoroughly enjoy our romance. Everyone can connect with the story of Cinderella and the price, wouldn’t it be nice if every commoner girl could find and marry her prince charming?

There is a whole category of books devoted to romance. There are plenty of films that script out the story of someone who finally meets this wonderful person who makes their life complete, and they live happily ever after. It is when we try to bring that fantasy into the real world that things go wrong.

Men, particularly older men have this fantasy, that should some woman, usually, a beautiful younger woman, enter their life, they will have wild passionate sex and live happily ever after. As long as this stays in the world of fiction this may cause few problems.

When these fantasies make their way into the counseling room this looks less like a flowery romance and more like a fatal car crash viewed in slow motion.

It is not unusual for a client to find they are falling in love with their therapist. They may be weak, vulnerable, and needing love and affection. Clinicians are taught to be aware of this and to work on helping the client learn to love again without taking unfair advantage of the client and becoming that new romantic partner.

Some codes of ethics say that a therapist or counselor should never date or become romantically involved. Some set limits, 2 years, five years, or more. The thought here is that after many years of not being in a professional relationship, then should you meet a former client on a cruise or at a school function you might establish a relationship. Even here the counselor is supposed to make a note in the chart indicating they thought about this, that enough time has passed and they believe this will not harm the client.

This is critical; will falling in love with former client harm them? By the way, ending therapy and giving the client a love letter saying call me in two years on date X and then we can date. That is just as bad as starting up the relationship while the counselor is still seeing them.

Given all these warnings why do counselors still engage in romantic and sexual relationships with clients?

Every time the new professional magazine arrives we see a list of professionals whose licenses have been suspended or revoked. Counselors who started using drugs or abused alcohol is always a big one. But right up there, sometimes in first place, are the reports of therapists that engaged in sex with a client.

Why does this happen? What is the ethical loophole that people stick their heads through that ends up strangling them?

Frequently this ethics issue begins with the counselor entertaining the notion that yes sometimes it is possible to fall in love with a client and live happier ever after. No, they would not do it, but they can see how it might be all right sometimes for some counselors and clients.

This can also start with the idea that it is possible for a counselor to develop an outside social relationship or friendship, without it becoming sexual. Sometimes it starts with attending a social event, going to a movie or having dinner together. There are all the usual excuses, the client needs to feel safe going out, we are helping them learn to make friends or socialize.

But having once said that it may be OK to have some dual relationship with a client that sometimes it might be OK for some counselors and clients to fall in love and have a romantic sexual relationship, it becomes possible that this time, they and this client, that is one of those exceptions to the rule.

Once we start making exceptions, looking for loopholes, sooner or later we are at risk to put our heads through that hole. Why should we care if an occasional therapist has sex with a client, maybe the code of ethics is too strict?

We should care because those relationships are inherently unequal and have a serious potential to harm the weaker party, commonly this weaker person is the client.

Falling in love with a client, that one is always a bad idea. Beware the tendency to look for loopholes. Many an unwary counselor has tried to put their head through this one and ended up hung.

David Joel Miller, LMFT, LPCC

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

Money and Friendships can cost you – ethical loophole #3

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

Ethics

Ethical loopholes strangle.
Photo courtesy of Pixabay.com

Dual relationships get a lot of counselors and clients into trouble.

Having multiple relationships can mess up therapy.

The big obvious one is sex, we will talk about that one later, but there are a bunch of other dual or “multiple” relationships that can cause problems. Here are some examples.

The client doesn’t have money to feed her kids; can I pay her to clean my house?

This sounds harmless enough. Counselors want to help people, that is why they became a counselor in the first place. So they might try to help out. Maybe give the client a little money. What about bus fare home? What about hiring the client to do a part-time job around the house? All this sounds good until it goes wrong.

You give that client bus fare once. They tell some friends who all ask you for bus fare. You have to start saying no. Now you have to tell that first client no. Then they all complain to your boss. Why does client X get bus fare and I don’t? Why did you give it to me and then take it away when I did not do what you wanted? See how that good deed can come back to get you?

What about paying them to help you? They could mow the lawn or clean your house. What if the lawnmower goes missing right after they cut that lawn? What do you do if your jewelry is missing? Can you make a police report on a client? Doesn’t that violate confidentiality? How can you explain that away?

The client is new to the city and does not have any friends. The counselor invites them, to attend church with them. The counselor goes and picks the client up and takes them to church. What could be wrong with that?

You are their therapist; you have power over their life. They are in a weak vulnerable position and you tell them they need to attend church and you are taking them to yours. Can they really say no? Will you withdraw care, stop seeing them if they say no?

What if their religious or spiritual tradition is one you do not approve of? Will you pressure them to convert? What if they consider your religion a “cult” will they be able to say no?

Think this doesn’t happen? Clients tell me, they have been told that their child protective services worker wants to be sure that their children are being raised in a “good Christian home.”  Does that constitute bias? Can the client say anything if they risk having their children taken away or if they have a mental health issue or substance abuse problems? Could those problems be used against them?

Revealing your religious preference to a provider can result in discrimination, loss of jobs, denial of promotion, or even make you the victim of physical violence. That’s why in this day and age members of some religious traditions still need to use the “decline to state” response to the question about religious preference.

I am not saying that all discussions of religious or spiritual values should be off the table in therapy. People with a spiritual connection do better in recovery. What is a problem is when the therapist crosses the line from listening to the client about what the client believes to doing a sales pitch or enabling the client to follow the counselor’s religion.

Encouraging them to practice a religious or spiritual tradition is a yes. Telling them they need to come to Zoroaster is a no.

Counselors do not have to stop going to church or another religious gathering place because their client attends, but they need to be very careful about transporting or arranging to meet clients there. It is probably an ethical boundary violation to be seeing someone in therapy that you also sit in a religious service and socialize with.

Wow! That new client just told me about this great money-making deal.

Money and client relationships, what a dangerous mix. Yes, we have to think about money. We need to get paid. But when we start thinking about money or other things first this can be a trap.

Investing money in a client’s business or investment opportunity or asking them to invest in one of yours, these are all bad ideas.

Lending money to your therapist is an absolute NO! If your counselor asks to borrow money run as fast as you can. Consider lodging a complaint on your way out to the appropriate person.

Think also about insider trading issues. Do you want to end up in court because you made an investment based on a tip from a client? Clients, do you want your therapist testifying in court about your therapy session and how this investment idea came up in the first place?

All of these ethics issues can start with just that little finger through the ethical loophole. Giving someone bus fare out of your own pocket, paying them a few bucks to mow their lawn, becoming involved in their religious or social activities, all of these can lead to trouble.

Client, I know that you may like your therapist, want to do something nice but remember that their ethics code like a priest vow of poverty may preclude them from accepting gifts, stock tips or other offers by you to do things for them.

For me, as a therapist, the best gift a client can give me is to tell me that something we did in session has helped them have the happy life they want. Hearing that I have been able to help, that makes my day.

Sorry if we can’t hang out or attend some social events together. I like you as a person but I respect our professional relationship and you as a client too much to mess this up by getting into another dual relationship with a client.

Next Friday ethics part 4 – the bad news for all you romantics at heart. Why falling in love with clients or your therapist so often ends so very badly.

David Joel Miller, LMFT, LPCC

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