Category Archives: Counseling and Therapy

13 things your counselor should know.

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

Counseling questions

Counseling questions.
Photo courtesy of Pixabay.com

What are the 13 Core Competencies of a Clinical Counselor?

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

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

1. Counseling and psychotherapeutic theories and techniques.

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

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

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

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

2. Human growth and development across the lifespan.

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

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

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

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

3. Counselors know about career development theories and techniques.

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

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

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

4. Group counseling theories and techniques.

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

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

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

5. Assessment, appraisal, and testing of individuals.

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

6. Multicultural counseling theories and techniques.

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

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

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

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

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

Next time part two of this list.

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

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

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

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Online dual relationships.

Computer

Internet.
Photo courtesy of Pixabay.com

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

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

Has the internet changed relationships between clients and therapists?

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

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

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

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

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

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

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

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

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

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

Therapists need to consult.

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

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

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

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

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

The internet has changed all that.

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

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

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

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

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

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

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

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

Can multiple relationships cause a lot of problems?

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

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

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

About life coaches.

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

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

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

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

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

Could you be mentally ill?

What Causes Mental Illness?

Mental retardation becomes Intellectual Disability.

How much do I.Q. scores tell us?

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

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

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

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

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

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

Clearly I.Q. is not the whole story.

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

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

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

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

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

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

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

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

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

Only time will tell.

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

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

When you should not make a child go for therapy.

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

Children Playing.

Children Playing.
Photo courtesy of Pixabay.com

Forcing your child to therapy.

There are times when no matter how firmly you believe that there is something the matter with your child you are making a mistake forcing them to go for therapy.

Most of these reasons fall under the heading of they are thinking or doing something you do not approve of and you want them to go for therapy to convince them to see things your way.

In a previous post, I wrote about the practical aspects of “Can you force a child to go for therapy.” The older they get the harder it gets to make them do much of anything. By 17 or 18, they either agree with you or not. You can get them to follow your rules but not to agree with your views.

There are a few things that are so important that whether a child or an adult wants to go they will be required to go for counseling. Suicidal actions are one reason. Drug use that results in illegal behavior is another. If your child’s life is at stake the need help whether they want it or not.

If a child has been abused or there has been violence in the family, therapy may be offered and sometimes it may be required.

In yesterday’s post we looked at some of the times you need to be a parent and insist your child see someone professional.

But there are times when you really wish your child would change. You know they are going to ruin their life and still, you should not make them go for therapy.

Here are some of these reasons. (Tongue-in-cheek so as to offend no one or everyone.)

Your child favors a political party you think is evil.

Some parents are frightened when their love child comes home spouting Republican doctrine. Sorry folks, the sixties are over and we have to make peace with the Republicans. Regardless of your political leanings, a therapist should not be trying to force a child to agree with their parent’s political leanings.

Political indoctrination is something that is practiced in totalitarian countries. We therapist-types have codes of ethics that keep us or should keep us, from trying to force people to change these sorts of beliefs.

Your child has picked a girlfriend or boyfriend and you are sure this person will ruin their life.

It is unlikely that any therapist can talk your love-sick teen out of loving the one they are madly in lust for just now. What we might be able to do is help them learn about healthy and unhealthy relationships and then if they begin to show some doubts explore those doubts and what they are learning.

This bad-person-for-you problem is often coupled with that person your child fell in love with being a member of the wrong race or religion.

There is a difference between an unhealthy relationship and getting together with someone who is different from you.

What we need to be able to do is help children see the possible negatives as well and possibly convince them to make no irrevocable changes like getting pregnant or running off to Antarctica.

Your child rejects your religion or adopts one you do not agree with.

You are firmly convinced the way to salvation is to shave your head, wear robes, and spend your days handing out flowers in the airport. Your child decides to grow out their hair, discard the robe and become a Lutheran.

Please do not look for a counselor who advertises that he specializes in getting apostate robe wears back to the airport.

Counselors, most of us, would consider this sort of practice as unethical. This even includes counselors who self-identify as being of the religion in question.

What a “Robed-Bare-headed-flower-airport child” Therapist would be willing to do is work with this child on their spiritual doubts, what do they believe, and why. What we should not do is collude with the parents to convert this child back to wearing their robes.

The parent of this child becomes upset when I tell them I will not help them convince their child they are following the wrong religion.

“Those Lutherans are a cult” that parent says. Maybe so. Maybe all Christians are cult followers, but that still does not justify me ganging up on that child and forcing them back into the robes.

Aren’t there some cults that can harm people and that we need to help children avoid? Probably so. My way of seeing this is that if the group seems to be taking a departure from reality then I think some good old fashion reality testing therapy is in order.

What kind of cults are a problem?

If the group bases their practices on unquestioning devotion to a living leader then I get really worried. Try to live up to the ideals of Buddha or Jesus; I’m good with those kinds of faith. Turn your will and your life over to the control of William Bernard Esquire III and you are getting me worried. That rule about having living leaders who think too much of themselves applies also to groups that give one or a very few people the right to decide what the dead leader meant.

Then again that worry about one person misinterpreting scripture may just be a part of my protestant hangover showing.

If this leader starts telling you to do things that are illegal or most people think is harmful be very suspicious.

This post has gotten a tad more sarcastic than most but I hope you get my point. Therapy should not be a way of trying to get children to change their thinking and agree with the parent’s preferences, even deeply held preferences.

Part of growing up is trying new things, new behaviors, and new beliefs. Kids need to take some risks to grow up and parents can’t protect them from everything.

What you can do is try to help them when they fall and scrape their knees. Sometimes you have to bear the brunt of the pain and hope they will eventually get it, but that is part of the parent’s job.

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

When should you force a child to go to therapy?

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

Therapy

Therapy.
Photo courtesy of Pixabay.com

Sometimes you need to insist they get help.

Parents seem to be concerned about when to force a child to go to therapy. Making children go for counseling shows up in search terms to counselorssoapbox.com from time to time. This is an important topic.

In a previous post, I wrote about “Can you force your child to come for therapy.”  Parents know that forcing a child to do almost anything is difficult to do. Sometimes you need to enforce rules and decisions and sometimes the battle is not worth the effort. When it comes to getting your child into therapy which is which?

Most of the “Can you force a child to go to therapy” post was about the practical problems of coercing someone to go for therapy. Therapy works best when the person in session wants to be there. Sometimes they only “want to be there” because their parents or their parole agent made them come. Either way, if they have some incentive it increases the chances therapy will work.

There are times when you the parent are worried about your child, you can offer to get them therapy but “forcing” the child can make things worse. In a future post, I want to tell you about those times you should resist the urge to force your child to see a therapist.

We also need to look at when, for what problems, parents should be so worried, so concerned that they absolutely insist their child see a counselor.

Here are some of the reasons to put your foot down and insist that your child sees a counselor other professionals outside the family. Families who have a good, open relationship, find their children will talk to them about more, but there are still those things that are just too embarrassing to tell mom or dad about.

Your child says they are suicidal.

Suicidal statements, talking about death, or starting to say or acting like they do not want to live anymore are not something to ignore. Children of any age can and do commit suicide. Do not brush this off as just a ploy for attention. Kids get embarrassed and do not tell their parents the truth.

If there is any chance they will try to self-harm get them to go see a professional who can assess for the risk they will carry through on this thought. This is one area where kids will often tell a professional the things they will not tell their parents.

If you suspect your child has been the victim of abuse, rape, or molestation.

If you think this your emotions may run the gamut. You will be angry, fearful, and just plain want justice. The danger here is that by questioning the child too hard you will scare them, and make them close up and stop talking.

You can also run the risk of asking the wrong questions or asking them in the wrong way and then thinking their answers mean something they did not mean. You can end up taking the wrong action. Repeated questioning can also make a young child think something must have happened even though they did not realize it and they will start “remembering” details to please you. You want the truth not a story made up to please you.

These sorts of problems need professional intervention and please let the authorities deal with identifying and punishing the person who may have done something to your child.

Asking for too many details about abuse can also make the child feel it was their fault. The last thing you should do is to put the child through a second trauma when they are being interrogated about what has already happened.

You see evidence that they are becoming addicted to a drug.

The longer you wait to interrupt a substance use disorder the more likely it is to become a permanent addiction. Seek professional help.

This does not mean that if your child is smoking weed or drinking a few beers that there is someone who can lock them up to prevent them from doing drugs.

In most areas, there is no way to detain a kid for very long even when the parents want them locked up. A few places may let you turn them in as incorrigible but the number of places that will do that is getting very small.

Watching a child full-time is a difficult job. If they are abusing substances keeping them locked up and away from drugs is a complicated task. The faculty can’t just hire anyone to do this and paying a professional for 24/7 treatment gets expensive.

For drug treatment, the most effective methods include involving the parent in the treatment. Most treatments are outpatient and the child comes home at night. If you want help with this problem you will need to be part of the solution.

Locking your child up will not take away the desire to do something. The second they get out they will run to do what you tried to keep them from doing. What they need is a “head change” not incarceration.

If there are sudden dramatic behavioral changes in your child.

If they are stealing, need money, cut classes or their grades suddenly drop through the floor, these are all warning signs. Look for help fast. Do not make the mistake of thinking they will “grow out of it.”

This may mean drugs, may mean depression or the beginnings of another mental illness or could just be a problem with a boyfriend or girlfriend. Either way, once the changes are in play it may take the help of a counselor or therapist to find out what is going on and formulate a plan to help your child navigate these issues.

As hard as it may be there are sometimes you need to put your foot down, be the parent and get that child in to see a professional.

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 long does the therapist keep your file?

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

Therapist

Therapist.
Photo courtesy of Pixabay.com

Will the therapist have my file from when I was a child?

There are lots of reasons counselors keep client files, legal, ethical and practical reasons. There are also financial reasons such as billing insurance companies and taxes.

Some files get kept a whole lot longer than others.

Just what goes into a file and how long to keep it can vary with the setting. There don’t seem to be any universal rules but there are some guidelines.

For practical reasons, you can’t keep everything forever. Now with electronic records systems, this may change. But when all files were paper, eventually the therapist, after seeing clients for years had so many paper files they had to pay to store them and worry about keeping that storage place safe or they had to start getting rid of something.

What therapy files to keep and what to destroy?

Two ways to cut down on the storage space problem; thin the files or toss some completely.

Some places, especially large agencies, might go through a file and dispose of unneeded pieces of paper while preserving the record of why the client was treated and what was done. These thinned records might get stored away for a very long time.

That same agency, at another facility, might dispose of any records more than a certain number of years old.

One major criterion for keeping files is the legal issues that can arise. If the client sues you for doing a bad job it is nice to have some records to show what you did. The length you might need to keep records can vary with the jurisdiction in which you live.

The usual length of time therapists are told to keep records is 7 years. But there are some legal issues that stay open for 10 years. The trend is to tell new counselors to be safe, keep your files for a least 10 years.

A significant reason therapists need their old records and the insurance company wants you to have them is if the client says you harmed them in some way. Especially if the client alleges you were romantically or sexually involved or that there was money moving between you for things other than for therapy.

What about juvenile’s therapy files?

These files should be kept until the client becomes an adult, eighteen at a minimum. But at that point, they may want to complain about something that happened to them. Maybe even sue someone. Because of this, it is recommended that files of juveniles be kept for 10 years after the client turns 18. So once they are an adult they have some time to file a complaint about the way they were treated and this can be checked out.

Keep in mind many files don’t always include the kind of details that the client expects.

Say a child was coming for therapy and tells the counselor that he is involved in gang activity. Most of this activity, while illegal will not be reportable as any sort of child abuse. The kid is choosing to do this stuff.

So the child tells the counselor that he was pressured to ride along on the commission of some crimes. Those details of which crimes, the dates, and who else was there, are probably not in the file. The counselor was documenting the progress of treating the client’s mental health issues, not his life events.

What will show is, was the client enjoying hurting others, or was he feeling guilty and how did the counselor help him with his emotional conflicts.

So while you told the counselor all about those kids that teased you that summer at grandma’s, the chances are that the names and addresses of those kids are not in your old file. What will be in there, if the file still exists, will be, was your response to the teasing a normal response or excessive, and what were the things the counselor did to try to help you adjust.

Do old psychotherapy files have to be destroyed.

While there are laws, rules, and ethical guidelines about how long a therapist needs to keep a record, I know of no law that says there is a point when they have to destroy old records. What they do have to do is keep them safe from unauthorized views. So if there is some good reason you need info from an old therapist it never hurts to ask if they still have your old file.

Recognize that it may take some time to find the old file or even to find out if it still exists. The information you are looking for may also not be in there.

Writing a note and keeping files is something we therapists don’t spend much time on in school but spend a lot of time on in the work setting. Thankfully in most agencies, there are people other than the counselors who also get involved in doing all this stuff.

This is a brief, more or less, response to a reader’s inquiry about would the therapist still have their old file from when they were a child. They did not say why they wanted to know so I am not sure if this answered their question but maybe it will help answer someone else’s questions.

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

Top 10 counselorssoapbox.com posts

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Counselorssoapbox.com

Top 10 counselorssoapbox.com mental health posts.

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

Just in case you missed one of these. Here are the top 10 counselorssoapbox.com blog posts for the month of August.

How much should you tell a therapist?                     

Do therapists have to report a crime?            

Levels or types of Borderline Personality Disorder               

Do people really forget what happened when drinking? – blackouts                       

Hyperthymia, Hyperthymic Personality Disorder and Bipolar Disorder                   

Are you Hyperthymic?                      

Which border is Borderline Intellectual Functioning on?                  

Do therapists tell parents what kids say?                   

Reasons Counselors and Therapists Lose Licenses               

Can you force a teenager to go for therapy? 

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 do therapists tell the police?

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

Therapist

Therapist.
Photo courtesy of Pixabay.com

What will your counselor tell the police?

Short answer – Almost nothing!

For counseling to work, you need to talk about what is troubling you. For you to be able to talk like that, we professionals need to make it safe for you to do so. Enter the concept of confidentiality. What you tell your therapist is mostly confidential and may also be privileged patient psychotherapist’s communication.

There will always be someone who thinks we therapists need to protect society and tell something or other. Say you tell the therapist you are scared because you are driving without a license. Do we call the police about that?

No way. That does not happen in any place that remotely resembles a democracy or a republic, probably not in a lot of other forms of government either.

So how come the police sometimes show up at your door anyway? What did get told to them and how?

Sometimes a situation is so very dangerous that the police get notified.

Your house is on fire, the neighbor calls the fire department, and here come the police to control the crowds and traffic. I suppose some people get caught doing something illegal, like running a meth lab, because the police arrive at the fire and they find it. But the neighbor did not report you to the police, your secret slipped out because of the fire.

A similar thing happens when you tell a therapist about a very dangerous situation and we need to figuratively call the fire department.

There are certain things we just have to report, mostly to try to save lives.

I have talked about exceptions to confidentiality in a few other posts. Still, this topic continues to show up in questions and search terms. So, here is some reiteration specifically about exceptions to confidentiality and the police.

A danger to yourself is an exception to confidentiality.

If you plan to kill yourself we have to report that so you get help. This is not just a wish or thought, we should check if you are just thinking of dying, or are you planning to kill yourself and when?

We call someone to get an ambulance and take you to a psychiatric hospital. Usually, the police get called to manage the situation.

Do you get a police record for this? Generally no. Not unless you are breaking some other law, like shooting at the police when they try to take you to the hospital.

Danger to others gets reported.

If you are planning to kill someone we need to prevent that. This is not just doing something reckless. This is planning, intending to hurt others. This can get complicated. If you plan to burn the mall down while it is packed, could people die? So yes that sort of thing, in most places gets reported.

Abuse of a person that can’t protect themselves gets reported.

Child abuse, Elder abuse, disabled person abuse has to get reported. The goal here is to get the abuse to stop. But as in the care of the fire exposing your meth lab, stopping the abuse may leak out the fact that you have been committing a crime.

Sometimes these reports go to child protective services or adult protective services. In some areas, these reports go to the police department to check out.

Therapists only keep your secrets if they are your therapist.

If you see your doctor in the grocery store, don’t rely on his opinion of the produce. He is not being a doctor when you talk to him.

If the judge makes you talk to a therapist or CPS sends you to one, check if this is going to be confidential or if their report, warts, meth lab and all are going to the judge.

Even here consider the therapist is not calling the police on you. But if the judge gets the report on your mental state and you casually mentioned a couple of murders you did, the judge may be required to pass that on to the police.

So most things, even past crimes, we therapists do not report to the police. Honest, that is the last thing most of us want to do. Because once we make that call you stop trusting, stop telling us things, and then we can’t help you.

But occasionally because of something that we are required to report, some of your secrets could slip out. We do not necessarily call the police, but once we tell others to protect you or society that information is no longer strictly confidential.

When in doubt ask the therapist to tell you more about confidentiality. And if you have secrets that need to come out, let the therapist help you with the telling in the right way to the right person.

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 do therapists stop seeing you if you aren’t getting better?

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

Therapy

Therapy.
Photo courtesy of Pixabay.com

Why would a counselor stop seeing you?

Sometimes the counselor will tell the client they need to stop seeing them because the client is not getting better. Why would they do that?

There is one major reason and a few smaller ones why this might happen. Honestly most of the time this does not happen. We, counselors, want to think we can help people and sometimes we go on seeing them past the point at which we should have noticed that the client is just not getting any better. But if your therapist does say they need to stop seeing you here are some possible reasons why.

Ethics tells us not to see people we can’t help.

It is considered unethical to keep seeing a client once you realize that you are not able to help them. Once the counselor realizes this, they first look at what they are doing, is there something else I could do to be helpful? Then they consider referring the client to someone else who might be able to do something differently.

Just a lack of progress on the client’s part does not mean the counselor is not being helpful. Sometimes the issues the client has may require help just to keep them stable. If the therapy sessions keep the client from getting worse and ending up in the hospital that may be a reason to continue therapy even if the client is not seeing their problems get smaller.

What would be unethical would be to keep seeing the client, taking their money or the insurance company’s money if the sessions were not helping the client.

A new problem emerges that needs special care.

Sometimes we start off seeing the client for one problem, say depression and during the process, the client starts talking about some other problem. Say the client now tells the counselor that they have a severe eating disorder they have never mentioned before.

Treating eating disorders is often considered a specialty. Not all counselors have the extra training needed to be able to help you with that. So they might need to refer you to an eating disorder specialist.

This should happen more often with clients who have a substance abuse issue. Unfortunately, some therapists are uncomfortable talking about substance use issues. They keep on working on the depression and ignore the substance use problem. The result is that the client fails to get better.

Sometimes the client wears the counselor out.

Some clients get stuck in an issue. They are angry or hurt because of something that happened in their past. What they might like to do is erase the event so it never happened. That or punish the person who harmed them.

The therapist wants to help them move on and get working on creating a new happy life. If the client is not ready to move on it can get tiring to listen to them. If the counselor runs out of steam in the listening department they should make the referral.

I do recommend to interns that if they start feeling this way they need to talk to the client about this. It is possible we professionals get impatient and try to end treatment just about the time the client is ready to make some changes.

Don’t ever stop just before the miracles happen.

If the counselor becomes impaired they shouldn’t see clients.

If the counselor gets sick, or they have a sick family member, then they can’t give helping you their full attention. Counselors who are going through a divorce or a custody battle may find they can’t give a client who reminds them of their ex their full attention.

Other professional impairments can include excessive or problematic use of substances, drug and alcohol abuse can be problems for counselors too.

You think you are not getting better but the counselor sees improvement.

Clients can start getting dependent on their therapist. Sometimes they look forward to the weekly session so much they can’t see how they can give it up. They feel they are not all better yet.

Counselors and insurance companies are not expecting you to be all better at the end of treatment. What is expected is that the symptoms will be reduced until they no longer interfere with your ability to work, have friends or family relationships.

If your symptoms seem stable, the counselor may decide that they can’t justify billing your insurance anymore and that means they need to terminate therapy with you or you will have to pay yourself.

Even in this circumstance counselors may need to revert back to point 1. When does the counselor’s seeing you become more for them, to make a profit, than for you?

Those are some of the reasons a counselor may say they have to stop seeing you, they may be others in particular cases. Hope that helps explain the process.

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 counselors report rape?

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By David Joel Miller.

When might a counselor report a rape?

Do counselors report rape?
Photo courtesy of pixabay.

If the victim is an adult – counselors do not report rape. Rape is a crime. We do not report crimes unless there is a legal exception to confidentiality that requires us to report something. As far as I know, rape is not one of those crimes that get reported.

If the victim is an adult they should report it. We will try to help them, walk them through the process.

After seeing how rape and abuse survivors can be treated and the way reporting trauma can re-traumatize them, I can understand why they may not want their rape or abuse reported.

If the client is the perpetrator we do not report that either. It is up to the victim to report. What we should do is tell this client to stop doing that. They are ruining their lives and the life of their victim. That is if we even chose to continue to work with a rapist.

What if the victim is a child? You report the rape then, don’t you? No, not really. Not the way I understand my reporting responsibility. I do not report crimes. I do not report rape.

Wait a minute – the victim was a Child? What we do report is abuse. This is child sexual abuse. See the rape part is not what triggers the report. It is the abuse of someone with power and control over a weaker person that makes this reportable as abuse.

This sexual abuse does not need to be rape or intercourse. Depending on the laws of the jurisdiction all sorts of inappropriate sexual contact between an adult and a child might be reportable.

But the victim does not need to be a child to make this a reportable occurrence. If the victim is a senior citizen that is reportable in lots of places. Or if they are disabled, that abuse gets reported.

Financial abuse of the elderly, that gets reported most of the time. There are rules about when but remember it is the abuse, not the financial crime that is getting reported.

So while counselors do not report crimes, yes we do have a responsibility to protect those who can’t protect themselves by reporting abuse.

I am sure this will not be the last time a question about when a counselor will report something will turn up in the comments or my email.

The basic rule is – crimes – no report.

Abuse of a disabled person, senior citizen, or child – report.

A person intending to kill themselves or others – report.

At least that is the way things work here in California and most other places I know about. If in doubt consult a lawyer or ask your counselor about the way it works in your jurisdiction or situation.

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