Reader Questions

Counselorssoapbox.com

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

A slight change in format and procedure here. In the past, I was calling this feature “Morning Questions” but there needed to be a change in my writing schedule if that book in my brain was ever going to get down on paper or electrons. So the main blog post will be going up in the early AM.

I thought about calling this feature short questions or brief answers but sometimes they will be brief and other times not so brief. I settled on the title “Reader Questions.” My goal is to provide useful information and commentary while avoiding filling your inbox with excessive posts. These Reader Question posts will probably be infrequent unless there get to be more questions. Henceforth when a question or comment comes in or someone uses a search term that needs an answer you will see a Readers Question post.

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Where does the Bipolar spectrum begin and end?

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

Person with masks

Bipolar.
Photo courtesy of Pixabay.com

Thoughts on Bipolar spectrum.

My understanding of the Bipolar Disorders, like many other “mental illnesses” has changed over the time I have been involved with this field. Not all professionals agree on some of these things so it is only fair I tell you some of my biases first.

When I first learned the technical part of diagnosis we had to study the diagnostic manual (the DSM.) The assumption here is that a really good clinician can distinguish between those with a mental illness and those without and further that those with a mental illness are in some specific way different from the normal ones.

Neither of those assumptions is necessarily true.

In school, it was really important to learn to distinguish the niceties of the diagnosis. I spent a lot of time on things like the differences between Schizophreniform disorder, Schizophrenia, and Schizoaffective disorder. This is very important in school and in taking your exams for licensure. In the real world, it is not so important. Both the meds and the talk therapy are likely to be the same for all of these.

Some of our view of the “Bipolar disorder spectrum” is distorted by the need to rule people in or out and to state which things are normal and which are diagnosable. The ruler you use can alter the results. Our venerable rule books on diagnosis in the mental health field fluctuate between the categorical approach, putting people into pre-sized boxes, and the continuum approach where we line them up from well to sick. Here are my beliefs on this.

1. There are NOT two groups, the “normal” and the “mentally ill.”

With some medical disorders, you either have it or don’t. Mental illness is not like that.

We are coming to recognize that there are not two distinct groups, the well and the unwell, but in fact, there is a continuum between being well and unwell. Something bad happens to you, then you should be sad or anxious. All of us have some days we feel better and other days that we feel less well.

Most of the things we count as symptoms are in fact normal human behaviors. It is just that the unwell person has more symptoms or more severe symptoms than the less unwell person. When the symptoms add up to enough to make a diagnosis is largely a judgment call.

People do not move directly from a healthy weight directly to obese. The move comes on slowly one ounce at a time. The same thing happens with mood disorders. It is not just the number of symptoms but also the severity of symptoms that cause a professional to assign a diagnosis. Two different professionals and you may get two different diagnoses even in research studies using “strict diagnostic criteria.”

2. Counting symptoms is not an exact science.

Each mental health disorder has a list of symptoms that are believed to make up the disorder. The client needs to have some number of symptoms to get the disorder. Say a disorder requires the majority of the list of symptoms, 7 of 13 possible symptoms, look at all the ways we could add this up. The mathematicians among us will recognize this as a factorial problem, the number of outcomes of 13 things taken 7 at a time. Email me if you do the math and get a number. Take my word for it the number of combinations is huge.

So as the clinician talks to you he considers, do you have enough characteristics of a symptom to count that one? Then he adds them all up and if you get enough you win the diagnosis.

Lots of judgment calls in this process.

So what about the spectrum of Bipolar disorders?

I think this is a long spectrum and a lot of it does not deserve a diagnosis. The most severe cases can and should be diagnosed because if you have that many symptoms you need help.

Are birds Bipolar? Are other animals? I think they are a little. Every spring the days get longer, there is more daylight and they are awake more. They become interested in the opposite sex. Here in the northern hemisphere birds start looking for mates by Valentine’s day in February and by Easter, they have bred, created nests and are hatching out chicks. People do this same thing.

We humans, tend to fall in love in the spring and marry in the summer. It takes a little longer for the children, but not that much longer.

There is also a seasonal decline in activities for all animals in the winter. Bears eat all they can and then go sleep for the winter. In humans, we call this atypical depression. So some change from active, even hypomanic behavior occurs naturally with the seasons. These mood changes are normal human behavior.

We probably should not give every teenager a Bipolar diagnosis, though most of the time their parents are sure that their preoccupation with sex and their moodiness should qualify.

People who have diagnosable Bipolar disorder do not really have different symptoms. What they have is a difference in the severity of symptoms. They also have different outcomes.

With all spectrum disorders, we should not make our decision based on the presence or absence of symptoms, which alone is not enough. The key factor is what effect do those symptoms have on the person.

If the increased interest in sex during the manic or hypomanic phase damages their relationships, gets them fired for sexual harassment of causes other disruptions in their work and relationships then they get the diagnosis. Also if the symptoms of the mood swings become unmanageable and they upset the person with those symptoms, then they should be treated.

So yes there is a spectrum of Bipolar-like symptoms from almost unnoticeable to debilitating severe. The thing we professionals should be looking at is not our judgment of the severity of the symptoms, but how are these symptoms, these problems in living life, affecting the client.

If the problems interfere with having a happy life then it has become severe enough we need to give it a diagnostic label and begin treatment.

Personally, I think there are a lot of people with less severe mood swings than what would be diagnosed as a Bipolar spectrum disorder that would benefit from some counseling. But as long as they can maintain the choice is up to the client.

Thanks to reader Dr. Charan Singh Jilowa for suggesting this topic. For more on this topic check the list of posts to the right or the post list on Bipolar disorder and mania.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

How does my therapist know that? Isn’t counseling confidential?

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

Is counseling confidential?
Picture courtesy of pixabay.

Did my last therapist tell?

This comes up a lot when people move from provider to provider. It especially happens when you see multiple people in the same agency. No not everything you told your old therapist will be kept secret from your new one. WHY?

Laws about confidentiality make a distinction between “Use” and “Disclosure” of information. If you are in the hospital anyone who is treating you needs to be able to look at your record and see what medications you are on, what procedures you have had and what allergies you may have. Anyone who treats you in the future at that agency probably has the right to look at your old record and see what was done to you. The same applies to psychotherapy.

Everyone at the hospital does not get to look at anyone’s medical record just because they want to see it. The only reason to access a medical record should be for the purpose of treatment. People have gotten fired for looking up someone’s medical record just because they were curious. Even looking in medical records to see if a famous or infamous person was treated at your hospital can get you fired. But if you are treating a client you may need to know what is in their record.

Psychotherapists do and can share records and that is considered “use” not “disclosure.” Laws about confidentiality primarily relate to disclosure. Some of this has to do with law, for that see a lawyer. As a therapist though, I find this is an important issue to many of my clients and they need to understand how our system works.

It is considered good practice to separate psychotherapy notes from your general medical file. Everyone who treats you in the emergency room for an accident does not need to know about your marital problems.

We also don’t need a list of the names you or your spouse call each other. What the counselor wants to know is that you two are having conflicts and that you resort to name calling with each other rather than problem-solving. One or two examples will suffice here. Long transcripts of the argument might be interesting in a movie script but they don’t need to be in psychotherapy notes.

Clients sometimes move from therapist to therapist. Sometimes clients want a new counselor, some therapists are known to “fire” clients for a variety of reasons. Ethically we should suggest a change of provider if we feel that we are not able to help a client. If your counselor retires, you may be assigned a new one.

When the client changes therapist, we do not, as a rule, start a new file. Would you want to go through all those tests and lab work every time you saw a different doctor? Same with taking a life history. It should be in your chart. The new provider should review your chart so they should have some knowledge of what your last therapist was treating you for and why.

Charts are needed to provide continuity of care as well as other reasons. Clients have told me they resent that the new therapist knows things they had not told them. They probably read this in the chart though they may have been briefed on the case by the last provider also. If the file moved to a new agency there probably was a release of information but at the same agency, the old paperwork still applies.

Personally, I like to meet the client first and form my own opinion about them, then review the chart. The risk is that the client will have to tell me something they just told the other counselor last week. The benefit is that in telling me again they may say something they did not say last time or I may ask a different question. A fresh set of eyes can sometimes see something new.

More than once after doing a new assessment I looked at the file and can see why the last counselor came up with the diagnosis they did, but having new facts I don’t necessarily agree with that opinion.

So yes, the new therapist may know something you did not tell them. That they were filled in by your previous provider is not a violation of confidentiality. Did you really want to have to retell your whole life history to a new person before getting down to the work of solving life’s problems?

The bigger question is why you would want to hide things from the therapist you are seeing now?  They will have trouble helping you if you don’t tell them what the situation really is.

The most important person for you to trust and get honest with is you. Some clients hide things from their counselor because they don’t want to face the fact that they have a particular problem.

The results of counseling are mostly about the relationship. We try to spend time up front getting to know clients and building trust. Some clients have more trust issues than others. If you are not sure you trust your therapist, ask them questions. The names of their kids and their spouse are not important but their views on how to raise a child or have a good relationship might matter to you.

You should be able to rely on your provider to maintaining your confidentiality and not disclosing your information to someone who has no reason to know. Don’t expect one doctor or therapist to try to hide your symptoms from another professional who is treating you.

The bottom line? If you want help in recovering from your issues, whatever they are, you need to get honest with yourself and your counselor or find a provider you feel you can trust.

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

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

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Do addict, mentally ill labels help or hurt?

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

Mental Health or Mental Illness

Mental Health or Mental Illness?
Photo courtesy of Pixabay.com

Do most people accept labels like “addict” or “mentally ill?”

The use of labels to identify clients keeps coming up. Does having a label, a name, for your problem help you find answers or does it stigmatize you?

The recovery movement often uses labels, usually self-applied to define the nature of their issue. Saying you are an Alcoholic helps you to understand the problem and what you need to do to overcome it. In this case, if you are really an alcoholic you should not drink.

In A.A. they don’t give out the labels. They present information and let people decide for themselves if the designation fits. This approach has a lot to recommend it.

Some people feel that giving out labels can be a barrier to recovery. If you say you are an addict then, of course, you will use drugs, the use of the label could be interpreted as a reason to stay in your problem rather than move towards a solution.

Personally, if I have a cough it makes a lot of difference to me whether I have an allergy or tuberculosis. I am frankly a lot suspicious of a doctor who wants me to take medication for my cough but does not want to tell me what is wrong with me for fear of labeling me.

People are not defined by their disorders. We should not refer to them as “the schizophrenic” or the “depressive.” We know that there are times the person with schizophrenia or another psychosis may not be experiencing symptoms or the symptoms may be milder. This sometimes is referred to as periods of lucidity. People with depression can get better.

Most people, in my experience, embrace these labels. They help define the challenge the person is facing. It is reassuring to know that you have treatable disorder rather than to think that you are crazy or that there is something so wrong with you and there is no hope. What most people find is that there are lots of other people who are struggling with the same illness.

As a professional, I feel I owe it to a client to tell them what I think they are struggling with. Knowing the problem can suggest solutions. I don’t find it useful to argue with clients overdiagnosis. Whenever possible we start by working on the things the client thinks are problems for them. Help them find a job and the depression just may go away.

Sometimes people put too much trust in a diagnosis. What if the person who gave you that one was wrong? Learn to use that information, their view of what you are struggling with, and go from there.

Now if you have been given medication, I recommend you take it as prescribed. If it is not working or you are experiencing side effects, talk with the prescribing doctor before you make a sudden change and please do not take a med only on the days you think you need it, unless the doctor prescribed it to be used that way.

Feel free to add other helpful things, like therapy, meditation and a strong support system to your medication. Medication can only take you so far. Working on your recovery includes learning and practicing the skills you will need to maintain that recovery.

So as far as diagnosis or labels go, if they help your recovery, use them. If your label is getting in the way of your recovery don’t worry about what it is called and focus on your recovery skills.

My view – for most people labeling the problem is helpful, labeling yourself is not. You are, after all, much more than any one problem you may be struggling with.

For more on this whole label-diagnosis thing see also the posts on:

What is wrong with me?

5 Axis diagnosis esoterica

Is it a medical problem or a mental health problem?

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

What is Passive-Aggressive Personality?

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

Couple fighting by not fighting

Passive aggressive.
Photo courtesy of Pixabay.com

Are you stuck with a passive aggressive?

Passive-Aggressive Personality is another one of those things that may be hard to define but you know it when we see it. The Passive-Aggressive Person (PA) doesn’t say much, but they sabotage everyone else. They can be especially annoying if you are confined with one in close quarters, at home or work. PA’s are responsible for a lot of organizations failure to meet goals. They create a lot of family pain.

The PA may smile and nod their head yes but their behavior says “No! No! No!” Their way of disagreeing is indirect. Sometimes defined as “obstructionist” they seem especially skilled at snatching misery from the jaws of success. Their favorite weapon is inaction.

PA people are known for their hostility, unexpressed hostility which leaks out by getting even with others through “not doing.” They are frequently late and forgetful, resulting in not getting things done that they were expected to do. When you look back at the record you may find they never said they would do it, they just didn’t say no when you asked them.

This failure to express themselves, particularly about emotions results in a lot of misunderstandings. When confronted with the discrepancy between what everyone else thought they would do and what they, in fact, did not do, the PA is likely to deny they ever agreed to do that, assert they forgot or all too often give the confronter the “cold shoulder” and say nothing.

PA is considered more a trait or a personality characteristic than a mental illness. It is not officially a DSM diagnosis, though it has moved in and out of the list of Personality Disorders over time. As a personality trait, PA can vary from a few rare occurrences to a characteristic pattern that someone uses most all the time.

Most people with PA traits often report “trust issues” but so do lots of people without PA traits. We think that developing PA characteristics is related to growing up in a home that was non-affirming or where it was not OK to express emotions. In this sense, it is like the “Attachment Disorders.”  They have learned to avoid criticism by avoiding action. They are good at excessive procrastination and other forms of learned helplessness. They go along with things but make sure that the project fails by withholding effort at a critical time.

In addition to highly critical parents, the PA person is also likely to have had painful disappointments in life. They have reduced their expectations for themselves and others to avoid disappointment. Setting low sights reduces disappointments. They become so afraid of being told no they stop asking.

People with strong PA traits will fear competition and avoid situations where they will be judged at the same time they avoid dependency. They tend to keep their distance from others and are especially hard to get to know. They often express the feeling that they are unable to please anyone no matter what they do. Others feel that they can’t depend on the person with the PA traits.

Lacking truly close relationships someone with a lot of PA traits creates a lot of chaos, makes excuses for failure to meet others expectations and chronically takes the victim stance. Rather than direct disagreement they use obstructionism and sabotage to undermine those they resent. Their sabotage is of the indirect “failing to do anything” in the face of an urgent need form.

A key characteristic of the PA person is a lack of assertiveness. Unable to directly confront others they use indirect methods to accomplish their aims.

In the workplace, PA’s can be hard to spot and can rise to the top ranks since they always seem to agree with superiors despite failing to meet goals. They always have excuses for why the goals were not attainable. Management does not always value the worker who openly disagrees even when their productivity is high. Working with someone with PA traits destroys teamwork.

In the home, people with PA traits can be hard to live with and often under function. We know from system theory that when one person in a family under functions another is likely to over function, the result is a dance that is hard to change.

The family member who is PA will be hypersensitive to criticism especially when they have let others down and may resort to telling the rest of the family that their expectations are unreasonable. The result is that the rest of the family takes on the PA person’s responsibilities.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

How much does marijuana effect memory?

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

Cannabis

Marijuana and Memory.
Photo courtesy of Pixabay.com

Marijuana affects memory?

Morning Question #25.

On average marijuana users need twice as many repetitions to learn the material as non-smokers. But they usually don’t care enough to study twice as long.

See the posts on State Dependent Learning and How does marijuana affect memory.    

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Ca. Professional Counselors – CALPCC and LPCC’s

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

October CALPCC board meeting.

This year California became the 50th state to License Professional Counselors. The official designation in California is “Licensed Professional Clinical Counselor” LPCC for short. Other states had some form of professional counselor’s licensure before California, so we are still finding our way as this profession matures and adapts to California.

CALPCC, a non-profit organization, is the statewide organization for this new profession. Last weekend was the annual “retreat” for CALPCC’s board of directors which I was able to attend.

CALPCC has seen fit to appoint me to that board to fill out an open board member term. I am excited about this opportunity.

Some short recaps of what we talked about are below. Remember that as a new board member these are my impressions and that I can’t speak officially for the board. So any sentiments expressed are purely my own. Here are some of the questions that came up.

1. Why are Marriage and Family Therapists (MFT’s or LMFT’s) becoming LPCC’s also?

At least 4 of the CALPCC board members, myself included, are also licensed as LMFT’s so there was some discussion of why LMFT’s might want to also become LPCC’s.

My belief is that there are things that each profession does that the other does not do and to best serve my clients I needed to be trained in both areas.

Most LMFT’s work with couples, families and sometimes children. Since I see some children, couples, and families I need to stay licensed, active and up to date in the LMFT field.

Much of my private practice is in individual counseling, particularly something I loosely call “men’s issues.”  LPCC’s are specially trained in things like career counseling and mediation. Sometimes this shades over into the area of life coaching. I approach these issues by trying to help clients solve problems that are causing social or occupational problems or interfering with having a happy life.

2. Why should someone join CALPCC?

Lots of counselors are already members of one or more professional therapist or counselor organizations. They asked why they should join another group.

My view is that if I was solely an LMFT I would need to belong to the one or two organizations in that field. Since I am also an LPCC I felt the need to join the organization that is specific to LPCC’s, which would be CALPCC. I chose to be a member of organizations in both fields and would recommend that to other people who are dually licensed.

3. What are the benefits of being a member of CALPCC?

CALPCC maintains a website. There is information on the website for anyone who is interested in the new Professional Clinical Counselor profession. There is also a member’s only area with additional information that is useful to LPCC’s that may not be of interest to non-counselors. Other professional associations also use this member’s only format for some of their website content to encourage those who use the resources to help pay the cost.

I recommend that if you are licensed or seeking licensure as an LPCC, you want to be a member of CALPCC and get access to the members-only content on the website.

4. Can LPCC’s bill Medi-Cal?

Not yet, but we believe this is coming and coming soon. At this point, there are only a few LPCC’s licensed in California. The last license number I heard was about LPC200. Those who are getting licensed now are people with previous other licenses who are getting a second license.

We were told that there is a huge pile of applications for the LPCC license that were mailed on the last day of 2011. BBS will be working on that pile for a while. By the time those licenses are completed and the BBS moves to issuing new licenses to people who did not have a previous license we hope that the Medi-Cal approval will be completed.

There are other federally funded programs in which LPCC’s are already being hired.

5. Can LPCC’s open a private practice and take private insurance?

Yes, they can. Who the insurance company place on their panel is up to each individual insurance company. I am on several panels and each one that I have looked at will take LPCC’s.

That does not mean that if you are newly licensed as an LPCC the insurance company will automatically add you.  Most insurance companies want to know they are sending their customers to someone who is reliable. They require providers to have a certain length of time in the profession before they add you to their panel. They also look to see if they have too many or too few counselors on their list for your area.

This is not insurance companies picking on the new LPCC profession. These rules have also been applied to existing LMFT’s and LCSW’s.

Most insurance companies I have looked at require you to have been licensed for 2 to 5 or even 6 years before they will consider you for their panel unless you have a particular skill they need on their list. So if you speak Russian and Swahili you may get on insurance panels sooner.

6. Should students join CALPCC now or wait till graduation?

I recommend that you join while still in school and read the members only updates while you are preparing for your exams. This keeps you up to date on the latest events and trainings in your field.

Also – the CALPCC student member price is VERY reasonable.

Consider that the really good counselors and therapists do not stop learning when they graduate. If you want to be the best possible therapist or counselor you can be, stay active and up to date in your field.

If you are a client or an out of California professional forgive the very California LPCC specific post. The last two weeks have been extra busy for me. Shortly I will return to my posts on recovery, resiliency and having a happy life.

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

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

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.