13 things your counselor should know – part 2

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

Counseling questions

Counseling questions.
Photo courtesy of Pixabay.com

In a previous post, we talked about the first 6 things that a Professional Clinical Counselor should know. Today the rest of that list.

7. Counselors know the principles of the diagnostic process.

What would you think of a doctor who sent all his patients for cancer chemotherapy first and then checked to see what was wrong later? You wouldn’t want to be treated for something you did not have, would you?

That is why diagnosis is so very important. It is also controversial and sometimes the diagnosis on a client’s file is flat wrong. I have written in previous posts about why we professionals may get it wrong and there is room for improvement but one thing a good counselor is to be able to do is to diagnose.

We may change that diagnosis over time. You may turn out to have more than one problem or we may treat the thing that looks the worse first, then move on to another thing.

However it is done, a good counselor needs to be able to diagnose and they need to be able to explain that diagnoses to their client. The diagnosis drives the treatment. We should treat the problem and leave the other things in the client’s life alone unless they want to change them.

8. Counselors know about research and evaluation.

Counselors need to know how to read research and understand the information. Some stuff looks good on paper but does not work when we try it on clients.

I read a lot of research in preparing to write this blog. I will not say I “get” it all. But I can spot some really suspicious research.

Recently I looked up a new counseling theory; there are over 300 of those and counting. This new therapy had one study done by the author of the book on this new system and then his study included only 5 or 6 of his patients.

I do not call that evidence.

See why professional clinical counselors need to know how to evaluate research? Would you want them trying out something on you that might not work or might even harm you?

9. Counselors know professional orientation, ethics, and laws in counseling.

Interesting that the law that created Licensed Professional Clinical Counselors lumped all three of these things together. In another context, this might be three separate things.

What this is telling the prospective clinical counselor is that they should know about their profession and presumably related professions. Who does what, when and why?

It is always really important to understand a little about the law. It is recommended that counselors have lawyers rather than trying to memorize all the things in applicable laws.

Clinical counselors also need training in ethics. Not that ethical principles are hard and fast rules, but the code of ethics for a profession are general guidelines for how to conduct yourself.

The big ones as you may have gathered from my past posts on ethics are avoiding things that would harm clients. You can read more about this topic by clicking on the law and ethics category in the list of categories to the right.

10. Counselors should know about psychopharmacology.

Professional Clinical Counselors do not prescribe medication here in California or anywhere else that I know of. That is fine with me, as I think that if you are prescribing meds you need to have attended a medical school and know about medicine.

Still, we Profession Counselors see a lot of people who are taking meds, psychiatric or others. We need to have an awareness of what the meds are that clients are taking, are they complying with their doctor’s instructions and so on.

Some medication that is prescribed for physical health issues can cause symptoms that might be mistaken for a mental health condition. We need to know when to refer clients to an MD and when to send them back so their primary care doctor might be able to take another look at the meds they take and the side effects they are experiencing.

11. Addictions Counseling.

Clinical counselors are supposed to have knowledge about the field of substance abuse. In the future, I expect to see more LPCC’s working in the substance abuse areas. I say supposed to because while LPCC’s have some training in substance use disorders. Some is just not enough.

It is amazing how little training in substance use disorders mental health professionals get. A standard MFT program might include a one weekend class, Friday evening and all day Saturday.

Contrast this with 36 units, eleven full semester classes on substance abuse and related problems, which are included in the CAADE Drug and Alcohol counseling curriculum which I teach over at FCC.

More training is needed but look to LPCC’s as the branch of the mental health field that combines mental health treatment with substance use disorder treatment in the future.

12. Crisis or trauma counseling.

Would you believe that there are mental health professionals that are uncomfortable handling a crisis? Sorry, you other professionals. I do not have time to wait around to make a referral to a program when someone is suicidal. (I know most of you don’t do that either.)

Crisis and trauma are huge parts of what brings people to counseling.

Stress, acute or chronic is a significant factor affecting mental health. Professional clinical counselors are trained to help clients with issues in these areas.

13. Advanced counseling and psychotherapeutic theories and techniques.

Beyond the basics, there are times when you may need tools in your counselor’s toolbox beyond the everyday ones.

This concludes part two of the discussion of the 13 things every Professional Clinical Counselor should know and understand. As I tell my students, these things probably will be on the test.

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

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.

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13 things your counselor should know.

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.

Senior 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 group. (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. 

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.

CALPCC board meeting – Professional Clinical Counseling

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

Just returned from the CALPCC board meeting. http://calpcc.org/

CALPCC stands for California Association for Licensed Professional Clinical Counselors. It is an honor and privilege to be able to hang out with a group of people who are so concerned about the future of the Counseling profession.

The things we talked about will affect those who work in the field and those who receive services from Professional Counselors everywhere. I try to balance posts on the counselorssoapbox.com blog between things that are of interest to clients, people in recovery from whatever challenge you have, and those who consider themselves professionals. Some people fit into multiple categories.

Today a quick summary and then in the future I plan to write some posts about things I learned and thoughts I have had as a result of this meeting. Today just the highlights of my thoughts, and while I can’t speak on behalf of the organization or the board, as always I have plenty of thoughts of my own.

CALPCC’s primary mission is to further the profession of Clinical Counseling here in California. Many of our board members are very active at the National level and beyond.

I see a difference between the processes of counseling, therapy, and coaching. My students know that while I am licensed as both a Marriage and Family Therapist and a Professional Clinical Counselor I see those functions as two different things and describe myself as a counselor first and a therapist second.

One size does not fit all

There are some disturbing trends in mental health treatment these days.

The first step for most clients is to get them on meds. If they need them that is all well and good, but sometimes the meds cause harm.  In this era of “there is a pill for everything,” it is hard to convince those who pay that clients might benefit more from some counseling than from a meds only approach.

Meds can only do so much, to help a person to have a life worth living; they may need some help learning new skills, like living without drugs or setting and accomplishing goals.

It is estimated that California will need an additional 5,000 mental health clinicians by the year 2019. Many of those clinicians will be working with the poor, the unemployed and the addicted.

Professional Clinical Counselors are uniquely qualified to fill that need. They are trained in 13 separate “core areas.” Including career counseling – getting a job, addiction counseling, and many have extra training in working with non-verbal clients or those whose primary learning styles is a mode other than words.

As more Clinical counselors get their license some are asking about the prospects of going into private practice. I am working on a power point and a longer article on the topic of counselors in private practice. That old Business Administration degree keeps calling to me. If that topic interests you, send me an email or other communication and I will put you on a list to get the link or the article when it is finished. The same goes if you are interested in the book that is in progress.

If you are interested in the role of Professional Clinical Counselors consider visiting the CALPCC website. (Links to CALPCC.org or counselorssoapbox.com are always appreciated.)

If you are a student, trainee or intern, consider becoming a member. The Unlicensed rate is a paltry $30 and includes some perks like accesses to the member’s only page, info on job opportunities and a discount on your liability insurance. That discount alone will pay for the membership or come real close.

CALPCC is a small but growing group. Most of the work is done by the members and volunteers, not paid professional staff. So when you join, consider volunteering to help and serving on a committee. Member input and participation in CALPCC is welcomed.

At this time the job openings for LPCC’s and PCCI interns are thin. CALPCC is working on getting more government and insurance positions open to LPCC’s. I believe that as more people know the things that LPCC’s can do the more job openings there will be. (Yes Mental Health Directors and other employers, LPCC’s are trained to and may see children.)

I know there are some behemoth counseling organizations who advocate for all mental health professionals, but if you are or plan to become a Clinical Counselor or another professional counselor then you owe it to yourself to join a group that advocates for Professional Clinical Counselors, particularly if you live here in California.

As you might guess I am a bit tired from the long drive and the writing schedule for the counselorssoapbox.com blog is behind schedule. It is a long drive from Fresno California to almost anywhere. If you find any typos that did not get corrected in the proofing, be kind, please.

Please – please, leave a comment or question. Those responses help me know if the things I am writing are useful and what other topics you would like to see posts about.