A thought provoking article in the Huffington Post written by Oren Frank entitled: Therapeutic Conversations: A Shameless Future For Mental Health, has led this psychotherapist to write a blog commentary. My detailed commentary is below:
As a psychotherapist providing counseling since 1993 I have seen the changes the mental health industry has gone through as well as the shift in perspective of what talk therapy can and cannot provide from the lens of the potential client and from the lens of the many therapists out there who are keeping up with the times and what our culture needs/wants. Included are 5 points in response to the article whole.
- FINANCIAL: I am the founder/owner of a solution focused private practice specializing in the relationship dynamics between people of which I, as well as my associates provide marriage, family, and individual counseling for adults and children: Dr. Karen Ruskin & Associates, based in Sharon Massachusetts. We offer a financial discount to accommodate the financial needs for those clients who desire to work specifically with our group and cannot afford our usual and customary rate. There are other practices in various towns/states that do as such as well. I urge if someone wants counseling to not assume that all therapists and all group practices all have the same fee rate, if that rate is outside of your financial means. Although there are some therapists of whom you will not be able to afford their fee, please do not feel hopeless, there are options. Mental health insurance policies that change due to political decisions affects the mental health industry and the client population that we serve.
- SOLUTION FOCUSED AND GOAL DRIVEN COUNSELING: Solution oriented and goal driven mental health and wellness professionals is a helpful and needed style of talk therapy for what clients are in search of these days. My specialty and the elite team of therapists in my group are solution driven. Whatever town/state one may live in, the key is to do a search of therapists to find those who are solution focused and goal oriented if that is what you feel you want/need. Ask the question on the phone before you decide if this is the right therapist for you: “what is your therapeutic philosophy for how challenges are resolved and how problems are addressed?” Although therapy is a process, the process needs to include goals throughout and a re-evaluation of the goals to assure the communicative exploration and strategies offered are tailored to fit the needs of the client. www.aamft.org and www.psychologytoday.com are great resources where you can read about various therapists in your town and learn about their specialty and therapeutic methodology. You can evaluate even before making the call if the therapist appears on paper to be someone who will fit your therapeutic needs.
- DIAGNOSIS/LABEL: A diagnosis is necessary if insurance is to pay, insurance will not pay without a diagnosis. That is simply the fact of which we currently all live by. If you pay out of pocket then the diagnosis is not a mandate/required. Even when using insurance to pay the provider for services, it is the therapist and the client’s perspective ‘about’ the diagnosis that plays a role in how the client views his/her own self and presenting problem. The lens upon which how we view a diagnosis impacts our view of ourselves. Specifically, a diagnosis does not have to become a self label and thus does not have to be ‘illness’ based – if that is how you view it. There are therapists providing talk therapy, not all, but they do exist that rather the lens upon which one views a diagnosis is to rather simply see that the labeled symptom is in response to a larger problem. In essence, the diagnosis does not define the person and rather is a symptom. If we as therapists do not view our clients as ill patients, and rather view them as a client coming in to receive concrete strategies to help themselves help themselves get to a better place, break a pattern/cycle that they are caught up in, then talk therapy becomes not about a broken sick person coming in to be fixed. Rather, counseling is about a person who is feeling stuck. It is through conversation with another (the licensed skilled professional) who is vested in their clients’ journey: personal, professional, relational (whatever the presenting challenge/challenges may be) who will play a role in helping that person to help themselves make positive healthy shifts and grow through the therapeutic process in an effort to enhance one’s self and achieve one’s goals. A diagnosis when viewed as “making sense” based on the contributing factors at hand, rather than through a lens of “mental illness” at times can be quite beneficial, where appropriate. For example, if a couple comes in for marriage counseling reporting that the husband has become paranoid, anxious, and displaying obsessive behaviors, how the therapist handles that report is of significance. Rather than the therapist saying: “You are a paranoid personality type with obsessive compulsive disorder and have anxiety” ugh that is not therapeutic if you ask me, the therapist can rather state: “It makes sense that each time your wife leaves the house you wonder if she is meeting with the man you recently found out she was having an affair for years with. It makes sense that you are texting her with marked frequency and that you are displaying symptoms of obsessive compulsive disorder and anxiety. When something so traumatic happens in our lives that we feel we have no control over, often the result is an anxiety type of symptomology. It is our way of trying to regain control when we feel so out of control. It is our inner voice telling us something is wrong and wants us to look at the problem and resolve it. Once we address the underlying problem which is fear of trusting your spouse again out of worry and concern that she may hurt you again, go through a healing journey, and the couple re-connects on a deeper level growing , then the symptoms will cease to exist. It is these current thoughts and behaviors that are reasonable and valid immediately following such a crisis”. When we as therapists “make sense” of the client’s thoughts and actions and help them to understand how their thoughts and actions make sense in the context upon which they are in, it is that increased insight combined with concrete strategies, techniques, and solutions that will put the control and power in our clients’ hands to understand their thoughts and feelings and manage their behaviors.
- GROUP COUNSELING: Many do not desire to air their life circumstances and concerns to others in a group format, whether it is a group session in an office, or the utilization of social media in a group format. (Which are two very different experiences albeit each of value when appropriate.) Then there are those who do. For example, when people comment on my blog articles: Dr. Karen Ruskin’s Blog, it allows the reader to view other people’s comments. What a great learning opportunity for each reader and to feel a part of a group. This is not therapy though, therapeutic yes, but not therapy and not group counseling and we should not consider it as such nor suggest/confuse it as such. Rather it is a form of personal enhancement, knowledge expansion, and expression opportunity, but it is not true therapy by the pure definition of therapy. It is another therapeutic experience of value. There are many who desire conversations to be in a confidential therapy environment between themselves, their spouse, their family, and their therapist. Group counseling is a very different style and approach to therapy then one-on-one, marriage, or family counseling. Group counseling certainly is beneficial and serves great value and purpose, and should not be compared to other forms of counseling as an either-or opportunity, and rather as another form/style of therapy option available to our population in addition to: individual, marital, and/or family counseling.
- TECHNOLOGY/SOCIAL MEDIA: Technology as well as the various forms of social media when used wisely is a fabulous option to help clients navigate their life challenges. Each time I am on television, whether it is during my regular monthly ‘Ask Dr. Karen’ segment on FOX News Boston (viewers from near and far are invited to submit their relationship questions and I answer them live) , or when I am on national TV as a guest expert (e.g., FOX News Channel’s: The O’Reilly Factor, FOX & Friends, Hannity; FOX Business Network’s: Cavuto, or NBC’s talk show: The Steve Harvey Show, and more) it is wonderful to receive direct comments from viewers and be able to either through twitter, Face book, or email, further a point or help them in some way that the forum of TV opened up the window to, and social media allows to continue when appropriate.