Often times when I meet someone for the first time and tell them I am a counselor, I get remarks about dealing with crazy or jokes about “don’t you psycho-analyze me too”. Very rarely are these comments more than light-hearted banter, however it highlights a wide variety of misconceptions about counseling. Typically, I like to take the first few sessions to begin setting clear expectations about counseling, introducing myself and also getting to know the client. This process is very important to creating that therapeutic relationship, but if there are fears or concerns you have about counseling, you are not likely to even make an appointment. So let me take this time to address some of the misconceptions I hear and give you a chance to decide if counseling is for you:
1. Seeing a therapist means I am weak, flawed or crazy
Mental health is something that every human being has to address at one point or another in their life. We have complex thoughts, beliefs and lives. This does not make you crazy or abnormal, this makes you human. Society has created a stigma around mental health where asking for help signifies you are weak, when in reality this actually means you are strong and have a support system to help you. It is ok to ask for help, and we are all a little crazy, embrace the fact that there is no normal, ironically it is normal to not to be strong or perfect all the time.
2. Therapy is just about common sense and advice
A lot of people ask me, “Why can’t people just go talk to their family or friends?” Nothing can replace a strong support system, however you can’t share everything with your family and friends. Often those closest to you cannot be unbiased because they know people or situations in your life, and their advice may be based on what is best for them, not what is best for you. Client’s come to counseling stressed, trying to juggle decisions, emotions, and facts and this can make common sense hard to see. Counselors hold a figurative mirror to the client to help them gain clarity and perspective, begin applying their own knowledge to the situation and have the client find their own answer. Counselors are cheerleaders, teachers, mentors and listeners, but you as the client will always know more about yourself and your particular situation so advice may not always be applicable.
3. Therapy is only for people with mental health disorders
Some insurance companies require a mental health diagnosis in order to pay for treatment, however more and more insurance companies are expanding to include stress, grief, relationship issues and other similar things without diagnosis. Private pay allows for more freedom in treatment planning, and allows the client to drive the goal-setting no matter the symptoms. Regardless of how it is paid for, research has shown that counseling can be effective on many diagnoses and symptoms and plays a role in physical health, so it should not be ignored.
4. Therapy is endless and will cost a fortune
There are two ways to pay for your treatment in counseling, either it is covered by your insurance, or you pay out of pocket. Insurance companies have very specific requirements for treatment including but not limited to licensure, forms, diagnoses, and treatment plans very clearly lining out the goals that need to be met before discharge. This is reviewed every 90 days. Insurance companies only allow therapies that have been studied and proven to work, they want to resolve mental health issues and end treatment as soon as possible. Private pay counseling is a service paid for exclusively by the client, allowing the client full freedom to terminate whenever they feel they have completed or met their goals. Results will come with time and work, but it will not happen overnight.
5. Therapy is all about feelings
Counseling can talk about feelings, but this is not all it includes. You can examine past events, thoughts, beliefs, values, and behaviors. A lot of people joke, are you going to ask me “How does that make you feel?” Yes, I might but I am likely to ask you a lot of other questions as well to help you clarify things in your life. I also hear about how men don’t have feelings so therapy is not for them. All humans have emotions, men and women may deal with them in different way, but that doesn’t mean men don’t have feelings. Often counselors have different approaches to men and women, and it is important to find a counselor who has techniques that feel appropriate and comfortable for you. If you do not want to talk about your feelings as often, find a counselor who is more direct or logical. If the first counselor you try doesn’t feel right, you can look for another counselor.
6. Counselors are not reputable doctors
No, counselors are not the same thing as doctors. Doctors study the hard concrete processes of the body. It is a very complex and intricate science. Counselors study people, behavior, thoughts and emotions which are not as defined as physical health, but still very important. Doctors spend 8 years in classroom instruction before starting residency programs. These programs are intended to let them practice under very close supervision for several years before becoming a full-fledged doctor. Physician’s Assistants spent approximately 6-7 years in the classroom. Both are licensed to treat physical ailments. Mental health providers also spend 6-8 years in classroom instruction before getting thousands of hours of supervision to get their licenses. These licenses may be in social work, counseling, psychology or psychiatry, and each of these can have specialty areas which require more training. The bottom line, counselors have gone through a lot of school, supervision and training to be licensed to treat you.
7. Counselors will put you on medications
Counselors are not licensed to prescribe medication but can sometimes partner with medical providers in order to give more comprehensive care to clients. Medication is not the answer to everything, but can be effective for specific mental health issues. For example, severe depression without medication to supplement neurotransmitters to help with energy, can limit a client’s ability to begin to work on the more homeopathic remedies or put work in for counseling. Research shows counseling can be effective without it, and depending on the specific issue being treated, might be most effective when paired with medication.
8. Therapists are all about the money
I have never met a counselor who went into the field for money. That being said, counselors still need to support themselves. We provide a service that we are passionate about. However, if the client doesn’t show up, typically we don’t get paid. Salaries range wildly, but the average counselor in the United States makes approximately $45,000 a year, ranging from $30-60 thousand a year.
9. One bad counselor = counseling doesn’t work
It always breaks my heart when someone tells me that they had counseling before, hated their counselor and decided to swear off counseling forever. You will not get along with every person you meet, why would counselors be any different? Counselors are people with emotions, thoughts and personalities. Sometimes they will remind you of another person in your life, good or bad, and you may attach those feelings to them. Other times, you may not like their approach, energy, or their personality, and that is ok. It doesn’t mean counseling doesn’t work, it means you need to find another counselor you can create a healthy therapeutic relationship with.
10. Therapists can only help if they have experienced the same thing
I hear this most often when working with addiction, but it applies elsewhere also. Typically, I ask the following: if you were diagnosed with a heart problem, would you require your cardiologist to have experienced a heart condition before they can treat you? Why or why not? Are they still qualified to treat you even if they haven’t experienced this?
11. No one I know sees a therapist
Counseling still has a lot of stigma and people do not like to talk about things they don’t believe other people will understand. That’s ok. Seeing a therapist does not need to be public knowledge. This means however that you might in fact know people who are seeing a therapist who just haven’t made it known.
12. My therapist will keep ALL my secrets
Confidentiality is really one of the biggest perks of counseling. Being able to talk to someone in a safe place and tell them things you feel you can’t share with others. However, there are situations where the counselors need to break this confidentiality. In the situations where a client might convey thoughts or plans of suicide or homicide, counselors are mandated to break confidentiality to protect the client and/or the community. This is similar to when a client reports abuse on a child, elder or special needs adult. These populations are less likely to be able to protect themselves, so counselors are mandated reporters. Lastly, if a judge subpoenas records for a client, a counselor can write a report summarizing the client’s treatment or may have to testify in court.
Counseling is a dynamic and evolving practice, and many people have lots of questions. Not all the answers are here, but if you find yourself curious, it is ok to call a counselor and ask more questions. Counseling is about serving others and we strive to make you feel comfortable so the process works. Take your time finding the right counselor, because your wellness is a journey, not a destination.