1. What are the different types of professional mental health workers?
Psychiatrist M.D. specializing in psychiatry; most often treats by prescribing medication; usually has limited training in psychotherapy.
Clinical Psychologist Ph.D. or Psy.D. in psychology; specializes in testing and evaluation as well as psychotherapy.
LMFT Marriage and Family Therapist; Masters or Ph.D. in psychotherapy with speciality in systems therapy; understands and treats individual, marital and family problems in the context of relationship dynamics.
LCSW Licensed Clinical Social Worker; Masters in social work; training in psychotherapy in addition to understanding how to access public and private agencies and social supports.
CADC Certified Alcohol and Drug Counselor; certification in substance abuse, intervention, treatment and recovery.
Pastoral Counselor Minister (pastor, chaplain) usually with M. Div. or D. Min. degree with special training in counseling; may be certified by AAPC (American Association of Pastoral Counselors).
Psychiatric Nurse Specialized training in psychiatric care of patients in mental health hospitals, mental or behavioral health units in general medical hospitals, mental health clinics or treatment centers.
2. How are Christian and secular therapy different from each other?
Christian therapy A wide variety of approaches based upon or at least incorporating spiritual perspectives founded in Christian theology.
Secular therapy Follows and uses techniques and understanding from a wide variety of theories of personality and psychotherapy including psycho-dynamic, behavioral, cognitive, humanistic, existential, and systems approaches; typically have shunned (except existential) spiritual aspects of personality development, dysfunction and healing.
3. What are some of the different forms of Christian therapy?
Integrative Therapy Christian therapists who understand the Bible as God's revealed Word.
Belief in the unity of Truth; that if something is true, it is from God whether He chose to reveal it in scripture or allowed it to be discovered through the use of the intellect, gifts and talents that He bestowed on the human beings He created.
Belief that discovered truth, in order to be accepted, must be consistent with the revealed truth which is found in the Bible.
Biblical Counseling All problems are spiritual problems requiring purely spiritual remedies.
The Bible contains all of God's truth; there is no value in science; anything from the social sciences that is not directly found in the Bible is from Satan.
Pastoral Counseling Based in the tradition of pastoral care and chaplaincy.
4. What are the differences between individual psychotherapy, couples therapy, family therapy and group therapy?
Individual Therapy Therapist meets 1-on-1 with an individual; when the problems and goals of therapy are best approached as individual rather than relational issues; or when others related to the issue are unavailable or unwilling to be involved.
Couples Therapy Therapy with two people, usually husband and wife, to resolve issues in their relationship or to work together to resolve problems that either person is facing; also, premarriage counseling and relationship therapy for couples involved in significant relationships.
Family Therapy Involves whole nuclear families, members of intergenerational families (grandparent, parent, child), or selected members of families (parent and child) who are impacted by a problem and working together toward resolution.
Group Therapy Therapy with individuals or couples who are otherwise unrelated, who share a common problem and common therapy goals.
Each member benefits from feedback and support from not only the therapist, but also from other group members.
5. Isn't it true that if I am a Christian living a life truly committed to God, that I shouldn't need any help other than directly from God and His Word?
This belief found in some Christian circles suggests arbitrarily that all one needs for life's various difficulties is found in individual and group Bible study, individual and family devotional experiences, preaching, collective worship and pastoral counseling. This view limits the Holy Spirit's ministry to only these approaches and denies the value of God's ministry through medical doctors, financial planners, marriage and family therapists, and other Christians who are professionally trained.
There is also in this position an often not too subtle condemning of people's relationship with God when they experience difficulties that can be helped through consultation with professionals who have specialized training in a variety of areas
6. When is it appropriate to seek the help of a professional therapist?
When personal and/or relational problems have not been resolved in spite of your best efforts, using your personal, spiritual and relationship resources.
When your level of depression, anxiety, compulsive behavior, obsessive thoughts, relational conflict or other psychological, emotional, or relational pain becomes significantly disruptive to your functioning or sense of peace.
When your medical doctor suggests that your physical complaints are exacerbated by or have origins in stress-related issues or other psychological, emotional or relational causes.
When contemplating major decisions and changes in your life (marriage, divorce, career changes, geographic moves, etc.).
When struggling to accomplish needed significant personal, spiritual, career or relationship growth.
7. What characteristics should I look for in a therapist?
Academic and professional training to at least the masters degree (M.A., M.S., M.S.W.) or doctoral level (Ph.D., Psy.D., M.D.).
Licensed to practice in your state (clinical psychologist, marriage and family therapist, licensed clinical social worker).
Values and sees the necessity of addressing your whole person including the spiritual, psychological, physical, and relational aspects of your being.
Adequate level of experience, years in practice and demonstrated competence with the issues for which you are seeking help.
Practices according to highest ethical standards regarding confidentiality; fees and insurance; professional boundaries; not "bending the rules" or making a “special case” or “exceptions” for professional standards.
Good reputation among colleagues, peers and community.
Member in good standing of the professional associations that are appropriate to the therapist's license and practice.
Personal characteristics and relational style with which you feel safe and comfortable.
8. What is my role/job as a client in order to get the most out of my sessions?
Clients who derive the greatest benefit from therapy are generally those who really want to change and accept that they are primarily responsible for the changes and growth that they are wanting. They:
are open to being nurtured, taught and led by the Holy Spirit;
are willing to establish a trusting relationship with the therapist;
come regularly to counseling sessions, are ready to bring up issues and actively listen to and engage with therapist;
do homework given by the therapist to complete in between sessions, and try out new thoughts and behaviors that arise during sessions;
are willing to take the risks and face the anxieties that accompany confronting long-term inner fears, conflicts and aspects of life that feel out of control; and
recognize differences between what they are responsible for and can change, and those things that are beyond the sphere of their control.
9. How many sessions should therapy require?
There is a wide variation between literally only one session and several years of intensive psychotherapy. The length of therapy is determined by the combination of:
personality characteristics of the person seeking help;
longevity and type of problem being addressed;
amount and effectiveness of support the person has in efforts to accomplish goals;
types of goals being sought after;
therapist's theoretical orientation and style;
effectiveness of the therapist; and
frequency of sessions.
We often suggest to clients to commit for up to 10 sessions, at which time, they will evaluate with their therapist the advisability of terminating or continuing therapy.
10. When is medication appropriate?
Psychotropic medications are those whose primary purpose is to effect positive change in the person's psychological, behavioral, cognitive, and/or emotional functioning. The most frequently prescribed are anti-depressant, anti-anxiety and anti-psychotic drugs. Though many psychiatrists believe most psychological disorders are best resolved primarily through medication, our general approach is to suggest medication only in order to help the person to contain the symptoms enough to be able to benefit from psychotherapy and to be able to make the personal and life changes that will be necessary to accomplish the therapeutic goals.
Medication is suggested only when symptoms are so intense that the person's functioning is severely disrupted and the client is unable to contain the symptoms without biochemical help. God can use this type of medication just as He can use antibiotics as a part of His plan for healing.
11. What if I don't think my therapist is helping me?
Even very good therapists will not be able to help every kind of client or be effective with every type of problem. There are several different reasons why you might think you are not getting the help you need:
your therapist may, indeed, not be offering you the help you need;
you may be, for some reason, highly resistive to the help your therapist is offering;
there may be a poor therapist - client match; or
you may be progressing well but have unrealistic expectations of your therapy.
When you think you are not receiving the help you need, try the following:
from the points listed above, decide what is the cause;
openly talk with your therapist about your thoughts and feelings;
determine, along with your therapist, how you can gain more from your therapy; and
if nothing seems to help, terminate your therapy relationship and establish a new course of treatment with another therapist.
12. How do I know when it is time to terminate counseling?
There are several good reasons for terminating your course of treatment.
When you have fully accomplished your therapy goals.
When you have made enough progress toward achieving your therapy goals that you can continue good progress without the help of therapy.
When your therapy is not producing satisfactory results and you have fully explored the reasons with your therapist.
When you have decided, along with your therapist, that a different strategy would be currently better for you (e.g. support group).
When you and your therapist agree that a temporary break from therapy sessions is advisable.
When changes in your life (geographic move, physical illness, change in job or family responsibilities) make it unfeasible to continue therapy.
Remember that it is often advisable to terminate therapy by gradually decreasing the frequency of your sessions (e.g. weekly to biweekly to monthly).
13. What about the confidentiality of my sessions and records?
Successful therapy requires that you be as honest and open with your therapist as you possibly can. As a safeguard to you and the information that you share with your therapist, the state of California provides a legal privilege which protects the confidentiality of the information that you disclose to your therapist. The fact of your presence in therapy, the verbal disclosures which you make to your therapist, any written or other documentation which you might give to your therapist, and all of your therapist's clinical notes are protected as confidential information.
There are, however, circumstances when you therapist may be required by law to break confidentiality, such as in the case of reporting suspected child abuse, elder abuse or dependent adult abuse. Additionally, confidentiality may be broken when a therapist believes that the patient is in such mental or emotional condition as to be a danger to self or others.
14. What kind of insurance covers therapy? What do I need to know about them? What about confidentiality and insurance?
Insurance plans vary widely concerning coverage, so you should carefully read the certificate of enrollment, plan summary, or policy of insurance. If you still have questions you should contact your carrier to find the specifics of your particular plan. In order to assist you in this process, here are some basic questions you might need to ask:
Is outpatient mental health a covered benefit?
Do they pay for "non-plan" or "out-of-network" providers?
Is there a deductible you have to meet? If so, what is the amount and has it been met? (Note: some plans have a separate deductible just for outpatient mental health).
Are there any restrictions to your coverage such as: Limited number of sessions per year? Is preauthorization or a referral from your doctor required? (NOTE: we do not participate in any "medical groups").
What specifically is their "usual and customary" allowance and what percentage do they pay? If possible obtain a dollar figure they say they will pay. If codes are necessary, they are 90806 for individual counseling and 90847 for conjoint counseling.
Is there a specific address that mental health claims need to be sent to?
What about confidentiality with my insurance? As the insurer pays for care, they have a right to information which supports the need for treatment. Your health plan may, with or without your authorization, obtain information from your therapist about your treatment to determine if, in their opinion, it is medically and clinically necessary. The only way to assure that your plan does not have access to confidential communications between you and your therapist is to personally pay for the treatment, without the participation of the plan.