How to Find the Best Therapist for You: Qualities That Make a Counselor Qualified
I’ve gotten these questions as a therapist from several pending clients in many different situations over the years:
- Are you an expert on this issue?
- Have you worked with this before?
- Are you just a regular professional therapist?
- I’m not sure if you could help, can you?
It is a good question to ask. And a question coming from a pragmatic, caring heart, as you want yourself or someone you love, not to waste time but to experience healing and growth. So, in this article, I want to provide some introduction to what you can probably expect your therapist to know and how likely they are to help.
Therapist Training
Let’s first talk about the knowledge and training a therapist gains from the ground up, and what you can generally come to accept as standard for your experience across the board.
There are three basic differentiations for therapists by experience and training, like the levels in carpentry, which look like
- Apprentice
- Journeyman
- Master carpenter
Therapist training levels are:
- Trainee: like an apprentice learning the trade, supervised often by professors
- Associate therapist: like a journeyman gaining experience, full-time practitioners, gaining supervision by professional therapists, often still pre-licensed
- Licensed therapist: like a master carpenter, working under own license
This is the marriage and family therapy model of training classification, whereas other counseling professionals, like clinical counselors, social workers, and psychologists, may have slightly different education and classification than MFTs.
Like any profession, you can have brilliant and skilled technicians or not-so-brilliant or skilled practitioners at any level of training. But let’s start with trainees and ask the questions: Are you an expert, have you seen this, and can you help?
As a trained therapist trainee, one has received a variety of education and training around areas as diverse as child psychology and the study of aging along the lifespan, abnormal psychology regarding the study of all types of mental illnesses, and the study of what makes romantic partnerships and personal lives thrive and blossom versus fail.
All trainees have been reared in a number of different theories and philosophies, looking at what causes problems in human functioning. They are also trained in vehicles of change for the betterment of quality of life and the factors in therapy that are conducive to that growth.
You can have appointments with trainees and work with them, generally for lower fees than associates or licensed therapists, and specific benefits can range from their recent academic scholarship and research, the supervisors who really invest in their maturation, and so you have two brains working behind your care.
Trainees are often tremendously gifted individuals by nature who apply some of the common factors beautifully, as well as begin to grow more knowledge of certain specialized treatments.
Below are some of the common factors that describe what therapy looks like in every office and are generally considered factors that contribute to many healing outcomes:
Common Factors
Support
- Catharsis
- Identification with therapist
- Mitigation of isolation
- Positive relationship
- Reassurance
- Release of tension
- Structure
- Therapeutic alliance
- Active participation of both therapist and client
- Therapist expertise
- Therapist warmth, respect, empathy, acceptance, genuineness
- Trust
Learning
- Advice
- Affective experience
- Assimilating problematic experiences
- Cognitive learning
- Corrective emotional experience
- Feedback
- Insight
- Rationale
- Exploration of the internal frame of reference
- Changing expectations of personal effectiveness
Action
- Behavioral regulation
- Cognitive mastery
- Encouragement to face fears
- Taking risks
- Mastery efforts
- Modeling
- Practice
- Reality testing
- Experiencing success
- Working through
Therapists at all levels will be trained to apply these modes of thinking, feeling, relating, teaching, and modeling, which means most interactions, when things fit, are examples of dealing with an expert in modeling and shaping changed thinking, feeling, communicating, and behaving at some level.
Trainings And Credentials
Therapists at all levels can receive specialized training (as permitted by the presenters). In fact, I took training this last year for an evidence-based couples therapy approach that had me surrounded by psychologists with PhD’s, licensed MFTs, associates, trainees just beginning to see clients for the first time, many saying keenly insightful things.
Some training and methods can teach you theories that are evidence-based (meaning research studies have proven effective in achieving positive outcomes) or can have you trained in subject matter as general as child psychology or as specific as trauma-focused therapy with veterans.
Other training can lead to certification and credentials such as CSAT (Certified Sex Addiction Therapist), Addiction certified through organizations like National Certified Addiction Counselor, NAADAC, EMDR certified, or Gottman method certified, and those who pursue them often spend years and thousands of dollars on those specialties.
That shows a passion and a commitment to that subpopulation, which is a good sign if you’re a client (and probably means you’ll need to pay more for their services).
The next level of general training every therapist must progress to is that of an associate therapist. After a trainee graduates from their graduate program and has seen hundreds of hours of clients by then, they then apply for an associate number to begin seeing clients under the tutelage of a supervisor in a professional and paid relationship.
Therapists in this stage gain even more hours and end up with upwards of 1200 face-to-face session hours with a supervisor coaching them before and after, and countless more hours learning the trade, amounting to at least 3000 hours of training. Associates, on top of education, amass a lot of real training in the field.
Many of these associate therapists work in agencies or private practices under the license of their supervisor, so they are well monitored and guided by those supervising licensed therapists. During this time, they must acquire training in telehealth, ethics, suicide, and risk assessment, and often do many hours of extra training in these topics.
For example, the agencies I worked with during my associate period trained me intensively in Dialectical Behavior Therapy, which is a model that largely helps clients who are dysregulated internally regulate, make effective choices, and increase mindfulness and flexibility.
I also was taught Trauma Focused Cognitive Behavioral therapy, which taught a method of working with traumatized children to assist them to grow in the ability to deshame themselves, notice their feelings and sensations, and process trauma in a suitable way that left them more able to continue with their lives. Then, with this trauma, I was able to implement the tools and techniques of those models and then be shaped and molded by my supervisors into a more adept practitioner with those tools.
What is the scope of competence versus the scope of practice?
Terms you may hear from a therapist are.
“That is not in my scope of practice.”
This means the therapist, and any therapist at any level or professional title, would not be equipped to deal with. To exaggerate, filing your taxes, giving you legal advice, or telling you how to reconstruct your porch would be out of a therapist’s scope of practice. However, it is harder to identify discrepancies would be giving medical advice, or usually prescribing medication (unless the therapist is a psychiatrist
What is within the scope of practice is trained listening, encouragement, discernment, interpersonal skill building, self-regulation skill building, insight development, crisis management, mindfulness, and thought process change toward truthfulness
“That is within my scope of competence!”
This means the topic that you are bringing to the therapist is one that the therapist is well versed in and trained or experienced in more than the average therapist. For example, all therapists are trained to assist family members in healthier discussions, etc., but some therapists have a greater scope of competence than others, maybe to assist a family member dealing with a son with severe mental illness, which a different therapist might not be as competent in handling
The last level of training is being licensed in your therapy field, such as a licensed marriage and family therapist (LMFT), licensed clinical social worker (LCSW), or licensed professional clinical counselor (LPCC). After completing the required hours and your associate phase, a therapist of any sort is now granted the privilege, in distinction from the professional boards of their state and or professional organizations, to conduct therapy on their own.
If the famous anthropologist Malcolm Gladwell is close to the truth about 10,000 hours of practice making someone an expert in something, then including the associate time of 3000 hours plus many hours of undergraduate and graduate education, any licensed therapist is pretty close or at least halfway to being an expert, or at least a skilled professional at handling mental, emotional, and social issues adeptly for the client.
And many issues overlap, and initial reasons for coming to therapy can often lead both the therapist and the client to see that there are other underlying things to be worked on. Therapists who engaged in different ways of becoming experienced can often see problem areas where they can apply what they know from different angles, whether it be a more researched approach, common sense, or general intuition and skillfulness at the therapist’s springs.
I, for example, have been shaped through training in different methods, life experience, overall years of clinical experience, outside interests in readings, psychological concepts, and how much time in my faith, reading the Bible, listening to sermons, and community, which speaks to the human experience.
So perhaps I may have a potential client who says their child with high functioning autism is really struggling and isolating due to social pressures in junior college as a forty-year-old attempting to be more self-sufficient.
I’ve never worked with a forty-year-old with autism, and I’m not considered an expert who has had countless training sessions and hours of experience. However, I know the client will need emotional regulation, some interpersonal skills, some acceptance and understanding of where to push to accept limits, and family support, just through general awareness and experience
Hopefully, I’ve been able to show the spectrum of the kind of helpful care you will receive and things that you can look for and ask for to gain greater clarity. Overall, seeing anyone at any level in this field, it is likely you will be meeting with someone knowledgeable who can provide adequate supervision of your care.
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Body shame could originate from several things. Past trauma (especially sexual), but also emotional and physical abuse, can lead to debilitating body shame. Being bullied or teased as a child and young adult and being compared to others with different body types, can cause it. Constant social media or pictures of celebrities with “ideal” body types, perpetual and unwanted singleness, or a lot of unwanted romantic or sexual attention can also lead to body shame.
It’s never okay to mistreat someone because of their body shape, size, or anything about their appearance. This is body-shaming and often abusive. Most of the time, it’s because of something someone did or said to you that led you to feel shame about your body. You’ve been able to identify what it was that hurt you most.
If they are presently saying negative things about your body, it will be up to you to stand up for yourself. This is a way of treating your body like it’s good. Consider what boundary you’d like to put in place. For example, never talk about physical appearance with a specific person or not shopping with that person. It could be that you decide to only talk positively about your body and others’ bodies around that person.
Consider counseling
Men who are depressed may not realize that is the problem, and often, depression itself is a symptom of a much larger issue or unresolved conflict. This can present itself as anger, irritability, or mood swings. Do you find yourself irritable over minor offenses? Are your loved one’s pet peeves bothering you more than usual?
Certain techniques of therapy fit certain people. There is no one-size-fits-all. In order not to make this a textbook-sized article, the following are over-simplifications of different types of therapy, including some highlights of the most used therapies out there such as DBT, CBT, somatic, psychodynamic, etc. Just as a reminder, this is an oversimplification.
Psychological disconnect (no replacement for in-person), but otherwise no difference is shown in short-term studies (in other words, real work can still be done online).
The beginning phase
Again, couples go through all sorts of things, and many healthy relationships will face challenges, sometimes with mixed results. However, the mark of healthy relationships is that they don’t remain in a state of conflict, nor do they endlessly repeat the same mistakes without learning or growing from them.
Negative spontaneous emotional reactions. Your partner’s gut-level impressions of you, such as whether they like you or find you interesting, or whether they think you are competent, or how you might compare to other people – all these can point to the health of your relationship. A relationship dominated by spontaneous negative emotional reactions is a cause for concern.
Boundaries are important for the health of any relationship. Boundaries signal that each person has their own personality and needs, and respecting those boundaries shows consideration and promotes individual integrity. Boundaries can center around finances, privacy, use of time, friendships, sex, and much else.
Rather, the freedom in mind here relates to things like feeling the freedom to be yourself, to make mistakes, to be with people such as your friends and family. It’s a problem when you’re constantly criticized for being who you are, if any mistakes you make are closely scrutinized while those of others aren’t, or if you get isolated from people such as your family and friends.
Your digestion begins before actually eating food as it relates to external factors like stress and anxiety that unknowingly greatly affect how your foods are digested. Additionally, if your diet consists of food high in sugar or processed, your gut lining and proper functions of your digestion will be impaired due to the constant state of inflammation.
So because this is all the craze, many people rush into then buying those suggested ingredients, supplements, or diet plans without truly preparing for the course that aligns with long-term sustainability.
When it comes to exercise, try an activity that is something new and different. Notice the change in words from exercise to activity. Placing your focus on a daily activity also changes your perspective from it feeling like a chore. Make small commitments then increase your frequency over time. When trying a new activity and you realize you don’t like that one you picked, try something new. Exercise does not have to be hours on a treadmill or doing squats.
Cell phones and the internet have made it easy for anyone to make a few clicks and be instantly connected with someone else. Pornography also has different channels of enticing many others, for example: collect calls with random call girls, strip clubs, movies, magazines, TikTok, apps, games, etc. Porn is not just on the internet, it is everywhere.
So, what can we do? Connect with the same gender consistently and constantly. In 2 Samuel 11, you will read the story of King David who took time off from his busy military campaign. He sent his army to go off to battle while he remained in the palace all alone. We know from Genesis that it’s not good for man to be alone.
A man of God will help another man become a man of God. This is key in many support groups dealing with addiction because you can’t have a mixed-gender group talking about porn addiction. It wouldn’t be appropriate. Men wouldn’t feel comfortable describing their fetishes with another woman when an actual woman is staring right at them.
This is challenging because we don’t want to be called to a different standard, so we want to keep those defenses up. However, in my many years as a professional, and can only tell you that the secret to the success of many leaving this addiction behind is simply getting constant and consistent training from someone who has deep convictions on this issue.
When the day is done and the night closes in, as everyone else sleeps, Addie feels drawn to the kitchen area. The day’s stresses fade away as she begins to relax over the food she finds there. From cookies, chips, and cake to a gallon of chocolate ice cream, she eats all she can manage to get her hands upon. Then she makes her way to her bedroom where more snacks she’s stashed await her.
She is doing all she knows how to do to cope with the way she feels. Therapy has crossed her mind but she thinks she should be able to handle her emotions and feelings on her own. Besides, unleashing all the pain is a scary thought. She doesn’t need the added stress.
Those who have been diagnosed with BED quite often meet additional criteria pertaining to other diagnoses as well. It’s not unusual for them to also display signs and symptoms of anxiety disorders, depressive disorders, and even bipolar disorders. Another typical problem is substance and alcohol abuse. For this reason, a professional who is trained to recognize BED will also generally check for additional diagnoses as well.
Eating past the point of feeling full
In this age of social media, more and more people, including popular entertainers, are posting their struggles with anxiety.
In CBT, the professional counselor helps the sufferer reframe how they think and how they understand their behavior. In this way, negative thought patterns may hopefully be reduced to something more rational and realistic, preventing these unnecessary mental worries and physical responses to worry.
Spiritual self-care, which many today seem to ignore, is very essential as a weak spiritual connection to God makes one very susceptible to all kinds of problems, especially worries about the future. Regular prayer time, reading of Scripture, meaningful Church attendance, and fellowship with other caring believers will do wonders for the spiritual health so that negative, anxious thoughts will not easily bring one down.
Now while yoga is very helpful for those suffering from anxiety, as a Christian, one must remember to only incorporate the principles of relaxation and mindfulness and not any non-Christian spiritual practices or beliefs. Compromising one’s spiritual beliefs should never be an option.