A few weeks ago I was speaking with a woman about her adolescent son. She told me that her son had been seeing a counselor for several weeks and she had seen no progress. She wanted to know my opinion. I understand that people may be frustrated by the mental health profession because they simply are not informed about the process. For many people, finding a therapist is as frustrating as buying a new car. They don't know where to look and when they do find one, they don't have any idea if they made the right decision. This month I would like to present some ideas on this issue.
I suggest that you do not use the yellow pages to find a counselor. Talk with people that you know who have used therapists and ask for their recommendations. You might find a good therapist by chance, but I assure you that there are many therapists who are not very good and some who are unqualified. Find a therapist who regularly works with the age child you have. Therapy is very different at different ages. A counselor who is very good with adolescents may not be skilled with young children.
Consider licensure as another issue. In Georgia, there are several levels of licensure. Licensed Professional Counselors, Clinical Social Workers, Marriage and Family Therapists are overseen by the state licensure board. They must have at least a master's degree, several hundred hours of supervised clinical work, and they must pass the state licensure exam. Licensed Psychologists have even more requirements as do psychiatrists who are also medical doctors (the only people in the mental health profession who can write prescriptions). All of these counselors should be able to accept insurance payments and are overseen by the state licensure board. Licensure does not guarantee a counselor is a good one, nor does the lack of licensure mean one is unqualified. However, in the state of Georgia, with the exception of clergy, only those who are licensed can legally practice therapy .
Once in therapy, the therapist should work with you to evaluate the problem(s), set goals for therapy, and establish criteria as to how you will know when those goals are met. Goal and criterion setting is crucial to therapy. For example, a goal might be to reduce aggressive behavior in a child. A criterion might be "five or fewer incidents at school in a month." Goals and criteria are individually tailored to the client. Goals can be added or changed as therapy progresses, but if you and your therapist cannot at any point in time identify your goals and how you will know when you get there, something is wrong.
Don't expect a therapist to give you an exact number of projected sessions for a problem. I try to give my clients a rough idea, but how long therapy takes depends on the skill of the therapist, the responsiveness of the client, and the level of involvement of the parent. One should not expect problems that have existed for five or ten years to be resolved in one or two visits.
Finally, your therapist should regularly remind you of your goals and provide a verbal or written progress report. I make it a point every week or two to discuss the goal(s) with the parents of my clients and let them know where I think we are. If my client's parent feels we are making no progress after several weeks, I will refer the client to another therapist. If your therapist has not reviewed your child's progress, ask. If he or she can't answer your questions regarding progress and goals, find another therapist.
Therapy can be time consuming and expensive, but the earlier problems are dealt with, the easier they are to correct. If you have questions about therapy, e-mail me at: gkm35@mindspring.com. I'll be happy to give you my opinion.
