Beyondpondering's Weblog

Northwest Arkansas Therapy

It is time to stand up June 16, 2016

Filed under: counseling,Therapy — beyondpondering @ 7:33 pm
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I have now come to an even “greater” conviction that there is only one way to prevent the exploitation of ourselves as therapists; and to prevent the exploitation of our clients. “That” way (as I see it) is for trained, ethical, hard working therapists to gather enough strength, stand up, and open their own practices. (Or, at least diversify, and have a side practice as a safety net for themselves.)

Stand up and walk. Walk to a destination beyond our comfort zone. We also need to learn. Sure we are scared because collage only taught us to work for someone else and not for ourselves. Yes, sometimes we need to move beyond our comfort level. Sometimes we also have to get mad enough, depressed enough, and “shocked” enough; we take our negative energy and do something different. We need to muster up courage.

By mustering our courage, even if it means channeling negative energy, we must learn how to run our own counseling practices. By running our own counseling practices, we are no longer contributing, perpetuating, or reinforcing the sociopathic system, which exploits us. Opening our own practice is a form of protest and self-protection. Furthermore, when we do muster our courage and open our own practices, we provide options for our clients.

Our clients (or perspective clients) are also tired of contributing, perpetuating, or reinforcing the sociopathic system. However, sometimes our clients are smarter than we are. They already know they are being exploited but they cannot find options. We still believe we are contributing to the “greater good”; meanwhile we are going down. We drown in our desire for altruism. Sure, we are scared but we cannot help people if we get our spirit, confidence, energy and life force is sucked out of us.

Interestingly enough, besides our clients, nature often possesses wisdom we do not. A mother bird always saves a few worms for herself. This is because nature’s wisdom automatically knows the mother cannot help her babies if the mother is dead. Similarly, we cannot help others if our life force is dead. Stand up. Learn. Move out of your comfort zone. Prevent the exploitation of yourself and help others.

At the risk of sounding elitist, I will sound elitist!

If you are an Arkansas LAC, LAMFT, LPC, and/or LMFT…you have passed some of the highest credentialing in the nation. You are more than just another spoke in the wheel. You are more than just another cog in the counseling industry…

You are “Crème Du La Crème”, the cream of the crop. You are part of an elite group of mental health therapists who have fulfilled Arkansas’ high credentialing. So have faith in yourself and stand up.

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SO SO TORMENTED BY THE RECENT NEWS March 7, 2015

I am so tormented be the recent news from my state.

I am so sorry for the child.

I am also so sorry for the adoptive parents who, undoubtedly, must have felt so helpless and hopeless.

No adoptive parent adopts a child with the intent of sending that child away to be sexually abused.

I would say for the most part, adoptive parents adopt out of a deep longing to help a child.

And there really isn’t help “out there” for parents after the adoption.

I have said before, and will say again…

That other adoptive mother,,, who sent her adoptive son back to Russia, probably came to the conclusion that that action was the most merciful; send him back to his own language, own culture, to the food he understood,to the things with which he was familiar…..

and she could not find the help she needed.

 

PARADIGMS September 30, 2014

Filed under: counseling,Relationships,Therapy — beyondpondering @ 12:36 am
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Okay, I have had writers block. I haven’t written in a while. Here goes…

PARADIGMS:  

A MILLION AND ONE WAYS TO LOOK AT THE WORLD

 YET I WILL BOIL IT DOWN TO ONLY

TWO FUNDAMENTAL PARADIGMS:

Problem Focused or Solution Focused

What is a paradigm?

According to Merriam-Webster :

A:  par·a·digm noun \ˈper-ə-ˌdīm, ˈpa-rə- also -ˌdim\

B: a model or pattern for something that may be copied

C: a theory or a group of ideas about how something should be done, made, or thought about

1:  example, pattern; especially :  an outstandingly clear or typical example or archetype

2:  an example of a conjugation or declension showing a word in all its inflectional forms

3:  a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations and the experiments performed in support of them are formulated; broadly :  a philosophical or theoretical framework of any kind.

Other words used to describe paradigm are: Example, pattern standard archetype, exemplar, and prototype.

 

So what does this have to do with counseling? There are a million and one ways to theorize about how human beings function, think, live, and process their emotions; and a million and one techniques to go with them. The Arkansas Board of Counseling mentions just a few listed below.

 Individual Therapy Focus

Cognitive Behavioral

Reframing exercises

Self-talk

Self-analysis/self-evaluation/self-assessment

Homework therapy

Relaxation techniques

Muscle relaxation

Deep breathing

Cognitive imagery

Guided imagery

Systematic desensitization

Problem-solving skills training

Self-monitoring

Cognitive restructuring

Role playing social problem-solving situations

Self-reinforcement

Self-instruction

Modeling

Positive incentives

Behavioral rehearsal

Monitoring negative thoughts

Restructuring negative or maladaptive thoughts

Person-Centered

Active listening

Reflection of feelings

Clarification

Empathy

Unconditional Positive Regard

Congruence

Adlerian

Gathering life history (genogram, family constellation, early recollections) ·

Therapeutic contracts

Homework assignments

Paradoxical intention

Suggestions

Confrontation

Interpretation

Providing encouragement

Paraphrasing

“Aha” experience

Catching Oneself

Acting “as if”

Gestalt

Reliving /re-experiencing unfinished business

Confrontation

Staying with feelings

Role playing

Empty chair

Creative expression (art, poetry, writing, movement)

Psychodrama

Putting feelings or thoughts into action

Body awareness (breathing awareness)

Guided imagery

Focusing on the here and now

Behavior

Reinforcement techniques

Relaxation methods

Modeling

Assertion/social skills training

Self-management programs

Behavioral rehearsal

Coaching

Contracts

Homework assignments

Reality

Evaluation of present behavior

Willingness to change

Development of specific plan to change

Awareness of how life would be different

Commitment to follow through with plan

Psychoanalytic

Interpretation

Dream analysis

Free association

Analysis of resistance

Analysis of transference

Questioning to develop case history

Existential

Identification of responsibility avoidance

Confronting irresponsibility

Owning of feelings, statements and actions

Attacking “wish” avoidance

Attacking affect avoidance

Unblocking decision-making

 Family Therapy Focus

From General Systems Theory:

Transgenerational/Bowenian/Contextual

Boundary making

Family sculpting

Genogram

Family reconstruction

Therapeutic contract

Going home assignments

Differentiation assignments

Family ledger

Structural

Enactments

Unbalancing

Tracking

Assess family structure

Assess family rules/roles

Reframing

Draw-A-Person

Kinetic Family Drawings

Family play

Strategic

Assess hierarchy/power

Circular questioning

Miracle question

Scaling questions

Exception questions

“As-if” assignments

Homework assignments

“Go slow” messages

Experiential

Positive connotations

Paradoxical interventions

Rituals

Ordeal assignments

Prescribing the symptom

Behavioral parent training

Restraining techniques

Identifying self-defeating patterns

Invariant prescription

2nd order changes

Family Sculpting

Family drawings

Hypnosis/trance

Here-and-now techniques

There-and-then techniques

Narrative

Questioning (opening space, meaning, future)

Deconstruction

Co-construction

Re-storying

Externalizing

Mapping influence of problem

Find Exceptions to Problem

Therapist’s letter-writing

Preferred view of self/from others

Psychoanalytic Family Therapy/Object Relations

Participant observation

Listening

Avoid reassuring, advising, confronting ·

Interpretation

Avoid counter transference

Integrative Family Therapy

Language of parts

Internal conversations

Micro/Macro lenses

Solution focus

 

WOW ! ARE YOU CONFUSED YET ?

MANY THEORIES HAVE BEEN LEFT OUT AND

MORE THEORIES COME EVERYDAY.

 

Okay, I will help you get off the Merry Go Round. I try to keep things simple. Everything listed above have been thought over and discussed thoroughly over the ages. They serve their purpose and help people. Yet even within the before mentioned paradigms, points of view, theories, techniques and approaches…

 

Therapy can be either

“PROBLEM FOCUSED”

or

“SOLUTION FOCUSED”

      Over the years of practice, I have done both approaches and have eventually come to prefer the “SOLUTION FOCUSED” approach. After using and watching both in action, I gravitated to the one, which seemed to me, proved more successful.

Here, let me give a brief synopsis.  PROBLEM FOCUSED:

“You are sad. You are so sad. How sad are you? So sad you couldn’t get out of bed for a week. So sad you couldn’t take a shower. So sad you couldn’t wash you hair or brush your teeth. So sad you couldn’t get up and let the dog out…..So sad the dog has now pooped on the floor…..”

Down……

Down…

Down…

Down….

Even I got depressed!

(The focus was on the problem of sadness.)

 

SOLUTION FOCUSED:

“You are sad. Okay…But I see you got yourself up…neat and clean, make up on…you got yourself here…Where did you get the energy and wisdom to come to a counselor?”

“Oh…you have known for a while you wanted to see a therapist and you finally made up you mind and made the phone call.”

“Yes, seeing a therapist is scary. But you know what? Most people do not even make the first phone call. Just the fact you made the call then showed up today, tells me a lot about how intelligent you are, your determination, and your willingness to do better in life. Congratulations…you are ahead of most people.”

(The focus is on strengths.)

Solution focus does not deny problems. On the other hand, why should strengths be denied? To me Solution focused is more balanced and healthier.

 

 

 

COST June 21, 2014

Filed under: Therapy — beyondpondering @ 4:02 pm
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5. Costs?

Cost is always a consideration these days. Not only is going to a therapist anxiety producing, the thought of going broke in the process, can also be anxiety producing.

“Never Fear, Help Is Here”

Before you flip your wig over the thought of an Associate therapist, there are potential benefits to seeing an Associate. They have most likely met their necessary qualifications. The very fact they have met these qualification indicates their quality. They did not drop out or get booted out of college. They just need time. Even their supervisor has met high criteria to be a supervisor.

If you are under serious financial strain, an Associate may have reduced fees. Besides that, you have the benefit of their Supervisor or Supervisors.   Everything is confidential, yet the Associate will discuss your situation with their Supervisor. This may be in an individual setting or in a group setting. You have the benefit of the ideas, suggestions, and insights from several therapists, for the same price. Now “how about that” as a good value for the price!

A Licensed Profession Counselor and Licensed Marriage and Family Therapist have met the high criteria set by the state. They have successfully met all the criteria to get their full licensure. You are essentially purchasing their extra education, extras training, extra experience, greater expertise, and longevity.

Remember the old saying, “You get what you pay for.” 

What is trending these days, is the therapist attempting to remove themselves from bureaucracy to have greater freedom to help you. They may try to keep overhead low by having a sliding fee scale, take cash or credit card. This can allow them more time to focus on you the client, rather than processing insurances, or hire someone else to process insurance.

So what is counseling all about anyway? We will talk about that next time.

 

 

 

 

 

 

4. LPC or a LMFT ? June 14, 2014

Filed under: Therapy — beyondpondering @ 8:22 pm
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What is the difference between an Licensed Professional Counselor and Licensed Marriage and Family Therapist?

“By the book”…education and perspective.

     “By the book”, an LPC’s education and perspective (or focus) is mainly on the individual.   The focus is on the wants and needs of the individual sitting in the chair in front of them. What does that one individual want?   What does that one individual need?    By the book, an LPC’s education’s main focus is the individual. Our society emphasizes individualism. That is good. That is fine.      I have no problem with that as long as the therapist understands no one is an island.

     We live in a complicated society which involves other people. The client came to be where they are due to multiple factors in society including family, friends, educational institutions, religious groups, so on and so forth. This is what Marriage and Family Therapists emphasizes. Not to say that an LPC cannot.  However, Marriage and Family Therapists get extra schooling which stresses “Family Systems”.

     A Marriage and Family Therapist’s education and perspective takes into account these reciprocal and interactive factors.  An LMFT will take extra classes to learn about these reciprocal interactive factors involved in the client’s world. Then the LMFT must pass through the Associate phase of supervision and practice counseling with a “Family Systems” supervisor.  Furthermore, they pass the MFT board requirements before obtaining their full licensure.

      An “individual” may want emancipation, for example.   A therapist can help with that. However, if that emancipation alienates that person from family, friends, alliances, and other support systems…is that really helping?   If that person becomes emancipated but is unable to support him or herself, is that really helping? A Marriage and Family Therapist will help the client understand these reciprocal interactive factors.

     So… an LMFT may help the person consider the social systems that are involved. The LMFT my encourage the individual to negotiate with family and friends to resolve tangled issues while also encouraging the individual to learn ways to value him or her self; work within the culture or system; or perhaps help the client to find new social support while the client is working on goals.  

     A therapist is not required to obtain their MFT licensure. They can practice with an LPC. An LPC may see couples. However, please be aware, only a LMFT may call themselves a Marriage and Family Therapist. They have earned it. Next time well talk about costs.

 

3. License? June 9, 2014

Filed under: Therapy — beyondpondering @ 10:54 pm
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     As I wrote the last segment, you probably noticed I used the word “Licensed” often.  I like what Merriam-Webster says:  

“Permission granted by competent authority to engage in a business or occupation or in an activity otherwise unlawful”.

     No matter if it is a Licensed Marriage and Family Therapist, Licensed Professional Counselor, Licensed Social Worker or any other Licensed Psychotherapist, each has an educational and preparatory procedure all perspective therapists are expected to follow. State boards establish these procedures before giving a license to a potential therapist, as a way to ensure quality.

      Each state has its own variation in their expectations: A little more or less, graduate level course work; a little more or less “practice counseling” under the watchful supervision of a more experienced Licensed therapist.  To make a long story short, there are two levels of counseling licensures: A lower level licensure for beginners; and a more advanced licensure.   In Arkansas a counselor must go through and apprentice stage before being allowed to practice more independently at the more advanced level. Merriam-Webster states an apprentice is:  “a person who learns a job or skill by working for a fixed period of time with someone who is very good at that job or skill”.

     In modern language the term “associate” is used. A Licensed Associate Counselor (LAC) or Licensed Associate Marriage and Family Therapist (LAMFT) never actually work FOR their supervisor.   However, they are guided, coached, taught, corrected, and perhaps even eliminated by a supervisor, if need be. This is all done to help you, the potential client.

     Arkansas Counselors have all completed a minimum 60 graduate semester hour Professional Master’s degree in Counseling or a closely related discipline (such as Clinical Psychology). They have passed a national examination, and a state examination. They must practice a minimum of 3000 hours under the supervision of an experienced counselor specially trained to supervise new counselors in order to be fully licensed as an LPC or LMFT.

     A Licensed Profession Counselor (LPC) and Licensed Marriage and Family Therapist (LMFT) have successfully met all the criteria to get their more full licensure. However, even between these two licensures, there are differences. This will be discussed next time.  

 

WHAT ABOUT ETHICS? June 1, 2014

2. Ethics?

What are some of the considerations in selecting a therapist? Allow me to first stress ethics. No matter if it is a Licensed Marriage and Family Therapist, Licensed Professional Counselor, Licensed Social Worker or any other Licensed Psychotherapist, each has a code of ethics they are expected to follow for their respective state licensing board. A code of ethics helps determine appropriate behaviors for professionals. Feel free to go to the State Board to gain information. A code of ethics is designed to protect the public and the therapist. You can also learn if any disciplinary actions have been taken toward any particular therapist.

 

A therapist is one who is to help you. To do that they need to listen, be kind, and empathetic. However, if a client has never had anyone listen to them, be kind, or empathetic to them, the client might confuse this unconditional positive regard with an emotional connection. It is the therapist’s job to set boundaries and not get involved emotionally with the client in a sexual manner. Now since you are aware of this, what can you do?

 

You need to “work on yourself” rather than get mixed up in an emotional relationship. Nevertheless, if your therapist is a good therapist, you should be able to bring up this topic in session and work through the matter so you can learn to develop healthy attachments and relationships in your personal life. Love yourself enough to not confuse kindness with a potential sexual relationship. Your first responsibility is to yourself and your own personal growth. Focus on your own growth.   Remember you want change for the better, not more confusion.

 

You can do this!