Never feel shame for seeking therapist’s help

Quack, head shrinker, hippie, touchy-feely, social-worky, rent-a-friend. These are just a few of the slang terms applied to the work I do. I’m never sure what people are expecting the first time they walk into my office, but I’m pretty sure I’m not it.

I am a counselor who assists people with mental health and substance abuse concerns. Chances are you know someone who uses or has used the services of a professional like me. You may even have considered counseling for yourself. You don’t have to be “crazy” to benefit from counseling, nor do you have to have an unmanageable addiction. The only thing you really need to have is a desire and willingness to change.

I consider it tragic that in 2007 using the services of a substance abuse counselor or mental health therapist still carries a stigma. People entering my office for the first time often feel ashamed, embarrassed or even defeated. Outside of my office, I occasionally meet people I think would benefit from counseling, but I often find they feel insulted if I suggest it. We live in a “get over it” society where we are encouraged to “deal” with our problems and move on. Counseling can be a great option when you find it’s progressively harder to move on or the demands of a given situation are difficult to cope with. It’s one of very few places in the world where it really is all about you.

People often ask me, “OK, but what do you actually do?” I talk to people. I listen. I help them sort out problems that they haven’t been able to work out on their own. I help them learn new skills and unlearn habits that no longer work for them. I help them consider how past experiences might affect their present behavior. I can offer an objective point of view because I’m not a friend or family member. I’m a sounding board and a teacher. I’m not here to judge or criticize or tell you how you should feel, think or act. I’m here to help you get where you want to go.

It is important to find the right fit when choosing a clinician. It can be tough to ask, but often the best suggestions come from friends or family members. In general, I encourage people to talk to their medical doctors and other professionals in their lives. These folks often have clinicians they favor and can make a referral for you.

Clinicians are like shoes; sometimes you have to try on more than one to find a comfortable fit. I encourage clients to interview me and make sure that I’m the right person for them to work with. Any counselor worth working with should welcome your questions and concerns. Feel free to ask about our experience, education and training. Ask what we have to offer and whether we are willing to allow you to guide where you want to go. Expect your clinician to be patient and to work at a pace you feel comfortable with.

If you meet with a therapist once or twice and feel it’s a poor match, simply say so. A good clinician will not be offended or upset, and may even be able to suggest someone else for you to see.

I often hear reference to the “alphabet soup” after a clinician’s name. Those letters can be helpful in determining the kind of treatment that clinician offers. There are exceptions, but as a rule, “CADC” and “LADC” after a clinician’s name indicates that he or she is an expert in substance abuse and addiction. “LCSW,” “LCPC” and “LMFT” refer to licensed mental health counselors. Some professionals are able to treat both mental health and substance abuse conditions. Being treated for both of these conditions simultaneously is referred to as “dual diagnosis treatment.”

Finally, I’m often asked what the difference is between a psychologist and a psychiatrist. A psychologist is an expert in human behavior and will often perform advanced testing. A psychiatrist is medically trained and is able to prescribe medications.

Most clinicians meet with their clients once a week. Meetings are usually 50 minutes long. Most counselors accept some form of health insurance. Clients over 18 can trust that personal information discussed with a counselor won’t be shared with anyone else, except in specific situations that the counselor will explain. Parents or guardians of children in therapy typically reach an agreement with the counselor about confidentiality.

A counselor will guide you through an assessment of your life in the past and present. The idea is to get a sense of where you are and where you want to be, and to help you to make a plan to get there. Generally, the steps you choose to take are written down as part of your treatment plan.

How long does it take for counseling to be effective? It depends on the size and scope of what you wish to change and the kind of resources and support you have in doing so. A short course of treatment would generally be about eight sessions. In general, six to 12 months would be considered a full course of treatment for most conditions, though it is not uncommon for treatment to last longer.

How does it work best? Be selfish. Consider what you need and make sure that it’s addressed in each session. Ask questions. Treat your clinician as a resource. There is an important balance between talking about things and doing them. A good clinician will help you be more aware, gain needed skills, and resolve inner conflicts.

Finally, I encourage you to ask for “homework.” Meeting with a clinician will not result in significant change without translating what you’ve learned into action in your daily life.

Jim LaPierre is the program manager of Manna Outpatient Services in Bangor.

Please join our weekly conversation about Maine’s substance abuse problem. We welcome stories, comments or questions from all perspectives. Letters may be mailed to Bangor Daily News, P.O. Box 1329, Bangor 04401. Send e-mail contributions to findingafix@bangordailynews.net. Column editor Meg Haskell may be reached at (207) 990-8291 or mhaskell@bangordailynews.net.