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Welcome to my blog, a place to explore and learn about the experience of running a psychiatric practice. I post about things that I find useful to know or think about. So, enjoy, and let me know what you think.


Saturday, February 14, 2015

Counseling

In response to my post, GASP!, a friend sent me some links to articles about acupuncture. Specifically, acupuncture was compared with counseling and treatment as usual for depression.

What is "counseling"? I've heard the word used any number of times, and I think I just assumed that it's what people say when they don't want to say "therapy", because they think "therapy" sounds too stigmatizing. Or it's therapy as practiced by someone not specifically trained in therapy,  per se, like the clergy.

But maybe not. Is it therapy? A specific kind of therapy? How does it differ from therapy, if at all? Who practices it, and why are they called counselors rather than therapists? Why would someone want counseling rather than therapy?

I Googled "What is counseling", and I got some interesting links.

There's the American Counseling Association, which offered this definition:

Professional counseling is a professional relationship that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals. 

They provide further detail:

Counseling is a collaborative effort between the counselor and client. Professional counselors help clients identify goals and potential solutions to problems which cause emotional turmoil; seek to improve communication and coping skills; strengthen self-esteem; and promote behavior change and optimal mental health.

Okay, so counseling is some kind of professional relationship involving mental health.

According to the site, there are 4 different types of counseling: Individual, Couples, Family, and Group. There's a little blurb about each of these, and interestingly, the Family blurb, but none of the others,  uses the word, "therapy".

There are a number of counseling specialties, including but not limited to:

Career and employment
School
College
Marriage
Military
Wellness
Adult Development and Aging/Gerontology
LGBTQ issues
Substance

and something called, "Assessment". When I clicked that link, it explained:

Counselors, educators, and other professionals advances the counseling profession by promoting best practices in assessment, research, and evaluation in counseling. Assessments are a systematic way to obtain information about the client’s problems, concerns, strengths, resources and needs.

Does this mean some counselors specialize in taking a history? I can't tell.

There are state licensure requirements. There are also 2 certifying boards, although certification is not required.

The National Board for Certified Counselors requires passing an exam, the National counselor Examination (NCE).

It also requires:

-Master’s degree in counseling or with a major study in counseling from a regionally accredited institution
-3,000 hours of counseling experience and 100 hours of supervision both over a two year post-master’s time period
-Post-master’s experience and supervision requirements are waived for graduate students who have completed CACREP accredited tracks.

I don't know what those tracks are.

The Commission on Rehabilitation Counselor Certification (CRCC) is the other board. It has its own exam, and a number of ways of meeting eligibility criteria for certification, which seem to involve supervision, work experience, a Master's or Doctoral level degree in Counseling or Rehab Counseling, or an advanced degree in one of 13 areas:

Behavioral Health                         Psychology
Behavioral Science                       Psychometrics
Disability Studies                          Rehabilitation Administration/Services
Human Relations                          Social Work
Human Services                           Special Education
Marriage and Family Therapy         Vocational Assessment/Evaluation
Occupational Therapy


I still don't understand the difference between counseling and therapy. I found a site with a piece called, "Psychologist v. Counselor". It claims that:
-Counselors usually have a master's level degree, and generally don't do research, or perform psychometric testing, though some get further training to so they can.
-Some psychologists get licensed as counselors.
-And:

Psychologists are more likely to work with individuals with serious mental illness. They are trained to perform psychotherapy with a range of clients, but in many settings, general therapy roles will go primarily to counselors and other master’s level mental health practitioners. The reason? These individuals are more cost effective.

Bottom line: I still don't know what counseling is. It seems like "counselors" have a certain type of training, +/- certification, with varying backgrounds and degrees. But what they do remains a mystery to me, although it sounds like therapy.