Tag Archives: Counseling psychology

December 5, 2012 · 10:27 am

Side effects of Counseling?


Next Monday is the last night of my Counseling & Physiology class (well, last night for the students as I have a boatload of papers to read and grade). As you might imagine, we spend a bit of time talking about psychotropic medications, their value, and probable side effects. Most students fall into one of two categories. Either they have personal and (largely) positive experiences with medications or they have concerns about side effects and observe the tendency of our culture to over-medicate.

But, it would probably be good for me to remind students that there are side effects to counseling or therapy as well. Most clinicians are trained to inform their first time clients that things sometimes get worse before they get better. Counseling requires that you attend to your problems, problems that you may have been in denial about. Talking about painful things usually means you think about them more outside of the hour with the counselor. In addition, you may find that the problem you entered with was only the tip of the iceberg. Or, you may find that the work to be done in therapy is much harder and slower than you thought, or the solution much different than you imagined.

There are a few other side effects that are worth pointing out.

  • You may discover you aren’t the righteous victim you thought you were; that you need more grace and mercy than you want to admit
  • You may discover you have bigger blind spots leading to new areas  to die to self
  • You may discover that others can love you despite your flaws
  • You may discover the joy of accepting some things you thought not possible to accept
  • You may discover better goals than the goal of getting beyond your troubles
  • You may discover strengths you didn’t know you had; success with new habits you had previously believed beyond you

Yes, counselors ought to talk to their clients about the side effects of proceeding in therapy (both general and specific to the particular intervention). Not to have this conversation is to not serve the client well. They need to know what they can expect from you and what other options they might choose. Of course, we also should discuss the side effect of doing nothing at all.

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April 16, 2012 · 10:48 am

In Counseling, Who is the Teacher?


Most counselors and therapists get into the field of counseling because they want to help people. This is a good thing! Imagine if they only wanted to make money or to be the center of attention. But, underneath the goal of wanting to help people lurks an insidious goal:

being seen as wise.

Being seen as wise (notice the difference between being wise and being seen as wise) tempts us to become the teacher, the teller, the obnoxious sage.  Teaching, telling, training are all activities that may happen in counseling, but only when necessary. Truth be told, we counselors resort to teaching and telling because it gives us a job to do and makes us feel good. This is especially true when we work with the most severely traumatized people. Here someone is hurting in front of us. We can see that they are stuck. Who wouldn’t want to pull them out of the mud? Now, there may well be important teaching moments–gently instructing someone on the symptoms of trauma and/or the physiology of trauma. This might be important for the client who believes that the symptoms are really signs they are sinning and that they can just choose to stop being triggered.

In Counseling, Who is the Teacher?

“The patient is the ultimate teacher about trauma, and a good therapist is a good listener.” (Boskailo, p. 81)

While the counselor has much to offer in regard to teaching, training, and goal setting, we must remember that the client is the one teaching us about their trauma experiences and how much they can deal with at a given time. For example, Boskailo reminds us (see above link for book) that while telling the trauma story is an important part of the healing process, the “how” of telling (and the “how much”) is something each client will need to teach us. One client may need to tell and re-tell the same story each week. Another may be better helped by drawing. Still another may tell once and never again.

We counselors are the student in these kinds of matters. It is our job to listen well and learn well!

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July 15, 2011 · 5:16 am

What does a counselor’s office tell you?


What does the decor of your counselor’s office tell you about the person? Or, if you are the counselor, what does your office tell your clients about you?

In the July issue of the Journal of Counseling Psychology (58:3, 2011, 310-320), Jack Nasar and Ann Sloan Devlin published, “Impressions of Psychotherapists’ Offices.” In their study (showing pictures of counseling offices) they found a couple of interesting facts:

“Studies 1 and 2 found similar patterns of response in relation to ratings that assessed feelings about the office and the therapist. As perceptions of softness/personalization and order increased, so did expectations about quality of care, comfort, boldness, and qualifications of the therapist. Perceived friendliness increased with increases in softness/personalization.” (p. 314)

This finding isn’t related to gender, age, or prior experience with counseling.

What should counselors avoid? Chaotic, cramped, messy, hard impersonal offices. Put your papers away. The lack of organization and the lack of personalized touches and softer seating may make your clients feel less safe and therefore experience less therapeutic gains.

So, what does your office say to your clients? I recall an office I had in community mental health (shared by several other counselors on a sign-up basis) was sparse, cold, and completely lacking any personalization, art, etc. No wonder many clients preferred talking to us on the street over the office.

My current office contains a love seat, a couple of other chairs, books in a bookcase, a warm wooden desk (that is usually neat in contrast to my academic office), one nice piece of artwork and another that is ugly, some beanie babies, and a blanket. While this office was set up by someone else, I think I’m going to change one bookcase that is in the eyesight of clients. It is a bit messy with various papers, books, and other junk.

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