Choose Wisely

Frequently, when people decide they would benefit from seeing a therapist, they are already experiencing significant upset in their lives. At the most obvious level, adults rarely enter therapy or parent skills training enthusiastically. As a result, resistance is likely to become a factor. However, once you begin the process, it will be important to keep an open mind. Discovering undesirable behaviors within yourself, often create uneasy feelings. At different times you may want to quit. But consider: You sought the skill of a highly trained licensed therapist because of specific psychological issues being experienced, either with yourself, your child(ren) or family. During those moments of self-doubt, stay focused on what brought you to this path in the first place.

It is also important to understand, that often it is not so much the difference between good schools of therapy and bad schools of therapy, but between good therapists and bad therapists. Research has shown rather consistently that the therapist/client relationship is largely what determines a successful outcome. A good therapist, like a good trainer, will never quit on helping you overcome “old habits.” Still, a therapist who is just perfect for one person, may not be a good fit for someone else.

So how do you find a good therapist? Word of mouth is a good starting place. If someone you know and respect has had good success with a particular therapist, that’s a good place to start. In addition, look for a therapist who has areas of behavior specialties such as: childhood defiance, adolescent depression, high conflict family issues or spectrum behaviors. Other places to look for a good therapist are schools, synagogues and churches where therapists give community talks. Be sure they inspire and not just lecture.

Finally, should you ever need to find a good child therapist, one word of caution. When you go to the office of a child psychologist, look for a relaxed space where the child gains an immediate feeling, “I can be myself here,” rather than being furnished like a serious business office, with a few offbeat toys strategically placed. A skilled and experienced child therapist always works in an environment that is conducive for children to know they can be spontaneous and uninhibited.

Our rules of personal behavior are always governed by our past. If too many of our early relationships were abnormal, we adopt abnormal responses. When that happens, we must break that linkage and substitute new emotional reactions. But first, we must know what is normal and not normal, in the context of relationships.

This need for change is not an indictment of the parents' abilities. Rather, it is simply a part of the therapeutic process that will allow parents to focus on new solutions. Family Therapy allows maximum expression for all members without fear of rebuke, to begin the process to open up and rebuild trust.

Play therapy is to children, what counseling is to adults. Toys are their words, and play is their language. The process of spontaneous play allows children to resolve the psychological tensions created by stressful events in a child’s life. Children are able to face difficult events because they are using familiar language and reactions where they have control of the play. The new scripts and schema that children create in the Play Therapy room are then generalized to their external environments.

Play therapists believe it is their job to understand children in their language, not the child's job to articulate his or her dilemma, in the language of the adult. Play Therapy is an evidence-based approach for preventing and resolving children's psychosocial difficulties. Studies have consistently demonstrated its effectiveness with a broad range of emotional problems.

Developmentally, young children lack the cognitive ability to meaningfully communicate their deepest thoughts and feelings through verbal language. The concrete objects (toys, art, music, etc.) and other play-based experiences provided in play therapy, afford children an age-appropriate means to express their difficult experiences. Children's behaviors are almost always an expression of what's going on inside them. Play therapy gives children an opportunity to make sense of their thoughts, feelings and life experiences in a way that is comfortable, safe, and non-threatening. In the process, children learn to develop greater trust in themselves, their abilities, and their relationships. Typical individual therapy for a child can last between 16 to 20 visits.

For adolescents, the approach of the therapist needs to reflect their own culture of life experience. Therefore, in addition to "talk therapy," therapy should also involve activity or experience around music, art and even play. These activities allow for powerful symbolic expression and release of internal conflicts.

Psychotherapy is not a teaching session and it is not advice. It is an honest search for what we do not see. The goal of psychotherapy is to acquire insight and clarity, create new priorities and gain the courage to change. A good way to think about psychotherapy -- is to consider: Does it foster insight? Insight is not pure learning in the intellectual sense of remembering facts. It is the capacity to gain a deep and intuitive understanding of others and oneself. It is the ability to understand the why of behavior. Within this model, insight must always be at the heart of all therapeutic sessions.

CBT is another form of psychotherapy that emphasizes awareness in the manner of how we think about the way we express ourselves. Cognitive behavioral therapy is based on the premise that our thoughts cause our feelings and behaviors, not external things, like people, situations, and events. The benefit of this understanding, is that we can change the way we think (and ultimately the way we feel), even if the situation does not change.

CBT therapists believe that clients change when they learn to think differently; therefore, CBT focuses on teaching rational self-counseling skills. CBT has nothing to do with "just talking." People can "just talk" with anyone. CBT theory relies on the Inductive Method. A central aspect of rational thinking is that it is based on fact, not simply our assumptions made. Often, we upset ourselves about things, when, in fact the situation isn't like we think it is. If we knew that, we would not waste our time upsetting ourselves. Therefore, the inductive method encourages us to look at our thoughts as being hypotheses that can be questioned and tested. If we find that our hypotheses are incorrect (because we have new information), then we can change our thinking to be in line with how the situation really is.

Group therapy is offered separately to adults, as well as children, all within the same age and gender who experience similar psychological issues.

The main benefit of group therapy is that suddenly, individuals who are experiencing specific difficulties are not alone. They are surrounded by others who have the same anxieties and emotional issues. Feedback from group members also offers a critical element to accepting the truth. Afterall, if everyone is giving an individual feedback about how they behave, it must be true. Members also gain a certain sense of identity and social acceptance from their membership in the group. Seeing how others deal with similar issues, often provides new solutions to their problems. As a result, the group provides a safe forum in which to practice new behaviors. Group therapy naturally simulates family experiences that allow new dynamic issues to emerge.

Studies have shown that group psychotherapy sessions benefit those who participate in them. Ideally, patients leave with a better understanding and acceptance of themselves, along with stronger interpersonal and coping skills. With the exception of young children, all members are asked to sign and maintain confidentiality about other members.