How To Choose A Therapist / Counselor

Choosing a professional to help in your life is one of the most important decisions you can make.  If that person is helpful, life will be better.  If not, it can actually be damaging.  A good fit is crucial.

A good fit is when you have a sense of looking forward to sessions.  You should feel lighter afterwards.  You should have a plan or a bit of homework.  Your thoughts might drift to “I should call him/her” if you are struggling.  You should see improvement, or at least more hope if your situation is more entrenched.

A bad fit is when you find yourself dreading sessions, not telling the truth, being resentful about paying or wondering what you are actually doing in this work.  A bad fit can be damaging in that a person could come to hate therapy, refuse to ever go back, effectively cutting off a huge avenue for growth for years to come.  Even worse, it could leave the therapist’s words ringing in your head, making you feel crazy or more self-conscious.  Talk to your therapist first, before leaving, if possible.  Often, changes can be made.  If not, switch practitioners.  Look for natural helpers (friends, school social workers, EAPs, pastors, etc) to generate many names.  Then, get each person talking on the phone.  You’ll have a gut feel as to how they answer, if it feels right.

Bear in mind that it will take a few sessions to become completely comfortable with so much openness with a new person.  But there truly should be a sense of this being “right” or “ok”.  Your therapist should also be able to articulate the direction they would like to take you in, discuss methods of progress towards your goals.  If not, watch out for “Uh Huh” therapy, as I like to call it … . (Basically, everything you say is met w an “Uh huh… .”) 

For a child/teen, choose someone who can bridge both the kid world and the adult world.  Many therapists are more comfortable in only one or the other.   An ability to be at the kid level with play therapy or an ease of connecting with a teen matters.  Look for toys or fun in an office and attitude as well as invitations from the therapist for you to be a part of this work. 

For couples therapy:  Choose someone who has read and thought about couple interactions and can discuss their learning (ie the theories they like).    A good couples therapist should be able to balance “both” sides and be able to discuss how they interact.  Look for someone who is assisting you two to talk w/ each other, too – not just someone who referees and is the ultimate judge of mental health. 

Finally, look for someone who is training to stay on the cutting edge.  There is a lot of movement right now in the mental health field and a growing split is occurring between the new technologies that are out there vs practitioners who are not learning and improving themselves. 

Are there differences between the various degrees?  Psychiatrists are MDs who prescribe meds that can effect a change in your brain chemistry to help alleviate symptoms.  In some states, PhD or PsyD Psychologists can prescribe as well.  Many psychiatrists don’t tend to have a lot of therapy experience, but are outstanding at understanding the workings of the brain.  Many people have both a therapist and a psychiatrist that should work together on your behalf.  Otherwise, there are minor differences in training and outlook between degrees;  but even more important, in my opinion, is what how long they have been in the field, the enthusiasm of their recommendations from others and their continued training in this complex area.  Gauge your comfort level with their personality and style.  The smartest doctor can have a horrendous bedside manner, as we’ve all experienced! 

What about in vs. out of network on my insurance?  Be aware that while insurance is helpful financially, many experienced practitioners are starting to opt out of accessing insurance reimbursements … mostly because they can.  Their training, expertise and warmth put them in demand and like any field, they would like to be paid for their work.  Insurance panels pay horribly low and are getting lower.  The right practitioner can be cost effective for you because they use each session wisely.  Consider for yourself if this is a life changing issue that will hamper you in life if not dealt with … it might be worth it to put some resources towards it with their right practitioner.  I you must be in-network, consider expanding the location of your search and commuting further.

Remember — effectiveness and comfort are where it’s really at – you need this problem to change and it won’t unless you can relax and be a comfortable partner with a person who knows where to take you.  Don’t settle for less!

What Is Somatic Experiencing?

Somatic Experiencing is a gentle, talk and movement method of guiding traumatic experiences to become less emotionally charged.  The definition of traumatic experiences is widened in this theory, to include anything that overwhelms the nervous system.  Some examples of trauma can include a divorce or sudden health issue, a difficult job loss, a fight w/ a friend, chronic criticism, medical treatment, or a car accident.  Not all of these experiences are automatically traumatic – that varies among individuals.  But some moments hold great physical “charge” in our bodies, even though our logic tells us that we have survived.  By helping the body bring down that emotional charge, then, we see many external symptoms (ie sleeplessness, anxiety, flatness, low motivation) decrease naturally as people learn how to regulate their own systems more effectively.   Sessions at first glance seem just like traditional “talk” therapy, but the focus of sessions quickly becomes one’s internal experiences/body reactions, instead of details of a story.  It is comparable to EMDR in that the clinician is assisting the client’s body to become more regulated/ balanced;  SE can be a gentler, more subtler method, however,  than EMDR.  In addition to talk, SE brings in simple movements; some clinicians bring play and artwork to the work as well. 

At Family Resilience, our clinicians think daily in terms of the SE principles and how to teach them to clients.  We believe it is important for our clients to become aware of the effect their nervous system reactions (ie anger spikes, constant sleeping, distant stares …) are having on partners, family members and significant others in their lives.  It becomes the “missing puzzle piece” once explained.  

Some sample SE principles we invoke often include –

The body is wise and able to rebalance if we don’t override that process with our thoughts.

Our defensive reactions are there for a protective reason;  allowing them to emerge and complete is important.

We can learn much from nature and are happier when we live more in tune with naturalistic processes (ie allowing ourselves to breathe naturally, not teaching controlled breathing techniques).

The resources/ supports that are in our worlds are often overlooked or rushed past and can be sources of much strength and peace when noticed and internalized.

Recovery from trauma is an age-old process.   Today’s culture can inhibit that process.

Here are two links that give further information:

Couples Work A La The Gottman Method

I’ve recently become more aware of the work of John and Julie Gottman and The Gottman Institute, and find their ideas to be so important  in the area of couples work.

John Gottman, PhD. is a prolific researcher in Seattle, recently voted once of the Top 10 Most Influential Therapists of the past quarter century by the Psychotherapy Networker(  Over the course of his career, he has piloted 20-30 year longitudinal studies of couples, examining their communication and body language.  He can predict which couples will stay together and which will divorce to approximately a 93% accuracy rate.  In so doing, he’s provided clinicians with clarity on which patterns are toxic to a marriage and which skills are proven helpful to be taught in order to improve a relationship.

The four most toxic facets of couple communication are (not in any order):  Criticism, contempt, defensiveness and stonewalling.   Couples treatment at The Family Resilience Group includes both noticing these barriers to communication (and learning concrete skills to remedy them) and growing what “works” within the relationship.  Stonewalling (refusing to talk, shutting down) —  as an example — tends to occur when a person is so flooded with emotion they are frozen.  Perhaps one partner is so unable to get past their sadness, anger or fear, for example that conversation does not occur.  Teaching emotional regulation skills, including breathing, acknowledging the intense feeling, and other self-soothing skills is important here.  In another example, people who tend to criticize may need to hear themselves taped and learn the language of complimenting or acknowledging effort. 

Other skills that the Gottmans have identified as important for a couple to learn include repair attempts (using humor, choosing to rephrase), learning to accept influence, starting up less harshly and learning psychological soothing.  The goals off therapy include modifying how a couple handles conflict, enhancing friendship and creating shared meaning within the relationship. 

For more information, go to  The Family Resilience Group embraces Drs Gottmans’ work and has seen it improve many couple relationships over the years.

What Is Resilience? How Can I Become More Resilient Or Help My Kids Bounce Back Better?

Resilience is fundamentally a belief that all people possess a natural ability to better themselves and their situation.  This capacity has been clearly shown in longitudinal research.  But more importantly, how can I become resilient or help my children be survivors?

 Longitudinal studies by Steven Wolin, Emmy Werner, Michael Rutter, Ann Masten and others have consistently shown an innate ability to bounce back.  Steven Wolin, MD’s work over 20 years with alcoholic families indicates that most of them do not repeat their parents’ drinking patterns.  Emmy Werner, PhD. found a third of the kids from poverty and abuse stricken households were not affected by their surroundings.   Of the remaining two-thirds, many of them had troubled teenage years, but by their 30’s and 40’s, had pulled themselves out of their troubled lifestyle and were determined not to repeat their parents’ lives.  And in studies with youth from war-torn, poverty stricken countries, anywhere from 50-70% of them developed social competence and overcame the odds to lead successful lives.

 But what can we use from research for our own lives?  Resilience generally grows out of a drive to maintain a sense of self.  Families having difficulty can produce children who feel powerless and lack a belief in their strengths.  A resilient person will internalize success and externalize blame.  They will seek out stronger adult role models outside the family; they may gravitate towards families with untroubled parents or marry into stable loving families as adults.  Survivors also cultivate insight and are not afraid to ask themselves questions internally.  Resilience, is especially, however, about relationships that create caring, concern, meaning and connection;  an anchor to the future.

 These traits are commonly found in resilient survivors (in individuals) and are strengthened by the staff at The Family Resilience Group:

1.  Social competency:  Caring, empathy, sense of humor and connectedness.

2.  Problem solving:   Planning, help-seeking, flexible, creative thinking.

3.  Autonomy:  An ability to be independent.

4.  A sense of purpose or direction:  Dreams, goals, hope, faith.

These are the factors of an environment (the family) that are shown to produce resilient adults:

 1.  Caring relationships:  Convey compassion, respect, and interest.

2.  High expectation messages:  Firm guidance and structure, an awareness of strengths.

3.  Opportunities for meaningful participation and contribution:  Having voice and being heard, acknowledging and supporting decisions and talents.

 Therapy should work on both aspects:  Individual AND environment to create the best possible outcome.

Want to learn more?  Read Resiliency in Action by Bernard;  Overcoming the Odds:  High-Risk Children from birth to Adulthood by Werner and Smith.