Choosing a Counselor or Therapist

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At some point you may face a problem in your personal life or at work that may seem too big to handle on your own. Or the unique responsibilities that are part of military life may have you feeling overwhelmed by everyday demands or finding it hard to enjoy life. For example, you may be having trouble concentrating at work or getting to sleep at night. Maybe you and your spouse are arguing more, or you're feeling anxious much of the time, or your child is eating poorly or seems "down." Whether your concerns are recent or long-term, it's important to know that there are professionals who can help you. This article will describe the different kinds of counseling and how they work.

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What is counseling?

The words counseling, therapy, and psychotherapy are often used to describe the same process. During counseling sessions, you will work with a trained professional who can help you identify problems and find ways to cope with them.

You are really retaining the time and expertise of a specialist who can help you understand more about who you are and how you can make changes in yourself or your life. For example, in counseling sessions you may discover patterns of thinking and behaving that you want to keep or change.

Counseling and therapy can take place individually, with another person (with your spouse, for example), with a family, in a group, or in a combination of these. Therapists working with couples often see the individuals separately as well as together. When working with families, they may see individuals, the parents, other combinations of family members, or the whole family together.

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Different kinds of counselors and therapists

Several different types of therapists who meet professional standards and licensing requirements may provide counseling or therapy across a wide range of issues. These issues can include parenting, grief, couples and family relationships, and combat stress.

Keep in mind that not all counseling is covered by medical insurance or TRICARE. Check with TRICARE for coverage information. Some types of counseling may be available free of charge through your installation or Military OneSource.

• Social workers have a master's degree in clinical social work. They have training in how people are affected by their environment, including family and culture. Social workers can provide individual, family, and group counseling.
• Marriage and family therapists have a master's or doctoral degree in psychology, education, or social work; postgraduate certification in marriage and family therapy; or both. They usually focus more on practical counseling and are trained to deal with personal relationships and family and couple conflicts.
• Mental health counselors also have a master's or doctoral degree in psychology or education. As with many counselors or therapists, mental health counselors specialize in helping people cope with a particular problem, such as grief, drug or alcohol abuse, or post-traumatic stress. Others may focus on a particular area, such as educational or religious counseling.
• Psychologists have a master's degree, and usually have a doctoral degree, in psychology, education, or social science. Psychologists are specially trained to use psychological and educational testing to aid in identifying and resolving problems. Like other types of counselors, they work in many settings, including mental health centers, hospitals and clinics, schools, and private practice.
• Psychiatrists are licensed medical doctors (M.D.s) who are specially trained to study, diagnose, and treat a patient's mental and physical condition. They often work as part of a team with other professionals. They are able to hospitalize patients and, in most states, they are the only therapists who can prescribe medication. Psychiatrists address people with more severe problems and collaborate with primary care physicians as well as therapists on implementing and managing a medication regimen for clients.
• Certified pastoral counselors are members of the clergy who have specialized training in psychotherapy. All service members have access to pastoral counseling by trained, qualified military chaplains through their commands and installations. These counselors are ordained by individual religious denominations before entering the military. Once commissioned they are further trained and certified to provide assistance to service members and their families of all faiths.

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Counseling options for service members and their families

Military service members and their families have several options for counseling services, and many are offered free of charge. If you are considering counseling, be sure to look into these resources:

• Your installation's chaplain. Military units and commands have chaplains who are also trained counselors attuned to military lifestyle issues and prepared to offer confidential, professional assistance. All services are free of charge and, unless there is a credible threat to security or people, counseling remains confidential.
• Military OneSource (1-800-342-9647, www.MilitaryOneSource.com). Military OneSource counselors and consultants can provide short-term, solution-focused, non-medical counseling, up to 12 sessions per person, per issue, with a licensed professional. Generally these sessions have to do with improving relationships at home and at work, marital issues, grief and loss issues (normal reactions that would benefit from short-term support), adjusting to a change in situation (such as a return from deployment. These personal sessions are available in three ways:
• Face-to-face. Military OneSource can arrange for you to see a trained counselor or therapist in your local community.
• By telephone. If you cannot or choose not to meet in person with a counselor in your area, Military OneSource will arrange a telephone consultation with a trained consultant.
• Online. If you would rather speak online with a consultant, Military OneSource can arrange for your sessions to be held in online, real-time "chat" format.

These services are offered free of charge to service members and their families, including Guard and Reserve members. Visit the Military OneSource site at www.MilitaryOneSource.com or call 1-800-342-9647 for more information.

Military OneSource counseling is not designed to address long-term issues such as child or spouse abuse, suicidal ideation, and mental health issues. People in need of long- term care are referred to a military treatment facility and/or TRICARE for services.

• Military and Family Life Consultant (MFLC). MFLCs are licensed professionals who can provide short-term, solution-focused, non-medical counseling, free of charge to military members and their families for everyday issues such as anger management, stress, parenting, family relationships, and deployment.

Ask the installation's Army Community Services (ACS), Marine Corps Community services (MCCS), Navy Fleet and Family Support Center (FFSC), or Airman and Family Readiness Center (A&FRC) about the process for using MFLCs.

• TRICARE or your nearest Military Treatment Facility. Therapy services may be available through TRICARE, either at a Military Treatment Facility (MTF) or through a network provider in your area. Your Primary Care Manager (PCM) can refer you to appropriate counseling or you may contact your regional Managed Care Support Contractor. (Find a listing online at www.tricare.mil/contactus/.) If you are using TRICARE, make sure you understand what services TRICARE covers and about any co-payments you may have to cover.
• VA counseling at Vet Centers. The VA provides free readjustment counseling to combat veterans and their families, including those still on active duty. The services are provided at more than 200 community-based Vet Centers by counselors who, as veterans themselves, understand the issues service members and their families face. More information is available online at www.vetcenter.va.gov.
• Outside military support channels. If you choose to seek counseling outside military support channels, make sure you understand the costs associated with counseling services before you begin a treatment program. As a service member, you'll also want to consider your responsibility to report counseling to your command. See "Understanding your rights to privacy," below.

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Choosing a counselor or therapist

Counseling is a highly personal process, and the match between a counselor or therapist and a client is highly personal, too. As a potential client, the more information you have, the easier it can be to make the right match. Some therapists specialize in treating men, women, children, teens, families, or couples. Others focus on issues such as grief or substance abuse.

There are many different kinds of counseling theories and psychotherapy treatments -- some explore past experiences and unconscious motivation, whereas others may emphasize behavior, learning processes, and surroundings. For specific problems, certain techniques may be more effective than others. A good therapist should know when to select a particular approach to treat a specific problem.

Even more important, however, is the way you feel about a therapist or counselor. You want to find someone who seems genuine, caring, and interested in helping you. Here are some things to keep in mind when choosing a counselor:

• Choose someone you like and feel that you will be able to trust. Research clearly shows that the relationship and rapport between the counselor and client are more important than the therapist's training, background, and approach. So when you're choosing a counselor or therapist, ask yourself these questions: "Do I like this person? Is he or she easy to talk with? Does he or she understand what I'm trying to say?"
• Advocate for yourself. Don't be afraid to ask questions that will help you decide whether you and the therapist share a similar sense of values. Think about whether you'd be comfortable discussing your problems and concerns with this person. Following are some questions you may want to ask:
• Do you specialize in treating people with concerns like mine?
• How much experience have you had treating people with problems like mine? Do you have experience with military issues?
• Are you licensed to practice in this state?
• Who will participate in the therapy (my child, my spouse, the whole family, only me)?
• How frequent will the sessions be?
• What are your hours? Are you available evenings, weekends, or for extra sessions?
• If out of network, how much will this cost?
• What are the repercussions for missing sessions due to illness or other emergencies or military duty?
• What happens if I decide I want to stop?
• What therapeutic approaches and techniques do you use?
• Have you treated people of my ethnic or cultural background before? People of my age and gender?
• Would you be comfortable providing a referral if, after a reasonable period of time, I feel little progress has been made?
• In an emergency, is there a procedure for reaching you?
• How long do you expect counseling to last?
• Be prepared to tell the therapist something about yourself and your life. Then decide how you feel about the response. Remember that it's OK not to reveal too much in your first meeting. Trust is built upon experience with another person.

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Understanding your rights to privacy

Whether through a military support service or a private therapist, your counselor should explain the limits of privacy. If he or she doesn't, be sure to ask. That said, all counselors -- military or civilian -- work to safeguard client confidentiality within the confines of safety and security-threat disclosure.

• Military counselors and therapists. For both Military OneSource (MOS) and Military and Family Life Consultants (MFLCs), the only exceptions to confidentiality are for mandatory state, federal, and military reporting requirements (for example, domestic violence, child abuse, or duty to warn situations such as situations involved your safety or the safety of others). Even then, only those who need to be notified will be informed. Service members may be afraid to seek non-medical counseling for fear that it may negatively impact their military career. The Military OneSource and MFLC programs stand by their commitment not to release information about the users of their services.
• Service members on flight status, in the Personnel Reliability Program, or with a high-level clearance are subject to more stringent reporting requirements. When these service members seek help from a counselor or therapist, they are obliged to notify the appropriate person in their chain of command.
• Insurance companies. Keep in mind that insurance companies, including TRICARE, have the right to audit your records and receive reports from the counselor or therapist in order to control the frequency and number of services. Some people choose to pay a therapist out of pocket to avoid giving insurance companies access to their files. Before doing this, make sure you understand the costs and any reporting requirements.

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Counseling for children

Sometimes children need counseling or an evaluation to help with behavior problems, depression, school problems, or family conflicts. In some cases, counseling might be part of a preventive treatment to help deal with illness, deployment, or divorce.

Therapists who work with children often use play and toys to help younger children communicate problems in their lives, and may ask a parent to be actively involved in a child's therapy. Depending on the situation, a child might meet with a counselor or therapist individually, in a group with other children or siblings, or with a whole family. Parents (especially parents of preschool children) are often involved at some point in counseling to help children deal more effectively with the situation. Children under 14 years of age benefit greatly from the involvement of their parents or caregivers, who need to help manage behavior changes.

When choosing a counselor for your child, remember to:

• Check first with your installation Family Support Center to see what free counseling options they may have, and then call Military OneSource for area referrals.
• Contact your TRICARE Managed Support Contractor for a listing of providers ( www.tricare.mil/contactus/).
• Offer an older child a choice about what kind of therapist he or she would like to see (man or woman, young or old). Involving your child in the decision can be helpful if your child is uncertain or hesitant about seeing a counselor or therapist.
• Be sure to ask the counselor or therapist who in your family will be involved in the therapy.

Beware of counselors or therapists who promise that they have all the answers and will give you the answers. Good therapists know that the solutions to life's challenges lie within you. They believe that their role is to help you discover your own answers in an environment of trust.

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Other resources

American Association for Marriage and Family Therapy

www.aamft.org

Provides an overview of marriage and family therapy counseling and a directory to assist you in locating certified marriage and family therapists in your area.

American Family Therapy Academy

www.afta.org

AFTA seeks to foster the cooperation of all who are concerned with the medical, psychological, social, legal and other needs of the family and with the science and practice of family therapy.

American Psychological Association (APA)

www.apa.org

Information on types of counseling and topics. Also provides a locator for psychologists in your area.

Military HOMEFRONT counseling page

www.militaryhomefront.dod.mil/tf/counseling

This DoD site provides additional information on no-cost counseling services available to service members and their families.

National Association of Social Workers

www.socialworkers.org

NASW works to enhance the professional growth of its members, to create and maintain professional standards, and to advance sound social politics.

National Board for Certified Counselors

www.nbcc.org

NBCC provides a directory of more than 36,000 master's degree or higher level counselors in the U.S.

National Mental Health Association

www.nmha.org

The NMHA information and referral center serves people seeking mental health information for themselves, family members, or friends.

TRICARE

www.tricare.mil

Information on services available through TRICARE, including health plan options. Access your TRICARE Managed Support Contractor at www.tricare.mil/contactus/.

VA Vet Centers

www.vetcenter.va.gov

Local Vet Centers in 232 communities provide readjustment counseling to veterans who have served in a combat zone and their families.

Your military support services

Each service branch sponsors information and support programs for service members and their families. You can call or visit any installation Army Community Service Center, Marine Corps Community Services, Fleet and Family Support Center, or Airman and Family Readiness Center regardless of your branch affiliation.

If you aren't near an installation, National Guard Family Assistance Centers are available in every state. The Local Community Resource Finder on the National Guard Family Program at www.guardfamily.org will identify your closest center.

Military OneSource

This free 24-hour service is available to all active duty, Guard, and Reserve members (regardless of activation status) and their families. Consultants provide information and make referrals on a wide range of issues. Free face-to-face counseling sessions (and their equivalent by phone or online) are also available. Call 1-800-342-9647 or go to www.MilitaryOneSource.com to learn more.

Written with the help of Rebecca Dion, M.S.S., L.C.S.W., Q.C.S.W., C.E.A.P. Ms. Dion is regional director of Behavioral Health Residential Services at Northwestern Human Services and is a member of the National Association of Social Workers. She is a past board member of the Philadelphia chapter of the National Association for the Prevention of Child Abuse.

© 2006, 2010 Ceridian Corporation, Military OneSource. All rights reserved. 030310

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