Services Provided

The answer is yes, there is a difference and yes I do engage both of these potentials. Often the two terms are used interchangeably. I find extreme value in the blending of both for a third-level genesis of treatment. When the two fields are combined, it makes for powerful treatment prospects.

Psychotherapy is truly an affirmed, life-changing experience, while counseling is focused on guidance, support, and education.

Even though psychotherapy and counseling are considered distinct disciplines, over the years we have seen the homogenization of the two and for practitioners like myself, the two have become one, in the scope of thinking and practice. Counseling by this view may imbue some psychotherapy, and psychotherapy may take on shades of counseling.

Psychotherapy is heavily “feeling” and experience-based, whereas counseling leans into the cognitive and behavioral disposition. In this way, we can consider psychotherapy as a primary process activity (larger picture) and counseling as a focused and functional secondary process activity (narrower, specialized).

Counseling engages talk therapy to help an array of clients. Counseling will engage clients with questions to encourage openness and forthrightness regarding current problems they are challenged with at the time. This form of treatment can help identify problems, behaviors or other aspects of a client’s life and help them find a solution or coping mechanism for stabilizing and ultimately managing them.

Psychotherapy considers overall patterns, chronic issues, and recurrent feelings, instead of narrowing in on individual problems. This requires an openness to exploring the past and its impact on the present. The aim of psychotherapy is to resolve the underlying issues which fuel ongoing complaints.

When it comes to therapy, I don’t subscribe to “protocol” kind of therapy because it can be distorted into a kind of “packaged” and  “formulaic” approach to treatment. Some of this has been created by the managed care industry. However, I take a very eclectic approach to therapy and treatment so that I may pull from a variety of resources to treat symptomology. I will use Emotional Schema Therapy as a treatment to help clients understand and work through how they develop cognitive schemas to address how they map to and think about their emotional content. I may employ Dialectical Behavior Therapy to address “mindful” practices, Cognitive Behavior Therapy to work on how thoughts influence behaviors typically exhibited and work towards directedness of their specific behaviors, or Mentalization-based therapy which is an evidence-based approach to helping people who are depressed to understand their thoughts before reacting to them. Teaching the discipline now for 20 years at the doctoral level and my time in the field, as well as being a research scientist, allows me the breadth of opportunity to pull from a vast toolkit of methodologies and approaches to issues. I don’t move towards a “prefabricated technique” but rather allow the issue and situation of the client to dictate the most amenable choices for treatment.

Therapy, when conducted effectively and compliantly, has great potential outcomes. Notwithstanding, there are a few therapeutic processes I won’t engage in because even though their base rates are good, I have known of a few negative outcomes. An example might be something like EMDR as a technique. We still do not have all the answers on why it sometimes works, and there are still outliers where some people have experienced nightmares or feelings of retraumatization. I understand the possibilities with such treatments, however, it is also important to weigh the adverse aspects. Notwithstanding, most therapies are grounded and aspirational and offer the hope of remediating issues, rather than perpetuating them. Therapy of any kind, even those that are evidenced-based, may unhinge some of the negative experiences a person is carrying with them but that is part of doing the work. The client and therapist take the journey of healing together and if such elements arise, the client and therapist can manage and negotiate the effect in a more positive way.

 do. Although in the profession there are visible patternistic aspects between clients and pathologies, which why therapists utilize the DSM Manual to categorically refer to, we also understand that each client experiences the world uniquely from their own vantage point. For instance, if there was someone experiencing for instance some kind of dramatic shift in physiological reaction when around family members, it may be because of past traumatic content associated with that relationship from the person’s past. Let’s say they further, that this reaction is something that isn’t as evident in the literature on trauma. As a specialist in trauma, I have seen a varied array of symptomology, but there are times where I have also reached out to colleagues across the country, as far as Japan, for insight into unique anomalies a client may be experiencing from trauma that don’t fall into something documented but where someone else might be researching it as we speak. So in this case, a patient’s symptoms can be very unique from a statistical model and medical model, this is true, but there will also be some very similar identifiers as well. This is why although certain things are unique, we do as humans, experience the same range of emotions, and there are categorical components in which we can reference based on documented histories, even though our social experiences of the world and even our own genetic make-up make us unique.

I will lean into the idea of evidence-based approaches here because no one method works better than any other. In fact, sometimes things require an experimental approach that has a basis in evidence-based science. But, if we look at what works best, then those approaches built on evidence, where there is authenticated credibility based on rigorous testing, reliability and validity that supports it, then it should be those that we can count on for utilizing in treatment.

This question is a complex one. There are too many variables in the question to answer since the mosaic of mental health depends on many factors. Some issues are refractory or resistant to change. Other elements may also affect treatment methods where perhaps the patient has introduced a discrepant variable either voluntarily or involuntarily, making it more challenging for treatment approaches such as the addition of drugs, or a reaction to meds that their psychiatrist or physician has prescribed. So in context, my answer to this is no. I think this nullifies mental health potentials and boils its complexity down to a generalization.

Not necessarily. Sometimes a patient can do extremely well with one approach and may adapt to it well as a resource. In that case, I would not need to add additional treatments if success is being achieved with one.

Absolutely. If it is available to the client then I think familial support or the support of a caring friend is always beneficial. We are a meaning-making species who need each other, even down to physical touch, which is evidenced by the release of oxytocin in the body-a a feel-good chemical. Such support can always help encourage the potentials of therapeutic treatment.

I think when the pandemic started, it became a life-saving option for many and a healthy choice for many others. In a year of doing this intensely as a world that had to shift due to COVID-19, there has been a tremendous amount written so far about the benefits. Let me list a few of those here.

Accessibility. Online therapy allows for the breakdown of proximity constraints where travel or mobility issues can make it much harder to get to an office. 

More cost-efficient. Allowing for fewer travel costs, time, money, vehicle mileage to name a few.

Frequency. With less demand on office variability, the therapist can open more sessions, and clients with acute issues and those who would rather see a therapist more frequently can potentially more opportunities for sessions this way.

Increased progression. More frequency equates to the prospect of more efficient gains made in therapy.

Comfort maximized. Being in the comfort of one’s own place allows for more familiarity and offers up a way to be more comfortable when engaging in therapy.

Flexibility. No doubt this has been the biggest asset, as there is no travel time, no risk in getting from one place to another, and no variable space constraints.

It helps socialize healthcare. The technological realm is utilized for so many things, why not therapy? This availability and medium are beginning to open the door for many people who cannot get to therapy for one reason or another. 

Equivalent. Online therapy is showing equivalents to face-to-face. Zoom and other technology allow us to have some dimension of virtual space sharing. Research studies also indicate that telehealth is equivalent to face-to-face care in various settings.