What kind of therapist are you? I get asked that question often. The short answer is I’m a master’s level therapist.
Masters level therapists are licensed by the state of Texas. We have passed state board exams, and we are held accountable to strict codes of ethics and legal standards by our state boards. Master’s level therapists have been trained to work with a broad and vast population of clients. We must engage in years of additional continuing education to maintain our licenses and must renew our license every two years, including three hours of ethics. We are not trained medical doctors, and we do not prescribe medications.
The work of a therapist can vary. There are over one hundred models or schools of psychotherapy. At one end of the continuum, is the psychoanalytic approach, where clients are working to make the unconscious conscious. The therapist is neutral, a blank slate, which allows the clients to project their unconscious mind onto the therapist and work through the issues. Psychoanalytic therapists are typically neutral and non-directive. The goal is to weaken a client’s defenses so the client can gain insight, self-awareness and access to repressed emotions and memories. The work is oriented toward the past and can be long-enduring.
On the other end of the continuum is coaching. Not unlike a sports coach, the therapist/coach can be directive, opinionated and expressive. The goal is to strengthen the defenses and achieve identified and agreed upon goals. The therapist/coach may assign homework and outside practice. Their approach can feel challenging and confrontational. The duration is more short-term and is more action-oriented in nature.
Determining goals of therapy often drives which approach works best for a client. If the goals are broad in nature: gaining insight, healing past traumas, eliminating self destructiveness or bringing about characterological change, the therapy will fall more on toward the psychoanalytic end of the continuum, and the investment is more long-term.
If the goals are more specific in nature: (I want to get a new job, I want to get my child into a 504 program. I want to find better ways to organize and manage my time), the work is very future oriented and those goals can fall more toward the short-term, action-oriented solution focused therapy. The investment in therapy may be five or six sessions.
As a therapist, I find most people fall somewhere in the middle of that continuum. They may come in for a very specific goal, for example: they want to get a new job. We talk about the mechanics of a job search. We develop goals around the job search. The client is future oriented and takes action toward that goal. There are assignments; there is homework, and the client often comes back and reports unforeseen obstacles, inaction or fear of moving forward, at which point I must shift my orientation and we must consider what forces are holding them back.
Here are some questions to ask yourself before you call a therapist:
1. Am I wanting short term or long term therapy?
2. Am I wanting to process memories, feelings and emotions and develop insight? Or am I wanting to move fast by taking action and making decisions?
3. Do I want to focus on the future? Am I willing to look at the past?
4. Do I want a therapist who mostly listens and lets me talk? Or do I want a therapist who offers solutions and opinions?
5. Do I want homework and outside assignments? Or do I want all the work to happen in the therapy session?
Remember, a good therapist has a toolkit. They should be able to make those shifts on the continuum. They should consistently evaluate when a client is ready to move forward and achieve goals, and when it is more appropriate to process feelings, memories and emotions. And it is important for the therapist and the client to work collaboratively to establish goals. It is also important for a client to remember that the past very much informs the present. Therapy can take you by surprise and lead you in places and directions you never anticipated.