Psychotherapy costs a lot. If paying full fee for for weekly outpatient therapy, it is usually one of our most significant monthly bills. It begs the question of what makes it worth it, and why therapists deserve to get paid such a high hourly rate.
Many folks, including some clinicians, use the terms counseling and therapy as if they are interchangeable. Many clinicians engage almost exclusively in the use of counseling techniques and mistakenly call what they do as psychotherapy. This is a serious pet peeve of mine. Okay, not really a pet peeve as much as something I consider outrageous and inappropriate and ultimately a dangerous misrepresentation of education/skill/technique level.
Counseling has as its goals to support and validate, to provide advice, suggestions, and resources, and to offer motivation for change. Those things are great. But they are not therapy. And we should not pay therapy prices for them.
Counseling is something we can often get from friends or family, or even from ourselves through journal writing, meditation or a long walk in the words. When in crises with a particular issue, like domestic violence, or a cancer diagnosis, a recent death of a loved one, or desired career change, we might benefit from seeking out professional counseling by a specialist, frequently in an agency setting, and at an agency price. This won’t result in alterations in how we see ourselves, the people in our lives or our world, but it can help support us through a difficult time when we need to make some quick decisions.
Some therapists offer/use some counseling techniques in sessions with clients, but for the goal of furthering the therapy work. But when used routinely, counseling skills actually interfere with therapeutic goals.
Here are some of the tactics used by counselors, and why they don’t work so well in therapy.
What does good psychotherapy contain?
Smith is an analytically oriented psychotherapist with 25 years in practice. She is additionally the Founder/Director of Full Living: A Psychotherapy Practice, which specializes in matching clients with seasoned clinicians in the Greater Philadelphia Area.
If you are interested in therapy and live in Philadelphia or the Greater Philadelphia Area, please let Full Living: A Psychotherapy Practice match you with a skilled, experienced psychotherapist based on your needs and issues as well as your and own therapists' personalities and styles. All of our therapists are available for telehealth conferencing by phone or video in response to our current need for social distancing.
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Psychotherapy costs a lot. If paying full fee for for weekly outpatient therapy, it is usually one of our most significant monthly bills. It begs the question of what makes it worth it, and why therapists deserve to get paid such a high hourly rate.
The confusion evidenced by this question is the view of psychotherapy itself. It assumes therapy is for crazy people, or at a minimum people who are not well. Psychotherapy is a tool for crafting the person we want to be and the life we want to live.
Therapists aren't just really good listeners, or solid shoulders to cry on. We aren't sages with wise advise when you are gathering opinions from folks around you. What we bring to our work is expertise in how the unconscious communicates.
It is Freud's Birthday and most Americans, even psychotherapists, see him as a joke. These same therapists routinely rely on his concepts like denial, repression, displacement, unconscious, super-ego and the like. Face it: we are ill informed.
Psychotherapy exists in the realm of the symbolic. The target of change is not the drama of the week. Therapists are not sounding boards or shoulders to cry on. We offer those things, but we have significantly more sophisticated tools to offer clients.
Psychotherapy is not meant to be limited to addressing external, concrete dilemmas of the week. The realm of psychotherapy is the resolution of central, ongoing, internal conflicts.