Under what circumstances should a member be told to seek "professional" help instead of or in addition to this site of people helping people?
I will admit that I've been a bit put off by members being told they need expert help by mental health professionals. Perhaps it's primarily in the way it's been phrased.
If something like that were said to me, I think I'd feel rejected, hopeless, too "sick" for a support group.
How do others feel about this issue?
[And I should be open about this: I am a retired clinical psychologist, for whatever that might be worth]
I think people bring up issues that are beyond the ability of a bunch of amateurs/strangers online to help with appropriately -- eating disorders, bipolar issues contributing to weight issues, medication issues, abusive relationships, specific questions relating to already diagnosed medical conditions including psychiatric disorders, alcohol and drug overuse, situations that clearly indicate low self esteem and so on.
There are group therapy situations which may be appropriate but very few of us are trained to recognize which ones need to be seen on an individual basis by a trained professional and which ones can be dealt with through support groups solely. Perhaps we see trained professionals as being the most able to sort this out.
Last edited by misskimothy; 11-14-2009 at 02:35 PM.
Personally, I'd much rather people were told to seek help when it wasn't needed than someone who's goals are so disordered that they might be tipping over into needing help being told to up/down their intake.
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If something like that were said to me, I think I'd feel rejected, hopeless, too "sick" for a support group.
I don't think that any of us like the feeling of rejection but maybe not being robust enough to handle something like that is a sign that someone isn't really up to the rough and tumble of a support group?
Is this a support group where people make suggestions what they see the other person needs...or is this support group a place where individuals tell their stories (like the 12 step programs)...or is it a little of both?
For me...this site is about taking care of myself...I can't see myself telling someone something that I feel they need (like psychotherapy) because I am not an expert...I can see I may tell someone that they it might be wise for them to seek outside help. Maybe it is the word "psychotherapy" that makes me uncomfortable.
Although, I believe "psychotherapy" has certainly helped me on my journey to where I am today !!
I guess I'm a bit surprised that you'd feel this way being a clinical psychologist. Did you only work with extremely disordered ("sick") patients? Or were they mostly normal people with decent coping skills overall, who just needed a bit of help with a problem they didn't feel comfortable sharing with freinds and family, for some reason (maybe because the friends and family were the problem)?
My masters' degree is in developmental psychology, so I didn't have a great deal of clinical training (some, but not nearly as much as a student in the clinical programs would have had), so that might account for my different perspective. I don't see seeking counseling as exclusively "treatment" oriented - a fix for severe disfunction. In my ideal world, everyone would have a primary care physician (and receive regular check-ups even if they had no sign of illness) and also a primary care psychologist, as well.
Most people use their friends and family, as their mental health provider. They may also expand those resources to social organizations and clubs, online chat opportunities, interactive game sites, support groups on and offline, their pastor.....
I don't know why it's perfectly socially acceptable to seek social support, someone to listen or give advice... and yet a sign of illness if you pay someone for the service (many prostitutes have stories of clients not wanting sex at all, just someone to listen to them. Sad that a man migh be willing to break the law, because he fears the the stigma of seeking counseling more than the stigma of patronizing a prostitute).
Most of my career I worked in county law enforcement (juvenile detention and adult probation) and substance abuse treatment. I did deal with a lot of severely emotionally and mentally ill people - but for the most part, I worked with surprisingly "normal" people. I even recommended counseling to some people who may have had their lives "together" better than mine was at the time, in many respects.
I recommend counseling alot - not because I think the people I'm recommending it to are "sick," but because I think a counselor can provide an objective viewpoint in a way that a friend or family member cannot (because they have a stake in the outcome). For example, I think marriages should "come with" a marriage counselor - just part of the package. An objective third party who can help a couple communicate without having a stake in the outcome. Some people are talented at seeking appropriate non- or semi-professional (usually free) resources (often without knowing that's what they're doing, they just see it as seeking a second, third, or fourth opinion) - the friend who can be objective, the pastor (trained in counseling), the friend or aquaintence who has training or just natural talent at listening and/or giving advice....
Starting to ramble here, but I think I've made my point. Seeking counseling should not be seen as something only mentally "sick" people do, should do, or can benefit from.
Having been around these parts for a while, I have seen plenty of comments suggesting that the OP seek professional help.
I have recommended that exact thing at least twice.
While I certainly understand the dangers that could arise from pointing out the person may be in need of more assistance than this forum can give, I would prefer to err on the side of caution, and at least suggest that the OP consider seeking the opinion of someone qualified to answer their question(s).
Example: When a poster that is 5'11" wants to continue losing weight because she still feels fat at 135 lbs, I do believe that she may need more than 3FC can provide. I loved the responses she got - lots of practical suggestions from wise chickes, but those that suggested she seek support beyond this forum were appropriate and done in a loving and caring way.
One of the things I like best about 3FC is that folk here do understand the nature and limitations of the medium. I believe that the majority of our chickies and roosters give sound and uplifting advice. And - for the most part - those that have suggested that the OP should consult a professional have done so out of care and concern for the health and well-being of the OP.
EDIT: And, for the record, I am a former counselor and social worker.
Last edited by CountingDown; 11-14-2009 at 03:14 PM.
I am of the opinion that mental health is not only everyone's right, but also their responsibility. There is entirely too much stigma attached to seeking psychological counseling, when the truth is that everyone could benefit from a little therapy. I think often people neglect their psychological health and then can't figure out why they're not happy despite all their efforts.
I have often advised fellow forum members to seek counseling, particularly in the "chicks in control" section where those of us who suffer with eating disorders post. I have never outright said "you should get counseling" but rather share about how my own experiences with therapy have helped me.
I know that people often think about seeking professional help and sometimes need a supportive nudge to overcome their fears about it. I think it's admirable to provide yourself with the opportunity to find a safe way to express your struggles with weight or whatever else. I would think that a clinical psychotherapist such as yourself would support reversing the stigma of seeking help.
"Life coaches" are becoming increasingly popular (and no training is needed for the title). Even "counselor" is a generic term, and doesn't necessarily mean the person has had any training in psychology.
People who would never consider counseling with a professional psychologist (because that would be admitting a problem) will pay an exorbitant amount for advice which may have no training or even life experience backing it.
Life coaching is an awesome concept, but why trust your life to someone without some training in interpersonal relationships, human development, psychology, sociology....
Playing Devil's Advocate here, to trust your life to anyone, trained or not, is a somewhat risky business. The profession of Psychology/Psychiatry has come under recent scruity for a number of reasons, not least of which is the new DSM manual under development (a disorder for EVERYONE!) and the eternal debate as to whether or not Psychology is indeed a legitimate science. Now, I'm not going to debate that because I'm just saying that there are issues today within these professions that are being more scritizined than they were in the past. Suffice it to say that being treated by a Clinical Psychologist or a Board-Certified Psychiatrist does not mean that you are actually being treated by a stable and sound individual. At least with Support Groups, you are spreading the risk of dealing with an oddball amongst a larger number of people which gives you the opportunity of hearing a wide range of opinions and advice rather than relying on that one person who you HOPE is knowing what they are doing and who you assume is sound in mind and judgement.
Last edited by misskimothy; 11-14-2009 at 07:51 PM.
I just wanted to add that many life coaches DO go through certification and training--so if anyone is considering a coach, check into their credentials.
Life coaches are not the same as "counselors" or "therapists." A coach helps you reach YOUR goals by providing support and guidance/suggestions. A coach doesn't get into your background, childhood, traumas, mental health, etc. Coaching is supposed to be very practical and focused.
I wouldn't suggest that anyone substitute a support group for medical or mental health advice. Nor would I advise anyone not to see a physician because some are crackpot sociopaths.
Yes, trusting anyone, any time, for any reason is a risk. That's why common sense is required when consulting any "professional" regardless of the profession.
Plumber, physician, minister, psychologist, chiropractor, or hair stylist - seeking a professional opinion should never mean blind faith in that opinion. If something doesn't seem on the level, trust your gut and get a second, third, and 30th opinion if necessary.
As for life coaches, I'm not dissing the profession or it's practicality - just the stigma against seeking counseling of any kind (so the need to call it something else, or avoid people with training in human behavior and psychology, because "counseling" has such a stigma - call it coaching or consulting and it's ok).
However, the implications of trusting one's life to a surgeon or a psychologist/psychiatrist are much more significant that trusting one's next hairstyle to a hairdresser or trusting one's bathtub caulking job to a plumber. Are we also assuming that people in serious need of health are able to make a good assessment of the situation? Often they go with their MD's recommendation adding a third layer to the mix. Not everyone is capable if they are in crisis to do due diligence. And even then, due diligence isn't faultless.
I personally think that there is a role for personal one on one therapy, group support sessions and life coaches/counsellors, depending on the situation. I don't think that being a certified clinical psycologist or board certified psychiatrist is a guarantee of anything, especially since we have alot of members on this forum who have provided counselling-type services successfully within their legitimate scope of professional duties without being a clinical psychologist/psychiatrist.
Last edited by misskimothy; 11-14-2009 at 08:34 PM.
You're entirely missing my point, which is that no one should entrust their life to anyone, including their doctor or a psychologist. We all must be self-advocates first. I do trust most people to be able to do so (and those that aren't, probably need a guardian appointed to them).
There are no guarantees - yes, that's true. But a person who is not stable enough to make a good assessment of their physician or counselor and the advise they receive from either, is also going to be unable to make a good assessment of the adviced they receive here. They'll be just as likely to take bad advise from someone here, as from their doctor.
I trust most people to use good judgement when taking (or ignoring) advice they're given, regardless of the source. If a person is prone to taking bad advice, or is unable to discrimnate good advice from bad, no advice is going to help them do otherwise.
Haven't been around a lot, sorry. I've been super busy lately and haven't seen any recent posts that may have prompted this question. But I do have some pretty strong thoughts on this subject.
I'm curious if any of you who think it is a good thing when members recommend therapy have been told in this forum that they should get therapy? If any of you, how did you feel about that?
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up to the rough and tumble of a support group
Since when is it OK for a support group to be rough and tumble? Aren't those concepts kind of at odds? I didn't think we were here to bludgeon each other into weight loss, unless someone is ASKING for a kick in the pants.
When I first signed up, I read this:
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The contents of this website are for information purposes only and are not intended as medical advice or a substitute for professional medical advice, diagnosis, or treatment.
There is the implication, right away, that this forum is not a substitute for seeing a professional and that people may need to seek outside help. It seems to me that applies not just to how people use posts but to how they make posts. While sharing that therapy helped you or someone close to you seems perfectly legitimate, as does encouraging someone to get therapy if they are asking about it, the purpose here doesn't seem to be unsolicited diagnosis and prescription. If you don't think that you know enough to help the person, what on earth is wrong with SAYING that you don't think you know enough to help the person but you are sorry they're dealing with whatever and "hugs?" If a person hears from enough people that they aren't qualified to answer, she can figure out on her own that a therapist might have the answer. And just because you personally can't help doesn't mean there isn't someone on the board who does have a background or bit of information that is helpful. I'm sometimes quite astonished by those who really understand what I or another poster is going through. Unless someone is attacking others, I think it's best to err on the side of not discouraging them from being here.
I've seen what I imagine are some pretty hurtful comments flung at people who do seem to think that the person posting IS too sick for this forum. To me, help can come in bits and pieces from a number of sources, and the forum can be part of helping someone, even someone who needs additional help. I've repeatedly seen people respond that they ARE in therapy, and I don't know that it's fair to pressure people into sharing that or having to defend themselves when all they want to do is connect with others.
There are some people who handle introducing the idea very tastefully and carefully (kaplods, you're a good example), but I would not be surprised if some people have sent would-be members fleeing with their insensitivity.
Not long after I joined, I brought up what I thought might be a common issue and was told abruptly that I should get therapy. No helpful advice, no words of wisdom, no compassion. It left me in tears, feeling too screwed up to be here, and I very nearly left the forum. Probably because I have had therapy, I was able to evaluate my emotional response and weigh the value of the words of the person who said that and calm down enough to stick around for a bit. And, as I suspected, the issue I brought up has been brought up by others again and again and again, prompting support and some good advice. I'm not sure someone else who had my reaction would have the skills to work through it in the same way. I still have a significant amount of weight to lose and am still working through the reasons for that. I have both the means and the decision-making power to decide if I want to return to therapy, and I can guarantee that no one here telling me to will motivate that. I'm not aware of anyone who willingly sought therapy because a stranger told them they NEEDED it; perhaps those with counseling experience can speak to this from the reasons their clients came in?
I'm one of those who falls into the camp of believing that those who have significant amounts of weight to lose, not caused by a medical issue, most likely have underlying psychological issues contributing to it. Repeatedly engaging in behavior you know to be harmful to you and counter to your goals kind of implies that something isn't right. But then, I agree with kaplods that most people could benefit from some mental health care. However, I'm also aware that there is stigma to it still, and factors can include time, cost and trust. I also don't believe that therapy is also the best course.
I also don't think everyone who suggests a poster get therapy believes those who could get more benefit are simply wounded people equally deserving of sharing their issues here. There really does seem to be a communication-snuffing factor to some comments.
In the end, no one here is responsible for anyone else's behavior or choices. Someone could have a terrible problem that makes you feel sympathy and the urge to have them help, or they could have a problem that seems to you to have a simple solution. Ultimately, though, I think it's important to let that person have power over her or his own life and simply offer your experiences and thoughts with the hope they are of benefit.
Support Groups Versus Psychotherapy?
