Counseling is big business. There are services for virtually every facet of life ranging from debt relief, to relationships and right through to bereavement. And there are different ways of providing such services such as face-to-face, group and telephone counseling. Many medical centers, schools and businesses retain the services of a counselor. Despite this apparent endorsement there remains skepticism over the true nature and value of counseling, with some seeing the process as little more than a comforting conversation.
What is Counseling?
A trained therapeutic counselor is very different to someone who might use counseling skills as a volunteer or as a part of their job. But, there are many different models and variations of counseling even extending to
and this can make things confusing. What's more, there can be considerable overlap in the variety of techniques used and the language employed. Rather than spend time distinguishing between psychodynamic, Gestalt, transactional analysis, and all the other approaches, I'm going to attempt a summary of the broad nature and purpose of counseling as to how it might apply to your situation with anxiety.
What is the Counselor/Client Relationship?
In general terms your counselor will want to help you explore the ways in which your feelings, experiences and behavior contribute to the issues troubling you. Your discussions will aim to help you to find some clarity and possibly resolution in this regard. This will be made all the more easy because you know everything you say is completely confidential. Your therapist is not there to judge you nor for that matter to advise or tell you what to do. At some points you may find their apparent lack of commitment a little frustrating, but actually this frustration is an echo of your own situation and circumstances. One of the differences between a
and someone who is just trying to help, is the therapist keeps their beliefs, their value system and the way they live their life, out of the discussion.
Counseling then is a helping approach that encourages you to talk openly and frankly about various aspects of life. These explorations may lead to insights due in part to the way the therapist revisits key issues and encourages you to examine them from different perspectives. Reframing issues can reduce confusion, lessen tension and lead to clarity.
Does Counseling Work?
Various controlled studies suggest that counseling is both popular and effective but when it comes to questions about the therapeutic nature of counseling and how its effects should be measured, things get a bit foggy. For example, some people argue counseling should be measured as objectively as possible, using standardized scores. Others see assessing the clients feelings as more significant.
This, to a great extent, reflects some of tensions that currently exist with regard to how or whether counseling can be compared with something like medicine where large randomly controlled trials and objective measures form the criteria for success. Counseling may well see its role, and therefore its criteria for success, in very different ways. Rather than setting out to cure a disease process or alleviate its symptoms the goal for counseling may be for the client to reframe their issue and become more accepting of it.
Even so, if you're wondering
when to seek therapy for anxiety
or considering counseling, the evidence from small controlled trials in medical settings suggests that it is as effective as antidepressant medication. Whether that's enough of a comparison, or even a useful one, only you can judge.
Adapted from my book, 'Overcoming Worry and Anxiety'. Sheldon Press