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Re: Therapist a mini-cult leader?
Posted by: corboy ()
Date: September 26, 2013 05:26AM


: “I have been to three therapists in the last two years and all of them tried to talk to me about spirituality, God, religion or New Age shit. Where the hell do I find a therapist that uses non-superstitious methods?”

It appears people are feeling annoyed that many licensed mental health professionals are introducing material into sessions that is *not* proper to psychotherapy.

The Secular Therapist Project



The Secular Therapist Project
Darrel W. Ray

In 2009, when I published my book The God Virus, I received an overwhelming number of e-mails and phone calls from people asking for help dealing with the emotional and psychological trauma in connection with their leaving religion. In response, I founded Recovering from Religion, now a rapidly growing organization headed by Executive Director Sarah Morehead. Then I published Sex and God (2012). I was deluged with another set of complaints, many of them unrelated to sexual issues. This time people were asking, “How do I find a secular therapist?”

I heard horror stories from people who had sought out therapists and found themselves barraged with talk about spirituality, God, or New Age drivel. At first, I assumed I could help these people simply by coaching them on what to look for in a therapist. It didn’t take long for me to discover how wrong I was. A review of therapists’ websites around the country revealed that even I as a psychologist could not reliably identify secular therapists. Their online descriptions were often so vague as to utterly obscure which practitioners were—or were not—committed to evidence-based methods.

Digging deeper, I found that literally hundreds of religious colleges and universities have taken to churning out marriage and family counselors, psychologists, and addictions counselors. Among them are such bastions of fundamentalism as Liberty University (founded by Jerry Falwell) and Regent University (founded by Pat Robertson). Many of these organizations teach that you can pray the gay away or that prayer can cure depression and mental illness in general. At Regent University, PhD candidates are required to spend one year studying Pat Robertson’s theology in order to get their degree! Unfortunately, when those PhDs receive their degrees, they become eligible for licensure in many states alongside more conventionally educated practitioners.

At last I realized the scale of the problem, one that so far as I knew had previously gone unrecognized. The religious Right has spent years conducting a quiet assault on the entire professions of psychology and counseling. So successful has this campaign been that in most locations, prospective clients have little to no likelihood of locating a secular, science-minded therapist on their own.

In cities like Atlanta or Oklahoma City, hundreds of counselors openly advertise as “Christian counselors.” Not one advertises as a “secular counselor.”

Meanwhile e-mails such as this one kept coming: “I have been to three therapists in the last two years and all of them tried to talk to me about spirituality, God, religion or New Age shit. Where the hell do I find a therapist that uses non-superstitious methods?” If only more secular therapists would identify themselves as such, I thought. Then I thought again. I live in the Midwest, and I know the risks of being an “out” atheist psychologist firsthand. I lost numerous clients when The God Virus was published, and many sources of my referrals dried up as well. Imagine being a secular therapist in, say, Oklahoma City. The minute word got out that you were an atheist, half of your clients would stop coming to you. Churches and ministers who once were important referral sources would stop referring. Hospitals and social service agencies would stop using your services as well because many of their employees are very religious. Even local judges would stop sending couples or children and adolescents to you because the judges are religious—or because they are elected and fear the backlash if they are seen sending families and children to an atheist.

Secular people need help, but it is difficult to find good science-based therapy. Good therapists can’t advertise or reach out to the secular community because it is too dangerous to reveal themselves. A similar problem exists in the dating world. Sites such as and have developed a way to help people connect anonymously and determine whether they are compatible without identifying anyone until both parties are ready. The same model, I realized, could be used to help clients find secular therapists.

Then I found Han Hills—if there were such a thing, he could be considered the savior of the secular therapy world. Hills is a web developer par excellence and a leader in the secular community in North Carolina (among other things, he is president of the Humanists and Freethinkers of Cape Fear, a local group affiliated with the Council for Secular Humanism). I met Hills while conducting a leadership workshop. I described the problem for him, and he immediately said, “I can do that for you.” I don’t think he realized then how much work he had just volunteered for. Neither did I.

It took us six months and hundreds of hours to develop a new website, We went live in May 2012. We asked secular therapists to register anonymously on our site and promised we would do our best to protect their identities within the confines of our system. Soon secular therapists from Atlanta, Wichita, Tulsa, Dallas, San Francisco, New York City, and dozens of other locations had registered with us. At the same time, we began reaching out to the secular community, urging people to search our database first if they needed a secular counselor.

The early going was frustrating. It seemed that we did not have enough counselors registered, nor were they in the right locations. We had six in San Francisco but none in Omaha. Needless to say, Omaha was where we needed them the most. Nothing against San Francisco, but surely folks in that freewheeling secular metropolis would have little problem locating a secular therapist. Then I realized that I was wrong again. The City by the Bay may not have a Christian counselor on every corner, but it has New Age and spiritual counselors instead. Bay Area seculars needed just as much help finding secular counselors as anyone living in the heartland. (Sometimes I wonder: How many times can I be wrong about my own profession before I am required to turn in my membership card?)

In recent months, we have begun to achieve sufficient coverage. Prospective clients are able to find like-minded therapists in many communities. In March 2013, we had more than 112 registered therapists and 1,328 registered clients; we hope to have 200 therapists by the end of 2013. As the project grows, it will become ever easier to find a secular therapist. Rest assured, he or she will not send you back to Jesus or tell you to get your chakras realigned.

How Does It Work?

If you are looking for a therapist, simply go to Register as a client and write a brief description of what you are looking for. This will allow you to search our database for a therapist in your area. (No names are revealed at this stage.) If you can’t find anyone near you, you can also search for therapists who do distance counseling by phone or Skype. When you find a therapist, simply e-mail him or her through our system. He or she will generally respond in twenty-four to forty-eight hours and may ask you some questions to further clarify whether your needs match his or her specialty and training. You can e-mail back and forth within our system until you are both satisfied there is a good match, and then you can make an appointment. No names or identification are revealed until you both are ready. Remember, this is not free therapy. Each therapist is a professional who makes his or her living through counseling. Therapists set their own rates; the Secular Therapist Project has no role in setting fees.

If you are a therapist, go to and complete an application. Four secular therapists will look at your application and make a determination. They are primarily looking for evidence that you are secular, that you use evidence-based methods, and that you will never let religion, spirituality, or New Age ideas enter into the therapeutic relationship. Your self-description, website information, and membership in secular organizations or other groups are all considered. Occasionally a religious counselor applies for our service. We generally do not approve them. There are plenty of places where religious counselors can register; this project is strictly for secular therapists. If you are secular but involved in the Unitarian Church or an Ethical Culture organization, this probably will not be an impediment to participation. If you are Baptist or Catholic, it probably will be.

For secular Americans, finding a compatibly secular therapist has just become far, far easier.


Darrel W. Ray, EdD, is the author of The God Virus (IPC Press, 2009), Sex and God: How Religion Distorts Sexuality (IPC Press, 2012), and many other books and articles. He was principal researcher on the groundbreaking study, Sex and Secularism: What Happens When You Leave Religion? A Survey of 10,000 American Secularists (IPC Press, 2011). As chairman of the board of Recovering From Religion and director of the Secular Therapist Project, his primary interest is in creating secular support networks for those who have left religion.

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Re: Therapist a mini-cult leader?
Posted by: corboy ()
Date: September 26, 2013 05:35AM

Some Things Psychotherapists Do Not Tell Us



The person on the couch isn’t the only one with problems.

1.“Your childhood was bad? Wait till you see your bill.”

Among those who seek psychological help in the U.S., 40% undergo therapy with a social worker, psychiatrist or psychologist, according to JAMA Psychiatry, a peer-reviewed medical journal published by the American Medical Association. All that talk doesn’t come cheap. There is no set charge, but therapists say rates can vary from $75 to $250 an hour. In fact, Americans spend around $10 billion a year on all kinds of psychotherapy — from relationship counseling to cognitive-behavioral therapy — according to research reviewed by Bruce E. Wampold, clinical professor of psychiatry at the University of Wisconsin-Madison.

One therapist’s fees for different clients can also vary wildly, experts say. When shopping around for a therapist, there’s nothing wrong with negotiating, says Simon Rego, director of psychology training at Montefiore Medical Center in New York City. Many clinicians offer a sliding scale for those with limited funds, he says. Sometimes, therapists dedicate a certain number of slots per week to low-income clients, he says, and there are counseling organizations that offer pro bono services to veterans and victims of natural disasters like Hurricane Sandy. In other cases, Rego says, therapists expect potential clients to haggle. “Some therapists claim a sliding scale as a rubric to negotiate,” he says.

There’s evidence though that good therapy is a bargain at any price. In clinical trials, psychotherapy has been shown to be effective in treating depression, anxiety, marital dissatisfaction, substance abuse and even sexual dysfunction, Wampold found. And relapse rates can be lower with some types of psychotherapy than with medication, according to research by Steve Hollon, a professor of Psychology at Vanderbilt University. For major depressive disorders, a 2009 Department of Veterans Affairs study on psychotherapy’s effectiveness suggests a combination of therapy and antidepressants as a first line of treatment.

One in five Americans in any given year will have a mental health disorder and two-thirds never receive treatment, says Paolo Delvecchio, director of the federal government’s Substance Abuse and Mental Health Services Administration’s Center for Mental Health Services in Rockville, Md.

2. “I may not have any training.”

While qualified psychologists, psychiatrists and licensed clinical social workers all require years of training, there’s very little stopping anyone from taking a night course in astrology or philosophy and calling himself a therapist. Therapy is an umbrella term that covers many professions and problems. It’s more of a descriptive term than a professional one, says John C. Norcross, a professor of psychology at the University of Scranton. In fact, anyone could advertise as a “therapist,” put it on a business card, set up a website and wait for people to call. “Seek mental health services from someone licensed to practice by the particular state in which you reside,” Norcross suggests.

Experts recommend that consumers who need mental health care turn to a psychologist, psychiatrist, or licensed clinical social worker. Psychologists must have a doctor of philosophy (Ph.D.), doctor of psychology (Psy.D) in counseling or clinical psychology or doctor of education (Ed.D.), and pass a state-level licensing exam. Psychiatrists have to earn a doctor of medicine (M.D.) and complete a medical residency. Licensed clinical social workers (LCSW) need a master’s degree (MSW or MA), and must meet medical clinical exam requirements. Licensed counselors also need a master’s degree (MA or MS) and pass a national licensing examination. The American Psychological Association, American Association for Marriage and Family Therapy, American Psychiatric Association, National Association of Social Workers and American Counseling Association can make referrals, as do state licensing boards and many health insurance plans list in-network mental health professionals.

For therapeutic services slightly outside the realm of mental health, though, another type of professional might be appropriate. For instance, some life coaches practice as therapists, says Julie Hanks, owner and executive director of Wasatch Family Therapy in Salt Lake City, Utah. (A life coach draws on techniques from psychology and career counseling, but working as a life coach requires no formal training.) Life coaches can be well-suited to helping people decide their next career move or improve their productivity, and plenty of informed consumers choose them over therapists for personal projects, business mentoring and creative endeavors. Many life coaches clearly state that their services are profoundly different from therapy or counseling. Nonetheless, Hanks says, she’s been surprised by how many clients have told her they weren’t aware their coaches weren’t trained to treat mental health problems.

Although it’s important to find a qualified professional, Hanks says, the degree does not make the therapist. “What it boils down to is the quality of the connection between the client and therapist,” she says.

3. “Will you ever stop talking?”

While therapists are paid to listen to a patient for about 45 to 60 minutes at a time, it’s not always easy, especially since people in therapy can get so wound up in the minutiae of their day that they ramble on instead of tackling real issues. “I’ve been bored out of my mind occasionally,” says Hanks, the Salt Lake City therapist. But there’s an upside to her only very occasional boredom: It clues her in that something isn’t working. Then, she says, she knows to ask herself, “What do I need to do differently with this client?”

Sometimes it’s the therapist, rather than the client, who isn’t giving real issues the attention they deserve. Marci Robin, the beauty director of lifestyle and cosmetics site, recently wrote about her experience with a therapist who fell asleep during her session — while Robin was crying. Shortly before arriving at her therapist’s office in New York, Robin had been assaulted by a group of boys who hit her with a cup filled with ice. “As I spoke, I noticed her drifting off,” she says.

Such incidents are relatively uncommon. But therapists, like anyone on the job, can succumb to drowsiness and distractions. “Patients who have seen other therapists have reported this to me,” says Mirean Coleman, a clinical social worker and senior practice associate with the National Association of Social Workers. “I have also been informed by patients of therapists who texted or played games on their cellphones during therapy sessions.”

And of course when there’s a third party in the mix, he or she can be the reason conversations wander. In couple’s therapy, for instance, it’s not unusual for the more dominant partner to attempt to hijack the session. “There are some people who are a bit narcissistic and enjoy hearing themselves talk, and the therapist never really gets an accurate sense of what goes on in the relationship,” says Fran Walfish, a therapist in Beverly Hills, Calif.

4.“I need you more than you need me.”

After a few sessions, therapists often recommend additional treatment. But insiders say clients should watch for signs it’s time to move on. “If you feel like your therapist needs you financially” — for instance, if he or she is pushing for more sessions even though you feel better — “get another therapist,” Hanks says. Although the majority of therapists go into the profession because they genuinely want to help others, she says, a weak economy can make it difficult for a therapist to let a client go. Therapists who are struggling to keep their practice afloat — or who don’t have a potential client to fill the available time slot — might be particularly inclined to try to squeeze extra money out of their clients. “A good therapist does not want their clients in therapy forever,” she says.

What’s more, even a good therapist might not be the right therapist for a particular person. Clients reporting little or no change in their emotional well-being within their first six visits for cognitive therapy tend to show no improvement over the entire course of therapy or end up dropping out, according to multiple studies over three decades by psychologists Barry Duncan and Scott M. Miller, both of whom are also licensed therapists. “You should feel that you are on your way within a month, says Miller, Cummings Professor at the Department of Behavioral Health in Arizona State University. A long-term client-therapist relationship with no early change can encourage inaction and co-dependency, he says. The length of time a patient should be with a therapist should be based on the treatment goals and progress of each patient, says Coleman from the National Association of Social Workers. “If a patient fails to meet their initial and revised treatment goals, then other alternatives should be considered.”

5. “Maybe I’m the one who needs therapy.”

There’s no shortage of patients who complain that their therapist has as many issues as they do. When it’s time to say goodbye to a client, for instance, some therapists themselves can exhibit signs of co-dependency. When Kathy Morelli, a family counseling therapist in Wayne, N.J., told her New York-based therapist that she was getting married, was moving to New Jersey and wouldn’t require her services anymore, her therapist wasn’t exactly tickled for her. In fact, she didn’t see why Morelli should have a problem going 25 miles out of her way. “She thought I could commute into the city to see her — at night,” Morelli says. “She made a big stink about it. It was very weird.”

Others have come across different peculiarities in their hunt for a good therapist. Stacey Glaesmann, a clinical psychologist and former therapist in Pearland, Texas, wanted to talk to her therapist about postpartum depression. But her therapist had more important things to discuss, she says. Chief among them: God. “I thought, ‘What the hell?’ I had come to her to talk about being depressed, not because I was looking for religion.” Another therapist she went to appeared to be addicted to her cellphone and answered it during a session. “She didn’t even say, ‘Excuse me,’” Glaesmann says. “How rude can you get?” Of course, such incidents aren’t the norm, says Lisa Brateman, a licensed social worker and therapist based in New York.

6.“A morning run might work just as well.”

A little exercise goes a long way. In fact, the effect of regular exercise on mild to moderate forms of depression is similar to the effect of cognitive behavioral therapy, according to the co-authors of the book “Exercise for Mood and Anxiety,” Jasper Smits, associate professor of psychology at Southern Methodist University in Dallas, and Michael Otto, a psychologist at Boston University. The two authors analyzed the results of dozens of published population-based and clinical studies related to exercise and mental health to arrive at their findings.

There’s little consensus on how or why exercise helps, but Smits says the public health recommendation for daily exercise — 75 minutes a week of vigorous exercise or 150 minutes of moderate activity — should be more widely prescribed by mental-health care providers, especially as studies show that 25% to 40% of Americans don’t exercise at all. “Some professionals argue that exercise is the non-pharmacological antidepressant and may work in the same way as these medications,” he says.

7.“I don’t have to practice what I preach.”

Some university programs and state licensing authorities require mental-health professionals to undergo therapy, but it isn’t universal. Utah and California are among several states that don’t require therapists to receive psychotherapy before they practice. Hanks, who does require it of those who work in her practice, says it’s crucial for a therapist to lie on the proverbial couch in order to understand what the client is going through. “I can’t take a client beyond anywhere I have not been willing to go myself,” she says.

Plus, Hanks says, when a therapist needs mental-health care, seeking treatment from another therapist is considered preferable to self-treatment. “Therapists need therapists like doctors need doctors. We need a different point of view.” Tina Tessina, a psychotherapist based in Los Angeles, says therapy helps a qualified therapist remain an emotionally strong and independent observer.

Some experts suggest consumers ask potential therapists about their own experience in the patient’s chair and their mental health. Tessina even recommends that those in the market for a marriage counselor seek a therapist who’s happily married. Others say a therapist who’s experienced similar mental health issues to a patient’s — including a marriage breakup — might be more empathetic and wiser. On the other hand, some argue that the therapist’s personal life isn’t relevant to treatment. After all, a doctor who’s never broken a bone is still trained to set one. And many therapists have a zero self-disclosure policy with clients, Glaesmann says.

8. “Your secret is (sort of) safe with me.”

Most patients assume their sessions are confidential, but there are many instances where these sessions could be made public. The records of therapy sessions could become part of a divorce proceeding or employment dispute if a client alleges emotional or mental damages on the part of a spouse or co-worker. Or they could be disclosed if there is a legal dispute between the therapist and the client. Laws also vary by state, therapists say.

If a client expresses suicidal or — indeed — homicidal thoughts, therapists may also be legally required to report that. Nor is a serious crime necessarily protected by client-therapist privilege. Glaesmann says she was obliged to turn over her notes on one client to the local district attorney after the client’s wife found child pornography on his computer, she says. “That had not come up during our therapy,” she says, “but if it had, I would have had to report it to authorities, as viewing child pornography is a crime.” Katherine Nordal, executive director for professional practice at the American Psychological Association, says the group advises therapists to provide a patient’s record only if a court orders it or if they have obtained consent from the patient.

The Health Information Portability and Accountability Act of 1996 does provide some protections for minors. Under HIPAA, the therapist must get a signed disclosure from a client ages 12 to 18 before releasing the minor’s health care records to anyone, including parents; however, in some states, parents may not be denied access to their child’s health records. Insurance companies are only entitled to certain types of information when evaluating whether a person qualifies for medical insurance; this excludes psychotherapy notes and diagnoses, which have special status under HIPAA.

9.“I’ll be there for you, but your insurance might not.”

Health insurance companies can place limits on how many therapy sessions they’ll pay for, and they may be keen to wrap up the sessions before the client is ready. Relying on insurance to pay for therapy isn’t always in a person’s best interest, says Joseph Winn, a clinical social worker in Arlington, Mass. “The insurance company will make their determination regardless of what you, or your therapist, feels is appropriate,” Winn says. If a client disagrees with an insurance company’s decision not to provide additional treatments, he or she can appeal, says Susan Pisano, a spokeswoman for America’s Health Insurance Plans, the industry’s trade group. And people can continue treatment by paying out-of-pocket. Under the Mental Health Parity and Addiction Equity Act of 2008, insurers must also provide their clients a reason why they stop or decline payment for mental health services.

There have been some efforts by lawmakers to make it easier for Americans to get mental health coverage. The Mental Health Parity and Addiction Equity Act, which employers with 50 or more workers began adhering to in 2011, requires that when coverage for mental health and substance use conditions is provided, it be generally comparable to coverage for medical and surgical care. That means, for instance, that insurers can’t put a cap of, say, 30 annual trips to a psychiatrist for mental health if they haven’t put such limits on treatment for other conditions, like cancer or diabetes. President Obama’s Affordable Care Act, which takes effect in 2014, broadened the 2008 act to include all insurance and employers providing health care and is expected to extend federal parity protections to 62 million Americans, with mental health coverage deemed an “essential health benefit.” Some insurers treat therapists as specialists, which typically require a higher copay: $30 or $50, say, instead of $20.

However, experts say handling insurance is currently still cumbersome for practices — and that the best therapists are increasingly the ones who won’t even accept insurance. “Insurance has become so difficult and expensive to work with,” says David Reiss, a psychiatrist in San Diego. “While there some very good therapists that work with insurance, if therapists can afford to practice without having to accept insurance, they often will.”

10. “Time’s up. Here’s a pill.”

There has been surge in the use of medication to treat mental health problems, studies show. In 2005, a mere 11% of psychiatrists — who, unlike social workers and some other kinds of therapists, are licensed to prescribe drugs — used talk therapy with all of their clients, down from 19% in 1996, according to a 2008 study in the medical journal of the American Medical Association. Similarly, the proportion of patients visiting psychiatrists for talk therapy fell to 29% from 44% in the same period. Psychiatrists get reimbursed by insurance companies at a lower rate for a 45-minute psychotherapy session than for a 15-minute medication visit, the study found.

As talk time went down, pill-popping went up — a trend which some mental health professionals find troubling. The use of psychiatric drugs among adults increased by 22% from 2001 to 2010, and one in five Americans now take such meds, according to industry data compiled by Medco Health Solutions, a pharmacy benefit manager in Franklin Lakes, N.J. And it’s not just adults who are increasingly being prescribed drugs for mental health. Some 6.4 million children ages 4 to 17 have received a medical diagnosis of attention deficit hyperactivity disorder, an increase of over 40% in the past decade, according to recent data from the Centers for Disease Control and Prevention.

To be fair, the Food and Drug Administration policy states that it only approves drugs after rigorous clinical trials and that any potential side-effects are stipulated on the labels. And many people get prescriptions from their primary health provider rather than from a psychiatrist. But compared with medication, psychotherapy has fewer side effects and lower instances of relapse when discontinued, says Nordal of the American Psychological Association.

Talk therapy can be as effective in treating depression as the most recent generation of antidepressants, according to a 2011 review of 15 studies and published in the Journal of Nervous and Mental Disease by researchers at Metropolitan State University in St. Paul and Dartmouth College in New Hampshire. That’s not to say therapy and pharmaceuticals are mutually exclusive options — or even the only options. Many people solve their own problems on a routine basis through exercise, yoga and meditation, or by talking to their families or attending religious services. But a professional can still be helpful, says Scott D. Miller, professor of behavioral health at Arizona State University. “There are many paths to having a more fulfilling and less troubled life, and psychotherapy is just one of those,” he says. “Like with toothpaste, people have a choice.”

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Re: Therapist a mini-cult leader?
Posted by: corboy ()
Date: September 26, 2013 05:50AM

If a therapist maintains strict anonymity, a client should never find out that the therapist is involved with a church, or with guru, because the therapist will keep that private. A therapist should keep his or her religion or lack of it off the table and out of the session.

But, if a client does find out that a therapist is a member of a church congregation or ashram etc (which can happen if one lives in a very small town), then a client has the right to ask the following and be responded to with respect.

* Will what I disclose in session be kept confidential and not ever be mentioned to the therapists religious leader.

* If a pastor or guru were ever to push a therapist for information about a client, would the therapist be able to refuse.

*If it so happens (small town) that the therapist and client are both members of the same congregation or ashram, would the therapist be able to put the clients welfare and well being first and formost if a choice had to be made between the clients welfare and the church or ashrams public reputation?

A therapist should not push or suggest, not even hint approval of inspirational material or speakers or give any hints or nudges about what decision if any a client should make regarding belief system or no belief system.

Clients should be trusted with the autonomy to find their own resources, whether it be dating or religion or a hearty preference for atheism.

However, it does preserve a clients autonomy for a therapist to offer advice on how to evaluate a workshop or seminar weekend or retreat if a client reports being urged or invited to join.

One bit of autonomy protection is, if one wants to go to an event, always take ones own car, and dont give in and carpool with others. That way, if you decide you do not like the event you can leave without worry that you will leave other people stranded.

(There are times when being green and reducing ones carbon footprint is not worth it. Those are the times to use your own car and not give rides to anyone else.)

Never allow anyone to pressure you to give up your car keys, watch, ID documents or jewelry. Leave. And if in the middle of the event, they want you to suddenly give these things up, just get out of there.

In preservation of and enhancement of a client;s autonomy, a therapist can advise on how to check the background of some workshop or meditation intensive being recommended by a friend--and a therapist can also advise that it is illegal for such pressure to be applied as a condition of keeping a job or being promoted.

Other autonomy preservation advice that is appropriate is for a therapist to advise that no event worth attending if one is required to sign away ones right to sue or mediate for damages if one incurs harm.

Two, clients, especially persons already diagned with bipolar affective disorder or have familiy histories of bipolar should be advised and educated to avoid any workshop or weekend intensive where one will be kept awake past one's normal bedtime--for such persons disruption of sleep wake cycles is high risk.

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Re: Therapist a mini-cult leader?
Posted by: corboy ()
Date: September 26, 2013 06:14AM

The role of a professional psychotherapist is to preserve and enhance client/patient autonomy, so that:

* The person will not need the therapists services

* So that the client or patient will remain able or become able to find communities and friendships.

For this reason, no ethical therapist can provide community for clients. That means a therapist cannot befriend clients or patients nor invite them into the therapists own community--not even by the faintest of hints.

[] (A discussion of Byron Katie's 'The Work' which many are misled to equate with cognitive behavioral therapy--which it is not. It fosters dependance on the public persona of the person marketing it, promising autonomy but never giving it)


The Work offers something no ethical therapist can ever offer:

An ethical therapist cannot give you a social venue or a tribe--therapists by the rules of thier profession, are supposed to protect and enhance your autonomy, and its up to YOU to do the work of creating your own community.

But this is a lonely world and lots of us are busy and plugged into cell phones and iPods, making it hard to achieve face to face relatedness.

The Work is presented as a mere tool, but covertly, it has become a point of contact, a tribe of people speaking the same language.

You share the jargon and the BK Cockroach and you're no longer alone anymore. You're part of a community.

That is powerful stuff.

Reading a book about genuine cognitive behavioral therapy gives a useful set of tools, but it doesnt give that same sense of community.

Folks, we wouldnt be sounding tough here if there were not reports that people are not being given information they need to make informed free choices.

And we would not be speaking in such radical anticult manner had it not been for the way primary source texts are being disappeared.

Cognitive Behavioral Therapy was not created by people who withdrew their earlier publications from circulation. Quite the contrary.

Real science doenst 'disappear' its past publications at all. There's no mystique, no family secrets.

But cognitive behavioral therapy cannot by itself give you a community to belong to, and maybe thats why it doesnt seem as appealing as The Work.

CBT is merely a set of tools and its up to us to use the tools to create our own communities.

The lesson of Passover, launched by the original Four Questions is that going from imprisonment to freedom is hard work.

One of the most human things about the Passover story is that when the people escaped Egypt and were free at last, but in the desert, they bitched to Moses about the hardships of camping. They missed the tasty food they'd had back in Egypt, in the days when they were slaves of Pharaoh.

Its tempting, when trying to escape bondage, to try to hang on to something worthwhile
from the days of bondage.

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Re: Therapist a mini-cult leader?
Posted by: RexTheRunt ()
Date: September 26, 2013 03:10PM

Thanks for posting this - very interesting reading.

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Re: Therapist a mini-cult leader?
Posted by: corboy ()
Date: September 26, 2013 10:07PM

A therapist (or other professional, for that matter) should have a diverse network of referral resources.

If, say more than one therapist in a group is in the same church or ashram, competing for favor with the pastor, or guru, this can lead to a big stinking mess. And compromise even clients who might not even be members of the congregation.

1) Even an excellent therapist cannot work with all persons who walk through the door. He or she should then be able to recommend others.

2) A therapist's referral network be socially diverse. It should not exclusively or even mostly of persons who are members of the same church or ashram as the therapist.

In a small town, this may be difficult to avoid. But, a licensed professional who gives professional services for a fee, no matter how small that fee, should always be ready to put the well being of the client ahead of the wishes of a pastor or guru or the public reputation of a church. What if a client who has divorced and is arranging to invest most of the money to safeguard childrens education is being pressured by a guru to give more to the ashram building fund, and the therapist also honors the guru?

That therapist had been be able to support the client in protecting his or her financial best interests even if it means the therapist/disciple standing up to the guru.

If a therapist is incapable of imaginging that a charismatic pastor or charismatic beloved guru could ever do harm, that therapist is incapable of protecting clients.

Even if the current pastor or guru is benevolent, what if he or she makes an error and appoints a successor who is corrupted by the role and turns predatory?

If a therapist is a member of a secretive and secret ridden church, that therapist is reenacting codependance roles that many learn in alcoholic families.

How can such a person be conscious and aware when working with a client who is seeking to work through issues of family secrecy?

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Re: Therapist a mini-cult leader?
Posted by: corboy ()
Date: September 26, 2013 10:20PM

To preserve client automony, a therapist has to remain aware of finances--a matter many of us feel uncomfortable about. But, the therapists role is to be the equivalent of a designated driver--sober and alert and steady. Thats what they are paid to do.

And in this economy, its important.

* Does a therapist over charge? Find out the range of fees.

*Is a therapist offering to have you do work exchange, rather than pay money? This is a potential boundary violation and has been discussed in literature on boundary ethics. Dont do it. (I never went through this. But there have been reports from other sources)

* (Rare but it happens) Does your therapist under-charge or say he or she does? It can seem generous but become a trap. One may risk feeling dependant on a therapist who undercharges for fear of the price increase of going to another therapist who charges at current market rates.

And I knew of a pastor who worked as campus minister at half salary. This led to his board of directors failing to hold him accountable. The pastor engaged in off campus activism that brought the chaplaincy into disrepute and discouraged potential donors. When the pastor retired, the chaplaincy suffered sticker shock when hiring his successor. Under charging for services can be a subtle form of power play and enforce dependancy as happened here with the board of directors.

And, no, it is not at all a satisfactory response for a therapist to reply with a smirk, "So do you want me to charge you my full rate?" If you bring this up.

Part of respecting client autonomy is to inform a client of affordable psychotherapy options available in the area. One experienced therapist told me quite a few in private practice keep a few slots open for clients who have financial hardships. THe local psychoanalytic institute is a place to investigate.

A capable therapist will minimize charisma and instead remind you that you always have other options and will tell you where and how to find them.
I would advise clients to do a quarterly or six month audit to see whether goals are being met in therapy.

Never forget that your therapist is your employee, a consultant, as it were.

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Re: Therapist a mini-cult leader?
Posted by: corboy ()
Date: September 26, 2013 10:48PM

A therapist may be quite good at maintaining boundaries. Over time, however, he or she may become less aware.

* If you two have been working together for many years, its possible to come to know each other well enough that boundary porosity occurs. A psychoanalyst said that even in the best circumstances it takes a great deal of work on a therapists part to avoid becoming 'stale' if conducting a long term analysis.

Dont become an inmate of your therapy. Set a time limit.

Having some precise goals can help. Many people arrive in therapy in crisis. That crisis may be resolved and there will be no need to continue. Or, new issues may surface once the presenting crisis is resolved.

But remain in therapy to deal with specific issues. Such as terror in doing job interviews. Or managing moods and medication if one is bipolar.

"Personal growth" is too vague and also is something one can attend to without paying money. And--personal growth is not a catagory in the DSM. It is not a problem in life.

One hires a therapist to be a therapist--not to function as a pastoral counselor or as a guru or keeper of one's conscience.

And a therapist should try to avoid slipping into the role of being custodian of a clients conscience. To do that hampers autonomy.

Early warning signs of boundary softening.

These are not legally actionable boundary violations. But are early warning signs that the therapist is getting careless, forgetting what he or she was taught--if he or she was in a good training program.

*No hugging or kissing. Period.

*No recommendations, not even so much as a hint, of the therapists preferred beliefs, whether religious or political.

*Therapists can dress nicely but should not wear perfume, obtrusive cologne, or what the middle school girls called 'date clothes' back in the 1970s. Casual professional is OK. Dressing as though for visit to the club, a party or a hot date--no.

*Sessions should begin and end at the stated times. If you schedule a session at 8 am, your butts should be in the chairs at 8 am.

If either of you start drifting into starting a session at 8:20 am, dont let this continue.

If 8:30 or 9:00 am is actually a better time for session, consciously and verbally negotiate this time and stick with it. Drifting away from the scheduled time slot should not go unexamined. This can be a marker for important issues just below the surface.

*I read somewhere that its at the beginning and end of sessions that one enters and leaves the boundary envelope. Important revealations may occur just as one is reaching for the doorknob. But this liminal moments at the beginning and end of a session may also be times when boundary leakage and compromise take place. If you or your therapist do something 'weird' during those times--examine it. It may be nothing.

Or may include behavior, which if consciously examined, may give clues that something is amiss.

No therapist should belittle you or use snark or sarcasm if you are the one who brings up the boundary drift (and frankly--thats what you are paying the therapist to do.)

Any defensiveness or sarcasm on the part of the therapist, or the therapist saying, "You showed up early, you started it"-- thats a sign the therapist is not fully conscious.

*Pseudoegalitarianism--trying to be your friend and saying that the traditional therapist client role is 'oppressive' or 'too rigid'. You're not paying X number of dollars per hour to get another friend.

* A therapist becomes more and more 'distractable' over time. You notice he or she 'lights up' (spark in the eyes, a slight leaning forward) if certain topics are mentioned that are extraneous to the therapy. What makes a therapist smile or laugh can have a subtly reinforcing effect upon the client.

Does a therapist become more distractable when metaphysical subjects are mentioned?

Or politics?

Do you sometimes get a feeling the shrink would rather function as a junior guru or chaplain than as a secular psychotherapist?

If you express misgivings and real fears, do you get genuine and respectful answers?

Or does the therapist appease by laughing, smiling and you're so relieved there's no adverse reaction that you allow this to satisfy you?

*Over time do you feel more and more pissed off before you go in for sessions?

* Do you begin feeling glad when you get sick because that means you can cancel a session? Dont ignore this?

*Where before you appreciated it, are you more and more resenting the money you are paying?

*Are you afraid to suggest taking a months break, for fear you will lose your slot?

(Remember the shrink is your employee.

What if you have a parent who gets sick and lives cross country and you have to go and arrange in home care? You'd have to leave town and be gone for a month. No therapist, unless a tyrant would forbid a months respite under such circumstances. Taking a month off to see how well you do without reporting to a therapist is just as legit a reason. No therapist should threaten you if you make such a suggestion.

You're there to augment your own autonomy)

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Re: Therapist a mini-cult leader?
Posted by: corboy ()
Date: September 26, 2013 11:15PM

Therapist attire and consulting room (therapy room) decor maybe worth our attention.

As noted above, a psychotherapist should not dress in a manner that is distracting or seductive.

Much depends on clientele. If a therapist works at a public health clinic and with persons who are living on or very close to the streets, he or she must dress in a manner that is a bit different from what would be considered casual professional in another part of town.

If a therapist's clothing or jewelry seem out of harmony with his or her personality, its worth allowing oneself to notice.

Consulting room decor.

Both client and therapist engage in a voyage together, with the office providing bounded space.

There has to be a balance. A therapist spends hours in that room and it must be nurturing for the the therapist. But that room also has to offer a sense of hospitality and safety to the different persons male and female, coming in for consultations.

A picture of a therapists guru or some other authority figure is OK for the therapists home or private office, but is out of bounds in a therapy room. A client should not have to compete with an icon of the guru for a therapists attention. Church literature, political pamphlets do not belong in the therapy room, or in the waiting room, either.

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Re: Therapist a mini-cult leader?
Posted by: corboy ()
Date: September 26, 2013 11:56PM

Some gurus or religious leaders are considered infallible by their followers yet they also do have clinical credentials--sometimes current, sometimes not.

This does not make it permissible for a therapist to share confidential information about any client with a guru, not even a guru who has a clinical license.

The roles are not compatible, no matter what the guru (or a guru dependant therapist) claims to the contrary.

The premises of clincial mental health are based on material tested by scientific method.

And by today's understanding of how science is actually done, this is not a process of seeking verification of one's hypothesis. Yes, in the old days, thats how scientists and the public understood the process. Look for evidence, look for verfication of one's hypothesis. If enough scientists report the same findings--its true.

No, no, no. This is out of date. Anyone still describing science in this manner is not aware of how it is done today.

One does science by positing that one's hypothesis can be proven false. thing not appreciated by nearly enough people because scientific education lags in this country--modern scientific method is not based on proving something is 'verifiable'. To repeat, this was the older understanding of how science was done.

But this is now out of date.

Karl Popper, in the beginning in the 1930s, added a most important element to our understanding of how to do science: principle of falsifiablity or what some call the null hypothesis.

Unless one has been exceptionally well educated in high school or as an undergraduate, one will not know of this. Unless you have taken (and understood) research design and statistics classes, one is unlikely to learn about the use of null hypothesis and priciple of falsifiability.

One must start with a hypothesis that there is no relationship between Treatment A and outcome X. Another way to put it is Treatment A is no more effective than a random outcome.

Testing of the null hypothesis is a fundamental aspect of the scientific method
and has its basis in the falsification theory of Karl Popper.


The Logic of Falsification

The notion of disbelieving in the null hypothesis is based on the principle of falsification introduced by prominent philosopher of science, Karl Popper (1902-1994). According to Popper (1959), we cannot conclusively affirm a hypothesis, but we can conclusively negate it.

The validity of knowledge is tied to the probability of falsification.

For example, a very broad and general statement such as "Humans should respect and love each other" can never be wrong and thus does not bring us any insightful knowledge.

The more specific a statement is, the higher possibility that the statement can be negated. For Popper, a scientific method is "proposing bold hypotheses, and exposing them to the severest criticism, in order to detect where we have erred." (Popper, 1974, p.68) If the hypothesis can stand "the trial of fire," then we can confirm its validity...

A good hypothesis or a good model needs a high degree of specification.

Quantification such as the assertion that "the mean of population A is the same as the population B" is considered a high degree of specification. Following the Popperian logic, the mission of a researcher is to falsify a specific statement rather than to prove that it is right.

Therefore, the attempt of falsification leads to the disbelief of the null hypothesis.


Why fuss with this? Because many religous authorities and believers base their claims and charisma on assertions that cannot be falsified and thus cannot be harmonized with use of null hypothesis/principle of falsifiability.

They look for verification of what they believe. And, these days many of these types look for perceived surface similarities between whats in their belief system and what a scientists or physician seem to report. But similiarities dont equal proof.

But one cannot do real science by looking for verifications. One does it by testing research designs set up according to Null Hypothesis and principle of verification.

And...licensed mental health professionals are supposed to have learned this in school. Thats one reason we pay them so much per hour.

And the material one learns in school and is tested on as part of licensure process is in the domain of science--principle of falsifibility.

Science cannot give us final absolute truth.

What it can do is give us models that have predicative power that is useful, and which can be superseded by models which can be tested as having better predictive power.

Science is like a set of clothes meant to be outgrown, not one set worn for the rest of ones life.

If a therapist doesnt like operating within the rules of science, he or she needs to get into another profession.

Sadly the American public is more literate concerning the rules of baseball than of science. These principles are not hard to learn if taught when we are old enough to be at a level of cognitive development where it is possible to understand formal operational logic and concepts of probability.

Many a street kid who is illiterate is quite adept at gambling. We should be doing better to teach the principles of science and probabilty to our high school students. And if we are adults, do some continuing education for ourselves.

And if one is a licensed mental health professional, it is legally and morally obligatory to know how science is done and that one's legitimacy as a therapist will be compromised if one forgets or devalues how science is done.

*One way to test a prospective therapist (or someone who claims to operate from a grand theory of everything that integrates science and spirituality) is to ask them to
tell you what they know about the null hypothesis.

Personal note: I was exposed to this information when in my twenties, by taking graduate level course work in research design and statistics. But I comprehended very little. At that time I was so severely anxious that I could not steady my mind enough to
grasp these concepts. Terrified, anxiety ridden people will have great difficulty learning or remembering material that requires formal operational logic.

That is why, BTW, people getting bad or frightening news from their physicians are advised to have a steady friend in the room with them to take notes.

The most intelligent of us can, when anxious or downright terrified (or in ecstacy) lose access to ablity to do formal operational logic, understanding of null hypothesis and be unable to apply critical thinking.

Which is why it is all the more important for licensed mental health professionals to remember how real science is done and keep religion and metaphysics as a private
pursuit and never involve clients in any of it.

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