What happens in counseling?

When I tell people I am a counselor, it always makes me smile when I learn that someone has been positively impacted through counseling.  Their response is invariably, “Oh, I LOVE my counselor!” From others, a usual response might come in the form of a comparison.  “Like a social worker?”  or “You’re a shrink?”  or “Like at a school or something?”  Questions like that help me remember that counseling can seem like a mystery to some.  What is this thing I do?  What happens in counseling?

Let me start by telling you what counseling isn’t.

1. It isn’t just random chatting or advice giving.
2. I don’t have a couch.  My clients don’t lie down on a sofa and stare at the ceiling while I say “mmm-hmmmmmm” a lot.
3. It isn’t the 10 minute office visit you get with your doctor or psychiatrist to have medications refilled.
4. It isn’t whining or wallowing in your sorrows.
5. It isn’t just for “crazy” people.

In my counseling practice, I typically start out seeing clients once a week for 60 minutes.  In every session, my goal is to find out how a client is doing, what their concerns are, and what they’d like to work on.  I have several assessments that I use regularly.  They are short and simple for clients to complete and provide information that helps clarify goals and guide our work together.  I listen.  I offer explanations on the chemistry and brain structures at work in anxiety and depression.  I assign homework to change the brain for healthy outcomes.  I give clients a safe, confidential place to explore painful pasts, current difficulties, fearful futures or all of the above.  But we don’t just explore that pain.  I engage clients in techniques to move them toward the positive places they desire for themselves.  I ask questions.  Sometimes clients cry, but not always.  Sometimes clients laugh, too, because the human experience really has a lot of comedic moments when you stop and think about it.

If it is going well, what happens in counseling is that a relationship develops between the client and counselor where the client feels heard, understood, respected, believed, and esteemed.  This is called a therapeutic relationship because it can lead to mental healthiness.  What happens in counseling?  Improvement.  Restoration.  Healing.  Magic.