Outpatient Counseling

General Statement

The therapists at Bethesda Christian Counseling believe that therapy is a two stage process that involves both healing and growth.  Most persons who enter through our doors come with a variety of past wounds.  These wounds frequently have a negative impact on our emotions, thoughts, behaviors, and relationships.  As therapists, our desired end state for those we help is that they find new and lasting ways of feeling, thinking, acting and relating in their key relationships.  In order for them to grow, however, the healing must first occur. 

We believe that pain in our lives, though never sought after or desired, can be redemptive.  In other words, God can use our pain to bring us to greater levels of emotional, mental, spiritual, and marital health.  Therefore, the elimination of painful symptoms in our clients is not the goal of therapy.  Rather, once our clients come to the place of an absence of their pain, we ask them to learn new life patterns and skills that will help them maintain their mental, spiritual, and marital health well into their futures.

The length of treatment is determined by many factors:  the nature and history of the defined issues, the commitment of the client to the therapeutic process, the expertise of the therapist, the chemistry of the relationship between the therapist and the client, and the complexity of the issues being brought for counseling, just to name a few.  The range of treatment lies somewhere between four weeks to several years.  At Bethesda we believe that the therapist must never create a client dependency on therapy.  Rather, as therapists, our job is to work ourselves out of a job.  Therefore, we do our best to assist the client in the achievement of their therapy goals with as much efficiency as possible.  The average length of treatment at Bethesda is six months, or about seventeen sessions.

Individual Psychotherapy

Individual Psychotherapy is defined by the treatment of one individual as opposed to couples or families.  Individuals seek help for a wide variety of situations.  For example, they may come through our doors expressing any of the following cries for help:

     …I want to feel joy, purpose, and hope in my life once again.

     …I want to not worry or be so afraid about my future anymore.

     …I want to get help with knowing how to get past a hurt in my past.

     …I want to know how to deal with my spouse who refuses to come to counseling with me.

     …I want help knowing how to be a better parent to my challenging child.

     …I want my troubled child to get counseling.

     …I want to learn how to deal better with my anger.

     …I want to stop my obsession with sex and pornography.

     …I want to feel better about myself.

     …I want to learn how to forgive.

     …I want to know how to adjust to a change in my life that poses some challenges for me.

     …I just want to stop hurting so much.

Most people come to Bethesda because they are having difficulty making the necessary emotional, cognitive, and behavioral adjustments to a significant change that has occurred in their life.  Another frequent reason people seek out counseling at Bethesda is because their past attempts to resolve a problem in their life has not worked. They are tired of trying to cope by using the old, familiar approaches that no longer work for them.

Psychological Testing

Psychological testing has many different forms, purposes, and applications.  All tests are measurement tools and are designed to identify and better understand yourself or your key relationships.  There are some measurement tools that are used to detect and measure the presence of a mental or social disorder/illness.  Other psychological measurements may be designed to identify key features of one’s personality, in which case all discoveries are within a range considered healthy.  Yet, other measurement tools are used to identify the strengths and growth areas in key relationships such as between marriage partners, co-workers, and engaged couples.

While many of these psychological or relationship tools can be administered by a therapist with a Master’s degree, some can only be administered and interpreted by a trained psychologist.  Bethesda has both on our staff; and can provide a wide range of measurement tools requested by the client or a third party.

Following are some reasons why people may benefit from the administration of such psychological tests:

  • The test may have been recommended by their therapist for diagnostic reasons.
  • The test may be required for premarital counseling.
  • The test may be helpful in helping a couple better understand what lies at the root of a chronic marital problem.
  • The courts may have ordered that a person be administered a particular test.
  • An adoption agency may require a couple to have the results of a battery of psychological tests for the adoption process to continue.
  • The test may be offered to assist a person in gaining a more defined and positive personal identity.

Some insurance policies will cover partial costs of the test.  Some insurance policies may not cover any costs related to psychological testing.  Because of this unknown, Bethesda requires full payment prior to the test being administered.  If and when your insurance does pay, you will receive a refund.

Marriage and Family Therapy

Marriage and Family Therapy is defined as a couple, several family members, or an entire family coming to the therapist together as a group.  Couples and families seek conjoint counseling when there are issues that are persistently presenting barriers to marital or family stability and/or satisfaction.  Such barriers may be…

  • poor communication and conflict resolution skills,
  • recovering and rebuilding a marriage after an affair,
  • adjusting to a life change such as a change in the family life cycle:  the birth of a child, empty nesters, retirement, loss of employment for one spouse, etc.
  • frequent outbursts and conflicts between parents and children,
  • persistent disobedience and defiance in a child,
  • a child threatening suicide,
  • an unresolved struggle from childhood surfacing in a marriage relationship,
  • complaints of a loss of joy and meaningful companionship in a marriage,
  • trust issues, either in the marriage or with children,
  • complaints of abuse, past or present.

What makes marriage and family therapy uniquely different from individual therapy is that the identified client is not an individual.  Rather the client (or the subject of therapy) is the presenting marriage or family. The therapist must assess, define and treat the marriage or family “dance”, rather than treating one individual.  The identified problem is never viewed as one person.  Rather, how a marital pair or a family reacts, responds, relates, interacts, or “plays off” each other is the subject of treatment.  The collective and interactive effects that the couple or the entire family has on each other is called the “couple or family dance”.  The task of a trained marriage and family therapist is to identify, search out the roots of a conflictual dance, and help a couple or family create a more satisfying and healthy dance.

Child Focused Therapy

When a parent observes that a child is having persistent emotional, behavioral, or social problems that do not appear related to other members of the family or peers, the parent may bring the child in to see a therapist.  The concerned parent will, frequently, report that the child is having social difficulties with peers or siblings, is persistently the subject of disruptive behaviors, or just does not seem to be developing according to normal developmental benchmarks.

In such situations, a specially trained child-focused therapist is required.  Such child-focused therapy may appear like play to adults.  However, it is through age appropriate play that the therapist is able to make a proper diagnosis and treat the underlying causes of the presenting problems.  Depending on the preferences of the therapists, such therapy can be done with children from the ages of two to eighteen.  What changes in therapy as the child-client becomes older is that the therapist will select activities that are more age appropriate.  Also, the older the child the more they can discuss their issues in more abstract constructs; rather than simply demonstrate them through behaviors and play.

When calling for help the parent needs to ask for a therapist who has experience and expertise in child-focused therapy.  At least one parent is required to come with any child under the age of eighteen to the initial session.  The parent will be expected to sign various documents required for treatment to begin.  Furthermore, the therapist will want to know the parent’s perceptions and definition of the presenting problem.  Likewise, a responsible adult should be in supervision of any child under the age of sixteen as they are brought to the clinic and picked up from the clinic after the session is over.

Premarital Counseling

Premarital counseling is recommended for any couple who is engaged regardless of whether they are anticipating their first marriage, or have been in multiple relationships.  In fact, if either members of the pair are being remarried, the need for premarital counseling increases many fold due to far more complex issues in second or third time marriages.  Many ministers are requiring that a couple attend some premarital counseling before they will agree to conduct the wedding.

Substantive and legitimate premarital counseling should involve the couple in taking an objective relationship assessment tool, which is evaluated by a pastor or counselor and used as the core basis of the counseling sessions.  For example, many pastors and counselors can offer the engaged couple the “Prepare/Enrich Relationship Inventory”.  This is a comprehensive tool that evaluates the couple’s relationship in terms of its typology, risks, strengths and growth areas, special focus items, family of origin issues, and how the personalities of the pair impact the relationship.  The administration of this tool requires that a pastor or counselor has received specialized training on this instrument.  Bethesda has two therapists on staff who are trained to administer the Prepare/Enrich. 

Premarital counseling is to be distinguished from traditional therapy.  The aim of premarital counseling is three-fold:  to aid a couple in better understanding their relationship, to assist the couple in heading off potential pit falls, and to give the couple some basic training in communication and conflict resolution.  Whereas traditional therapy assumes that wounds and conflicts will be the motivation for therapy, premarital counseling assumes a more awareness and educational motif.

Medication Management

Of all the organs in the body, the brain is the most complex and least understood organ.  When the organ of the heart begins to malfunction one experiences symptoms such as heart palpitations, difficulty breathing, loss of energy and strength, and chest pains.  When the liver begins to malfunction one, generally, become jaundiced.  When the digestive organs begin to malfunction the symptoms are experienced as stomach or intestinal discomfort, lack of appetite, or heartburn.  However, when the brain begins to malfunction the symptoms will be experienced as distressing emotions, irrational thoughts, and troubling behaviors.

Because these symptoms are so closely linked to our values and beliefs, when the brain becomes dis-organ-ized, people attribute their symptoms to moral and spiritual problems or lapses of the will.  Yet, no amount of spiritual, moral or behavioral interventions seem to be of any help to some who are experiencing such symptoms.  In fact, there are times when such attempted interventions only further exacerbate the symptoms.  There are many forms of mental illness that are directly linked to or are, in part, affected by a brain malfunction:  schizophrenia, bi-polar disorders, ADHD, Dysthymic Disorder, Cyclothymic Disorder, some forms of depression, and some anxiety disorders, just to name a few.

When someone complains that they have suffered from these symptoms over a long period of time, or report that other family members have had a history of similar symptoms, or they report their symptoms came on without any circumstantial or environmental cause, we must consider a purely biological cause.

When someone is suffering from an organically based illness, or when their presenting issues are so severe that they are unable to do the work of therapy, the clinician at Bethesda will recommend that the client be evaluated for the appropriate type and quantity of medication.  There are times when such medication makes an essential difference in either the client’s ability to profit from therapy, or in their recovery to health.

Nevertheless, many clients at Bethesda will move through their entire therapeutic journey without being placed on any psychotropic medication.  If their symptoms are not significantly interfering with their daily lives or their ability to comply with the demands of therapy, or if there seems to be no organic origin to their symptoms, the client can return to full health without medication.

Proper utilization of psychotropic medication has two appropriate functions:  a) to bring a person back to a healthy and a functional level who is the subject of an organically based illness, or b) to work as a temporary bridge to help the person regain an acceptable level of function until the work of therapy has brought them to a healthier place where they no longer need the medication.

Trauma Recovery

From current behavioral health research we now understand that people who have been exposed to traumatic life events require a uniquely designed therapeutic approach.  These trauma survivors do not, normally, respond well to traditional talk therapy.  However, they do respond exceedingly well to some very specialized therapy interventions designed specifically for trauma recovery.

A traumatic experience is defined as any experience that presented either a persistent or extreme invasion of a person’s sense of self, leaving that person to experience prolonged feelings of shame, anxiety, self-worthlessness, anger, and vulnerability.  Some examples of a traumatic history would be:

  • prolonged emotional abuse,
  • physical abuse,
  • bullying,
  • sexual abuse or molestation,
  • rape,
  • involvement in a serious accident where there was loss of life or shocking visual images,
  • combat experiences and the persistent and real threat to life,
  • viewing the abuse or threat to life of another person,
  • mass shooting survivors or victims of crimes which posed a real threat to one’s safety, person, or life.

Several therapists at Bethesda have received specialized training in several different therapeutic interventions that were uniquely developed to address the challenges faced by trauma survivors.  Such interventions as Life Span Integration (LSI), Eye Movement Desensitization and Reprocessing (EMDR), or Mindfulness Therapy are all best treatment options for a trauma survivor.  Through the proper application of these therapeutic interventions, the client achieves symptom relief and a complete recovery within a relatively short period of time.

If you or someone you know suffers from the long term effects of any of these traumatic life events, ask for such therapy when you call to schedule an appointment.

EAP Assessments

EAP stands for Employee Assistance Program and is offered to many employees by mid-sized to large employers.  The purpose of an EAP is to offer employees access to a mental health assessment without costs to the employee.  An employee who wishes to use their EAP benefit must seek pre-authorization by calling the EAP company providing such services to the employer.  This must be done by the employee prior to setting up the appointment.  Most EAP authorizations will cover anywhere from three to ten sessions with a therapist. 

All therapists at Bethesda are members of most EAP panels.  However, not all our therapists are on the same panels.  When calling Bethesda to set up an EAP appointment the prospective client is advised to provide the name of the EAP company and inform Bethesda if proper authorization has been requested.

It is important to remember that the purpose of these EAP sessions is not to conduct or complete the work of therapy.  The formal work of therapy does not, generally, begin until after the fourth or fifth session.  In nearly all situations, the initial three to four sessions are devoted to assessment work.  Most EAPs are intended to take the client only to the place where the therapist is able to do an assessment and provide feedback and recommendations for further care to the client.