There was an interesting article in "Ami Living" (issue #62) about unlicensed advice-givers, whether they call themselves counselors, therapists, marital counselors, etc. The author interviewed three men who have no degrees and yet offer advice. To sum up:
pro licensing/anti unregulated counselors:
1) public protection - people have been hurt by self-declared practioners
2) the material studied for a degree plus the supervised training is invaluable
3) formal schooling plus a natural aptitude are a winning combination
4) the shtetl rav knew his limits
pro unregulated counselors:
1) there are awful licensed therapists, a degree is no guarantee of competence
2) a chush (instinct, talent) for advice giving cannot be learned in school; those who are professionally trained often lack common sense and a listening and sensitive heart and go "by the book". Being able to give good eitzos (advice) is not something you learn in school.
3) formal schooling in which you must study ideas that are contrary to Torah is not an asset but a liability
4) they can be fine for most human relationship and personal problems
5) good for those who don't want to get involved in anything medical because of the stigma (even though psychologists and social workers are not in the medical profession)
What did people do before the field of mental health developed and became regulated? Of course there were always rabbis, rebbetzins, mashgichim, pastors, chaplains, and friends to turn to for advice.
The frum psychologist Dr Sorotzkin's answer to the question of what people did before psychology is the same as for antibiotics, "Some lived and some died." I think that is true now too, though not in the way he means it, with many people "dying" with the lack of help or outright harm perpetrated by some professionals.
He believes that all things being equal, the chances are higher that a trained and licensed therapist will be better than one who isn't. He thinks that licensed people are more likely to be effective and quicker to know what they can and cannot do. Sounds reasonable but until it's proven (and how can it be proven?) it's an opinion.
A frum psychologist quoted in the article said that the rav and rebbe of yesteryear "were guided by a strong sense of morality, spirituality and plain old common sense." He thinks that many of those trying to give advice today are lacking in all three. He also thinks that the advisors of yesteryear were focused on the person who needed help as opposed to today where many are as interested in being advice-givers as they in helping. "There is much less listening, much more advice-giving."
The professionals feel threatened by those who get referrals even though they did not put in years and money into a degree. When a social worker is quoted as saying, "A person should never do anything he is not qualified to do. A dermatologist would not promote himself as a brain surgeon," I am not impressed. What's the comparison? How is an counselor who gives advice comparable to one type of doctor who promotes himself as having another specialty?
This same individual is annoyed by congregational rabbis who counsel. What bothers him is the case, for example, of a couple going to their rabbi for marriage counseling and not getting the desired result and concluding that counseling doesn't work without realizing it was the unqualified rabbi who was the problem. This social worker apparently believes that anyone with a degree or license will give only excellent advice, which is wishful thinking.
If only a study could be done in the frum world about the efficacy of frum unprofessional counseling versus professional counseling, but that seems impossible
As for money, it didn't come up in the interviews in the article. A sidebar said that the mental health advisor (i.e. non-professional) rarely charges, volunteering the bulk of his work for the mitzva.
I think that when someone consults a professional, he or she is paying for a specific chunk of that person's time. They are also paying for the person to understand specific types of circumstances such as depression, physical illness, abuse, divorce, etc. that a non-professional may or may not understand. One example that comes to mind are social workers who work with people with specific health issues and have to understand those issues and how they impact the person and their family members. They also have to know what community resources are available to recommend to the patient. The social worker's job is to listen to the patient's concerns and help the patient to form a plan of action regarding those concerns. The social worker may give information about available services but usually avoids actually giving the type of advice that would be making a decision that the patient needs to make himself.
ReplyDeleteIs the rabbi who wants to give marriage counseling ready to a troubled couple vent for hours and hours? The couple may not be willing to pay what the rabbi's time is worth but their insurance may cover several sessions with a trained professional.
Let's take the case of someone struggling to control their weight. This is a complicated struggle for many people and can't easily be solved with some flippant advice. It is so complicated that the US government allows valid weight loss services to be covered as a tax deduction for those whose doctors prescribe such services and who are willing to write a letter stating that the patient is ill without those services. Is a rabbi willing to weigh someone and supervise their diet? How many people succeed in controlling their weight due to advice from a rabbi? Many shuls have Weight Watcher groups meeting there and the rabbi may be able to do little more than direct overweight shul goers to the group.
There are specialties such as professional organizers who have basically labeled themselves as such because at the moment there are no licensing requirements for that specialty. These people often work with elderly people who must downsize to move into assisted living apartments. They must help these elderly people part with treasured belongings in a professional and compassionate way but in truth, at the moment, anyone can hang out a shingle as a professional organizer. There are some courses being offered but there is no current college degree in the profession. Life coaching is in the same category. Some courses have been developed but probably anyone can hang out a shingle as a life coach without any sort of license whatsoever.
Of course any friend can offer their 2 cents worth but some problems are more serious than that which can be solved with friendly advice.
I'm sure that part of being an effective counselor is being able to cut to the chase and control the length of conversations. Rabbi sometimes put in numerous hours into a couple or individual. If that is part of his job description, so be it. Rabbi Goldwasser, for example, does this regularly and has shared many of his experiences with his readers.
ReplyDeleteAs for weight loss, perhaps it is the rabbi's role to present the spiritual context of eating and provide chizuk from Torah sources.
Money and time may be reasons people opt for professionals but that doesn't guarantee them success.
Few medical or emotional things come with guarantees. Surgeons can't guarantee the outcome of surgery. Physicians can't guarantee the success of medical treatment. Mental health therapists and their clients don't always click. Part of getting well emotionally and mentally is wanting to get better. I sat next to a woman at a wedding who admitted that she had diabetes but was not following her doctor's advice. She obviously does not want to put effort into staying healthy. The same thing is true of emotional health. The professional cannot guarantee a happier life. They can only help the person understand why they feel the way that they feel and how to channel or overcome the feelings.
ReplyDeleteThe solution to me seems to be to create courses for aspiring frum counselors that qualify one with credentials but omit objectionable content.
ReplyDelete