In fact, many of our clients have found improved success by walking with both a Regen coach and a licensed mental health professional.
This article will help you understand when you may need to find a therapist, what to look for, questions to ask, and things to consider early in your therapy journey. Do I need a therapist?
Is Coaching Enough?
In many of our groups, men and women are encouraged to grow in identifying their emotions. When I participated in a Regeneration Group years ago, I noticed that every week my current feeling was “anxious.”
Thankfully, in a span of 7 days, I was encouraged by two different mentors AND that particular week’s Awaken lesson to pursue therapy for my anxiety struggles.
Therapy turned out to be an extremely helpful piece of the puzzle for my life, and within a few months of beginning therapy and continuing my Regeneration Group, I had made substantial progress with anxiety and with sexual integrity.
In fact, a large portion of people struggling with addictions, whether sexual, substance, or even multiple addictions (see appendix 1) also have an underlying mental health condition. (See appendix 1 for information about navigating multiple addictions.)
Therapy turned out to be an extremely helpful piece of the puzzle for my life
Consider the following checklist. If you find yourself connecting with several items, or if one item really jumps out, you may want to consider therapy in addition to or instead of coaching (or groups, etc.):
- I feel like I need my coach more than they are available
- The stress of life overwhelms me a lot between sessions (including possibly having a lot of flashbacks, panic attacks, or suicidal thoughts)
- I have mental health issues (such as anxiety, depression, or obsessive thoughts) that haven’t decreased in intensity even with coaching
- There isn’t significant relief in first 2 months of coaching (not perfection, but clear movement)
- I cannot effectively implement the tools I am being encouraged to use in coaching
- I see patterns of mental health issues that seem to go beyond by spiritual health
- I have questions about medications for mental health
- I have experienced significant trauma (use an ACE questionnaire as a starting point here)
- I have multiple addictions (see appendix 1 below)
- My mental health symptoms are interfering with my ability to function at school, work, or in my interpersonal relationships.
- My mental health symptoms are interfering with my daily functioning in that I am having trouble with sleeping, eating, getting out of bed, or taking care of my ADLS (activities of daily living).
- I am having thoughts about hurting myself, ending my life, or hurting someone else.
So, do you think you may need a therapist? Realizing your need is a great start! If you think you might need a therapist, the next step is to understand how to find the right therapist for you.
Finding the right therapist
Begin with prayer. Ask God to guide you to the right person for this season.
We often encourage our clients to find a Christian therapist, but any licensed therapist is trained to respect the faith of their client. However, unfortunately, the tenet of client self-determination is often not upheld when it comes to issues related to same-sex attractions or gender confusion.
So if you are dealing with these or related issues, make sure to state your goals clearly (e.g. “I want to learn to manage these same-sex attractions in order to have a thriving heterosexual marriage” or “My Christian convictions are very important to me, so I am looking for help to bring my sexual behavior in line with my Christian beliefs, and I’m looking for a therapist who can support me.”), then ask directly if the therapist is willing and able to support you in this goal(s).
Most therapists are generalists, meaning they will be able to deal with any mental health issue in general. And, if you are new to therapy, you can use your intake with the therapist to ask questions that will help you determine if they seem like a good fit (more on this below).
For those that are interested in pursuing specific modalities of therapy, see appendix 2 for a basic understanding of the most popular and well-researched forms of therapy.
My first two therapists primarily used the psychodynamic modality, which laid a great foundation down. However, when I had made enough progress in general, but was still having physical symptoms related to my mental health (think: post traumatic stress), I decided to pursue EMDR which was incredibly powerful in helping relieve those symptoms.
After identifying some of what you are looking for, there are two primary ways of finding a therapist: referrals and web searches. Referrals are great if they come from someone you trust. If, however, for whatever reason you can’t work with a referral, consider using websites like pyschologytoday.com (PT) to find a therapist. PT allows you to refine your search by faith background, approach, modality, and even those who take your insurance (although you can also reach out to your insurance provider to see if they provide ‘out-of-network’ reimbursement). But do be aware that not all therapists listed have the same credentials, and not all who call themselves Christian are orthodox believers. See appendix 2 for tips on both of those issues.
Questions to Ask
Once you have identified one or more therapists, the next step is to ask for a free, 15 minute consultation call to determine if they are a good fit for you. This free consultation call is standard practice for therapists, so don’t feel like you shouldn’t ask for it.
Below are questions taken from meetmonarch.com to consider asking during your consultation call, but it is also important that you pay attention to how you feel and how easily you connect. If your gut tells you that they won’t be easy to trust a particular therapist, you may want to try interviewing other therapists until you find one that you really connect with.
- Location: Do you meet in person? Virtually? Can you serve people in my state (if they are out of state)?
- Cost: Do you take insurance? If not, do you offer a sliding scale or any scholarships/discounts?
- Issues: Do you have experience working with [BLANK] issue? If so, how do you work with clients based on [BLANK] issue?
- Approach: What primary approaches do you use (consider modalities chart in appendix 2). How do you use them?
- Faith: How does your faith play into your therapy approach? How does your faith impact your understanding of sexual integrity
Note: If you have seen other therapists in the past, share what you have worked on, what has helped, what hasn’t been helpful, and ask how they would work with you in areas you want to work on.
Once you have found a therapist you would like to move forward with, consider asking them to try out 4 weeks in a row and then reevaluate the fit. Therapists are used to clients not working out, and any good therapist will be glad to do this with you, and even provide you with recommendations for others who can best help your specific needs. This provides an easy off-ramp if you are nervous about how to end a therapy relationship once you have started.
If you continue forward for longer, never feel bad about deciding to stop seeing a therapist, and perhaps going to someone else. Some therapists will be better at dealing with certain issues (e.g. my first two therapists were not certified in EMDR and therefore could not engage EMDR with me), so consider having a candid conversation with them if you would like to move on. They may even provide you with referrals for other therapists who specialize in specific issues.
Also, you can update your therapist in real time, letting them know what is or isn’t working. If they are unable to adjust to meet your desires, that may mean it is a good time to move on.
We often recommend that people in recovery who really want to see freedom find BOTH individual help (therapy, coaching, etc.) AND group help (Awaken, Path, Unwanted, SA, therapy group, etc.) since they each help in different ways.
So, even if your primary concerns are focused around sexual integrity, seeing a therapist could be a great compliment to the work you are doing in groups or coaching at Regeneration.
If Regen can support you as you seek a therapist, let your coach know. And, if you think you would benefit from group work in addition to therapy or coaching, check out our groups here.
Appendix 1: Multiple Addictions
A person with multiple addictions (e.g. alcohol and gambling, drugs and sex) should work their recovery for all their addictions at once (where possible, it helps to have a trained therapist or another experienced professional who can help the person integrate their recovery work for the multiple addictions).
The reason is that addictions serve as both symptoms and coping mechanisms of deeper problems, so if a person quits alcohol but continues to indulge in pornography to cope, then he remains more vulnerable to relapsing into his alcohol addiction.
In addition, if his other behaviors/addictions cause him distress or shame, then their persistence also increases his risk of relapse.
For example, here’s a quote from Windmill Wellness: “As important as it is to detox from substances and behaviors when treating addiction, it’s the act of changing thoughts and behaviors that allows for successful recovery. It then becomes crucial for those struggling with multiple addictions to receive treatment for all their problems at once. If not, the patient’s mind will remain in a state where compulsivity and escape from reality are the norm.”
So, for example, if a woman’s husband has just returned from treatment for alcohol, now is an opportune time to begin working on whatever extra-marital romantic/sexual patterns he may also have. If he is seeing an addictions therapist, that therapist may already have experience dealing with both substance addictions and behavioral addictions.
If he were to choose to pursue coaching with Regen, it would be important that he disclose his alcohol addiction and to continue in his substance abuse recovery along with the coaching he receives here.
Appendix 2: Common Therapy Approaches, Licenses, and Faith
Common Therapy Approaches
|Psychodynamic||views human behavior from the standpoint of unconscious motives that mold the personality, influence attitudes, and produce emotional disorder. The emphasis is on tracing behavior to its origins, as contrasted with the nosological approach, which concentrates on overt signs and symptoms of disorder|
|CBT: Cognitive Behavioral Therapy||integrates theories of cognition and learning with treatment techniques derived from cognitive therapy and behavior therapy. CBT assumes that cognitive, emotional, and behavioral variables are functionally interrelated. Treatment is aimed at identifying and modifying the client’s maladaptive thought processes and problematic behaviors through cognitive restructuring and behavioral techniques to achieve change.|
|ACT: Acceptance Commitment||emphasizes acceptance of negative thoughts, feelings, symptoms, or circumstances. It also encourages increased commitment to healthy, constructive activities that uphold your values or goals. ACT does not focus specifically on symptom reduction because focusing solely on symptom reduction has been shown to inadvertently exacerbate and further entrench symptoms. Instead, ACT focuses on living mindfully and making choices consistent with your values. This paradoxically leads to symptom reduction.|
|DBT: Dialectical Behavior||a flexible, stage-based therapy that combines principles of behavior therapy, cognitive behavior therapy, and mindfulness. It establishes a “dialectic” between helping individuals to accept the reality of their lives and their own behaviors on the one hand and helping them learn to change their lives, including dysfunctional behaviors, on the other. Its underlying emphasis is on helping individuals learn both to regulate and to tolerate their emotions. DBT is designed for especially difficult-to-treat patients, such as those with borderline personality disorder.|
|EFT: Emotions Focused||Based in attachment theory, EFT helps people tune in to and feel emotions to help them move through those emotions instead of getting stuck or overwhelmed by them. It helps clients expand their sense of self and connection with others. This is a popular and helpful form of couples therapy but there is a form for individuals as well.|
|IFS: Internal Family Systems||a broad conceptual model that focuses on the relationships between and among interacting individuals in a family. Therapists must see the whole family, rather than work only with individual members, to create constructive, systemic, and lasting changes in the family.|
|EMDR: Eye-movement Desensitization & Reprocessing||used to reduce the emotional impact of trauma-based symptoms such as anxiety, nightmares, flashbacks, or intrusive thought processes. The therapy incorporates simultaneous visualization of the traumatic event while concentrating on the rapid lateral movements of a therapist’s finger, light-bar, or other devices.|
|Eclectic/ Integrative||Therapist uses multiple approaches in their practice (most do!)|
License: Notice on PT (Psychology Today) what degrees/licenses are listed for the therapist. The top degrees in the field are psychologists (those who have doctorates): PhDs and PsyDs. Some may also be Psychiatrists (MDs or DOs) and are therefore allowed to prescribe medicine. Many psychiatrists, however, focus more on medicine than talk therapy, so it is important that you are also seeing a therapist who does more talk-work on a weekly basis if you are being medicated for mental health.
Additionally, many licensed therapists have Social Work (LCSW) or Marriage and Family (LMFT) backgrounds, and some also are Licensed Clinical Professional Counselors (LCPC). There are also those who are licensed, but are still in training, including Licensed Graduate Professional Counselors (LGPC) and their social work counterparts (LMSW). Looking for someone with one of these degrees or higher (such as the Licensed Psychology degrees mentioned above) is really important. For the best help, we recommend typically not seeing anyone who is unlicensed, or associate, since they are still in training.
Christian Faith: If you are searching for an orthodox Christian therapist (think: someone who has a biblical concept of sexuality), you will need to do more than just filter for Christians on Psychology Today. To do so, start there, but when you click on therapists, notice the ally section. If it says they are allies to the LGBT community, that means that they affirm LGBT practices. HOWEVER, a Christian therapist may list that they work with LGBT identified people, without being an ally, meaning they have some measure of expertise and comfort, but do not affirm LGBT behavior.