Feeling Stuck? Need a Change: How to choose a “Shrink”

Whether you are already in therapy or feeling the need for a professional to guide you through these rapidly changing times, it can get confusing as to when to see a coach, a career counselor, a psychiatrist, or a psychotherapist.

Here are six tips to assist you in making the right decision:

1)     Do you have insurance?  Those who are career counselors or coaches only, may not also be licensed in California to practice as a counseling professional. However, there are licensed professionals who also do career coaching, life transitions coaching, and crisis management.  If you want your insurance company to reimburse part of your sessions, be sure to ask the coach when you make the call. Even if you don’t have health insurance, make sure they give you an official invoice or super bill that you can write off as an educational expense if it applies to your professional improvement.


2)     Are you depressed or highly anxious? If so, is it preventing you from functioning on the job, managing your children, or participating in social activities? Working with a coach who doesn’t have clinical training can be a mistake if they do not have the skills to assess when they are in over their head. For example, coaches are sometimes trained to interpret the client’s non-compliance with homework assignments as a form of resistance. They are not often trained how to assess clinical depression. I was referred an anorexic patient who had gone to a coach for hypnosis. By the time this patient was referred to me, she needed to be hospitalized. This is an extreme example but a licensed therapist, whether they be a psychiatrist or a psychotherapist spends at least three years in graduate or medical school, two years in a clinical internship with supervision, and then is required to take state board exams both orally and written before practicing on their own.   There are no coaching programs that require this kind of rigorous training and supervision.


3)     If your life is in chaos, are you de-compensating and need medication to function? A licensed psychotherapist (if they are good) will know to refer you to a psychiatrist. What is amazing is that if you were to go to your family practice M.D.  and report being stressed out he/she may prescribe anti-depressants without the thorough evaluation that an M.D. trained in psychiatry would do to make sure they put you on the appropriate psychotropic medication to rebalance your neurotransmitters. A psychiatrist is also going to follow up to see how you are doing on that brand and dosage. There are also psychiatrists who treat these imbalances with nutritional supplements and herbs. These doctors are called orthomolecular psychiatrists.


When I work with my clients whose brains are in overload, I work closely with a holistic psychiatrist who practices near by – Dr. Hyla Cass- CassMD.com. 


4)     Is your life working so-so, but you want more meaning and purpose? Are you just in job burnout and want career counseling?

Traditional career counseling involves elaborate questionnaires to determine your interests and skill set but may not tap into what you are passionate about. There are coaches who do not have academic training in psychology but who have developed their own methodology for helping people discover their life purpose, their mission, or their vocation of destiny. They will give you homework assignments and a structured program to follow and these coaches and programs for the high functioning individual can be very effective.

5)     Are you experiencing a creative block? Some people know they are meant to do something artistically but are going through a dry period or maybe the demands of their day job in corporate America is getting in the way of contacting the inner muse for their artistic needs at night.

This may be the domain of either a therapist or a coach. Choosing which to go to may begin with you exploring how deep seated the issue is. If there is childhood trauma connected to the block, you may need a therapist trained in hypnotic regression that can take you back to the origin of the trauma and provide the healthy adult protection your child self may need to heal the issue.

A coach may work with you more in the present and deal strictly with your conscious beliefs that are getting in the way and give you exercises to re-inspire your creativity. In my practice, I have found that when a client is feeling blocked, it helps to have them close their eyes and breathe into their body bringing an awareness of where the fears are stuck in the body. I don’t necessarily need to go back to childhood because the unconscious trauma is still in the body and when we surrender into these places, it drives the fear to the surface and we can use the breath to morph the old beliefs into a new reality. I also have found that dream interpretation works really well with writer’s block and other creative obstructions.

6)     Are you dealing with an issue that needs the augmentation of group support?  Sometimes we need a community around us such as the Anonymous programs if you are struggling with an addiction. If you are healing from breast cancer, no one understands what you are going through like other survivors who’ve gone through it. Or, perhaps if you are in a spiritual crisis, you may need to attend services at a church or temple in affiliation that is aligned with your beliefs. Also, when people are going through a transition in their lives, group therapy may be beneficial as a cost effective means of having a breakthrough.


In summary, by asking some of these questions when you contact a coach or therapist, you will clarify for yourself who is suitable.


Dr. Toni Galardi is a licensed psychotherapist, marriage, family, and child counselor as well as a career and life transitions coach. She also specializes in working with frustrated artists and those wanting a life that is joyfully fulfilling. Her new book, The LifeQuake Phenomenon: How to Thrive (not just survive) in Times Of Personal and Global Upheaval is available through her website www.LifeQuake.net and the major online bookstores.