What is a Mental Health Therapist?

The primary duty of mental health therapists is to provide a safe, non-judgmental space for clients to explore a range of issues that may be troubling them. “Good therapy is a dynamic, unique, and creative process with one sole aim: to provide help and support to the client,” explains Dr. Brittany Aleshire, assistant professor of psychology at the University of Massachusetts Global.

When it comes to defining exactly what mental health therapy is, and what a therapist is, I think the above quote is a good place to begin. It seems at least to be connected to the Hippocratic oath that has governed doctors’ practice for centuries: “First, do no harm.”

There are all kinds of therapists out there, good, and bad. Just talking about the “good,” there is a range of approaches and styles out there that can make choosing the right therapist daunting. I’m not sure how to tell someone exactly how to choose a therapist, other than my own experience working with both couples and individuals over the past ten-plus years. If nothing else, do you feel safe with this person? Then maybe give it a few sessions and see if things are improving at all.

So, my answer to this question is going to be highly informed not by only my education and training, but probably even more so by my personal and professional experience working with people in the counseling room for thousands of hours over more than a decade.

One benefit besides mere experience that comes from working in the same field over a long period, is that patterns emerge. And, as these patterns have emerged, I find myself returning to similar spaces with clients regardless of age, gender, ethnicity, or presenting problem.

That being said, I believe a good therapist is nuanced. They are present. They are paying attention to the particular circumstances of the people sitting before them. And, at the same time, they are drawing on their experience of working with people over many years, merging the two in a way that is beneficial to the client.

I liken it to a skilled carpenter, with a trusted set of tools. The tools in the box will not change much over time. I believe the choice of tools gets smaller, and the tools themselves usually have higher and long-lasting quality.

A carpenter shows up with his toolbox. The same tools are in the box each time, but the tools are diverse enough and specific enough to be useful in particular people’s lives. It is safe to assume that every carpenter would have a hammer, a screwdriver, a wrench, a drill, etc. He may also have more specialized tools that you haven’t seen before, but there will always be some form of that basic set.

Here are my basic approaches as I’ve come to characterize them now.

First, I believe that a therapist will always be working on some level with the mindset of the client. In other words, what thoughts and beliefs are showing up when trouble happens?

It is important to know that this is not a simple, positive mental attitude approach, or some sort of quick “head adjustment.” It is deeper and more mindful than that. To realize what we are thinking, believing, and how those thoughts and beliefs may be fueling the emotional state we find ourselves in, we have to start by paying attention. We have to know what is there, to know what needs to be changed (if anything).

So one of my tools in the toolbox is typically some sort of mindfulness practice. This is not just a traditional sitting on a prayer pillow or meditation mat and watching one’s breath, although that can often be useful. Rather, my understanding of mindfulness is more fluid than this.

I like to assign practices that can be performed anywhere, that are highly portable, that can be done not just when sitting in a dark, quiet room, but when actively engaged in an argument with a spouse, or driving.

One might ask: isn’t mindfulness some sort of non-Christian, New Age, or Buddhist practice? My answer is: not necessarily. The purpose of this essay is not to defend its inclusion in every Christian therapist’s toolbox. But look up the practice of “contemplation” in the history of Christianity. If anything, this has been a part of the Christian tradition longer than it hasn’t.

Its absence is more a symptom of modernity than it is of some sort of specifically Christian exclusion of it. I think most Christians could benefit from an increase in mindful awareness of their thought processes as they relate to emotional states, and the conflicts we find ourselves in. I’m not alone in this, either. But you may not find this in most Evangelical Twitter feeds.

Another tool in the toolbox for me is communication skills. I can’t imagine doing relationship work without somehow helping my clients to speak more clearly and understand each other better. 95% of the time, over my years as a therapist, couples, in the first session, will say that the reason they have come to therapy is to increase their ability to communicate with each other.

I’m not going to take the time and space here to fully flesh out the connection between mindfulness practice and communication skills but is not hard to imagine it. The more aware one is as an individual of how their own thoughts and beliefs are influencing their negative emotional states, the more one is aware of the roots of our argument patterns.

What is flying into our arguments with our spouse? What is in our heads already? What has been there for a while, and tends to come up and drive my anger, making it hard to connect and be at peace with my spouse?

This leads to the third tool in the box. Knowing how the past is influencing the present. This brings in awareness of past wounds, past unhealed, trauma, etc. It is one thing to become more aware of present thought patterns, and how they are influencing our negative emotional states. It is another thing to know where they come from.

This is where story work comes into play. In other words, there are skills to be applied in the present, for example, communication skills, and mindfulness. But some skills draw on knowledge of the past, our family of origin, our childhood, traumas, and experiences, our past relationships, etc.

Think about it this way. It is easy for us in a current conflict with a current partner to assume that all of the negativity we are experiencing is coming just from them. This is an easy assumption to make, and it is most often incomplete and not nuanced enough to get to the root of the problem.

I often tell new couple clients to consider the line between what is showing up in the present interaction with a partner, and what might be coming up from the past. Do we know the difference between what our partner directly or indirectly causes us to feel?

So, this is a brief explanation of a three-pronged approach. A combination of mindfulness, communication, skills, and knowledge of how the past influences the present.

In my mind, a therapist connects these three tools in the interest of helping the client to grow not only in self-knowledge but in self-regulation. Self-regulation is another way of saying self-control. As a Christian therapist, Galatians 5:23-25 is always a good place to return to on repeat.

Therapists must depend on God for the wisdom and ability to speak with nuance and effectiveness into our clients’ lives. Notice that in the fruit of the spirit listed in this Galatians passage, self-control is the last of the nine.

I am always in some form as a therapist helping my clients to increase in self-control. But as a Christian therapist, I believe that self-control cannot truly be increased without the spirit of God helping, and placing it in there in the first place. I am as dependent as my clients.

I’ve spoken of tools, and what any therapist should be doing to help their clients. I’ve used the analogy of putting tools in a box, the “tools” being the skills, and the client being the box. But, in a sense, I also see myself, as a Christian therapist, as a tool in God’s box. God has grown me so that I may grow others.

One of the best biblical examples of this is 2 Corinthians 1. God has allowed me to have experiences in my story that enable me to enter the lives of others with empathy and understanding. We suffer so that we may help others in their suffering. A good therapist understands this on some level.

In another essay, I would write a lot more about humility. Humility is essential. May we all, clients and therapists alike, grow in both humility and dependence on the Father for wisdom, and how to move through life in a way that shows those who don’t know Jesus what he is like, more and more.