Re: Pleae define the difference between crisis and therapeuticcounseling

[<MichaelD55@xxxxxxx>]

Wonderful question. What is it you are attempting to resolve? Here is my too 
long answer of the moment. 

Crisis counseling is focused on regaining or maintaining function during a 
period of stress. This might include debriefing after a particular miserable 
event such as a sexual abuse exam. Popular models is include critical 
incident debriefing or initial phone counseling for rape victims. 

An examiner might counsel (speak/listen) to the child after the medical exam 
when the child is dressed and in a more even position.  I did such exams in 
1979 in our major foster care center and saw it as particularly stressful for 
children 5-12. They might be angry at me. One delightful child girl about 7 
would greet me in the next few days with "I get to hate you forever and my 
dog can bite you dead." Then she would jump in my arms and I would swing her 
around. Great romance. 

Therapeutic counseling would address "deeper" issues. A child who has no 
protest for a frightening medical examination might be provided an opportunity
 to express herself over time. She may eventually be able to say through her 
art that she is afraid of anger because her anger would kill. This might be 
based on years of conflict and a defense against helplessness that includes 
an irrational sense of power. (Toddlers express such total competence and 
then helplessness for the same task. Watch them try to learn to tie their 
shoes.)

"Counseling" as I see the word used would not require training and a license. 
"Therapeutic" means it helps. Therapy requires training and license and 
implies a learned process of addressing problems that cannot be treated so 
well without that training (psychoanalytic, behavioral, family, conjoint...) 

We have written a statement for our victims of crime funds in California that 
will be shared in San Diego. It addresses a problem the fund managers had 
with what to pay for. A counselor might assist grief and mourning but could 
not treat a specific disorder. Still, a child "counseled" by such a person 
might find relief of their PTSD.

Sigmond Freud reportedly said that psychoanalysis was not a way to treat the 
mass of people and added a comment that fortunately life can provide 
therapeutic experience. 

I don't know where line is between these two processes. Watch for our 
California report. 

Michael Durfee, MD, board certified child psychiatrist and son of a child 
psychiatrist, (lots of training since childhood)