Choosing a Therapist: A Guide for Catholics

By: Gregory Popcak


~“Do you feel that you have to think exactly the way the Pope tells you to think?   I want to help you learn to think for yourself.”

~“I’m a recovering Catholic”

~“I’m spiritual, but I think that religions are oppressive and unhealthy by nature”

All of the above statements are actual quotes made by therapists to Catholic clients who, frustrated by their counseling experience, eventually found their way to my office.   In my work as the Executive Director of a counseling agency that works primarily with Catholic clients, it is not unusual to hear clients report comments like these.  Historically, the counseling profession has not been terrifically welcoming to people of faith. This trend continues to a somewhat smaller degree even today.   For instance, the following quote by a well-known cognitive therapist was published in 2004 in the Journal of Counseling and Development, the flagship journal of the American Counseling Association.

I believe that religion is at the root of most wars as it often divides people  rather than brings them together. It certainly does not teach tolerance…. The Roman Catholic Church’s position against homosexuality, birth control,  and abortion seemed archaic to me….The clergy’s hypocrisy on these  positions (given their actual lives) seemed ludicrous…..Religion is probably at  the root of most evil deeds in history. Religious fanatics have led their people to conduct some of the most serious crimes against humanity such as the Spanish  Inquisition, the Crusades, and Salem witch burning.

The point of this article is not to dispute the disappointing ignorance of such comments.   Rather, the point is to note that, for Catholics, choosing a therapist can be even more challenging than it is for the average consumer of mental health services.   In fact, a 2006 nationwide survey conducted by the Pastoral Solutions Institute, found that religiously committed Catholics are significantly less satisfied than Protestants with the counseling services made available by their church and community.

Hope on the Horizon

Of course, the news isn’t all bad.   In many ways, this is a better time than ever for a Catholic to seek help.   While there is a long way to go, all of the various professional associations of counselors, psychologists, and clinical social workers have codes of ethics that call for religious sensitivity.   More importantly, Catholic counselors across the US are responding to the call of the New Evangelization and banding together to reinvigorate the theory and practice of an authentic Catholic psychology.  Here are some points to keep in mind when evaluating your counseling options.

To Counsel or not to Counsel?

Most people naturally want to handle personal problems on their own.   We especially don’t want strangers poking around in our personal lives.   But if you consistently and unsuccessfully struggle with a relationship or personal problem that sucks up more than its share of emotional energy, or if you have been experiencing emotional problems that last for 3 or more months despite your best efforts to overcome them, it might be time to seek help.  Having made the decision to seek counseling, one is often confronted with a confusing array of possibilities.   Should I consult my priest?   Should I seek medication?     Perhaps a counselor would be best for me?   How do I know what help I need and who is best qualified to give it to me?

Alison, a woman in her 40’s was experiencing depression that she thought was, in part, related to the death of her mother, with whom she had always been close.   She asked me, “How do I know where to turn?   Part of me thinks I need medication.   At the same time, I really hate to take anything if I don’t have to, so maybe I should start with counseling.   But then, what kind of counseling?   I’m so frustrated with God for allowing all this to happen to me.   Part of me thinks I need to talk to a priest about some spiritual direction but this seems a little more complicated than what the average pastor can handle.   I don’t know where I should turn. “

When a problem has physical, emotional, and spiritual dimensions, and most problems do, my suggestion is to get an evaluation by an expert in each of these areas.   For example, Allison talked to her family doctor, who suggested that she first see a therapist for evaluation and some counseling. Meanwhile, he would keep an eye on whether medication might be useful over the long term.   Her therapist began working on certain unhealthy thoughts and behaviors that contributed to Allison’s depression, and suggested that she consult with her pastor, and make regular use of the sacraments, to confront the spiritual dimensions of her problem.  Allison explained, “At first, I was reluctant to get all these different people involved in my problems.   But when I finally started reaching out, I felt like every part of me was being attended to, and my mind, body, and spirit were able to heal together.”

But Whom Should I Choose?

There many different kinds of professionals to choose from.   Psychiatrists, psychologists, clinical social workers, marriage and family therapists, mental health counselors, and pastoral counselors, all offer similar services while approaching therapy from slightly different perspectives.   How do you know which professional best suits your needs?   Let’s examine at the different professions that are out there.

Psychiatrists are medical doctors whose primary role is to prescribe and monitor medication.   For the most part psychiatrists no longer receive extensive training in psychotherapy or counseling unless they specifically seek it out.     Psychiatrists are best suited for supervising chronic, serious mental disorders.   They prescribe and adjust medications, do monthly medication checks, and often have counselors on staff to do therapy on their behalf.

Psychologists have, for the most part, received doctorates in psychology.   They specialize in psychological testing and counseling.

Clinical Social Workers, Counselors, and Marriage and Family Therapists are primarily highly trained, Master’s level clinicians who specialize in various models of psychotherapy and counseling.   Social workers tend to have more of a background in marriage, family, and group counseling while counselors often tend to be more focused on individual therapy, and marriage and family therapists specialize in interpersonal relationships.   Generally speaking, however, their training is very similar.

Pastoral Counselors are psychologists, social workers, or counselors who are licensed in their clinical discipline and have received additional, extensive training in theology and spiritual guidance.   They are especially helpful to clients who are interested in discovering how to apply psychological techniques in faithful ways, and in applying their faith tradition to their marriage, family, and personal problems.

Finally, Psychotherapist is a catch-all term that refers to any professional that does therapy.   Psychologists, counselors, pastoral counselors, and clinical social workers are all psychotherapists.   In some states, however, people may call themselves psychotherapists even without professional training or a license.   If your therapist refers to him or herself primarily as a psychotherapist, make certain of his or her professional training and state licensure.

Some Questions You Should Ask.

Here are some questions you should ask any professional you consult.

Are you licensed for independent practice or do you require supervision?    

A therapist-in-training may be quite competent, but I would prefer to work with someone who has demonstrated to their licensing boards that they are ready to practice independently (usually this requires at least two years of post-graduate supervision).  If your therapist does require supervision, ask questions about your therapist’s supervisor.   What is his or her level of training?   How often will they meet to discuss your case?   (Weekly should be the minimum)   Find out if you can meet this supervisor.   His or her attitude will be informing your case, you should know with whom you are dealing.

What models of treatment does your therapist use?

There are many different types of therapy, and some of which are more scientifically valid than others.   The most scientifically validated schools of treatment have been the solution-focused and cognitive schools of therapy, as well as some models of family therapy.   These therapies have been subjected to literally hundreds of studies and are at least as effective as medication for treating even severe mental disorders and the most complex relationship problems.   These models focus on identifying practical goals and giving the client many new skills and tools.   Generally speaking, “supportive counseling” in which the therapist mostly listens and empathizes, is not effective and should be avoided if you are looking for practical answers to your problems.

What is your therapist’s success rate for treating clients with problems similar to yours?

No therapist can give you a guarantee of progress, however, your counselor should be able to give you some idea of the duration of treatment, as well as his or her own success rate in treating problems that are similar to yours.  The more you know about your therapist’s professional background the more you will be able to make a decision regarding whether or not a particular therapist is for you.  In addition to the above, there are several questions that a   Christian should ask when choosing a therapist.   For example;

What is the therapist’s view of religion?

You do not have the right to ask your therapist intimate details about his or her religious practices and beliefs, but you do have the right to know if your therapist personally values the importance of religious belief, and whether of not he practices his faith.  A therapist who says, he or she is “spiritual but not religious”   may very well be a good therapist, but he or she may not be the best therapist for you who are presumably seeking to be both spiritual and religious in the healthiest way possible.

What does your therapist know about your faith?   What does he or she think of your faith?

It is one thing to be confronted about the way you view your faith or live your faith by therapist who actually knows your beliefs at least as well as you do.     It is quite another thing to be lectured by someone who, for all intents and purposes, is ignorant of what you stand for and what you believe.   Make sure any counselor you use is sensitive to your faith journey and competent to guide you on the way.

Is your therapist willing to pray with you or for you?

Certainly, not every session needs to begin and end with a prayer (though your therapist should be praying for you in between sessions), but your therapist should be comfortable offering prayer if he or she feels that it would be helpful, or be willing to pray with you when you ask him or her to do so.     If your therapist is uncomfortable with prayer, how can he or she help you discover and act on the plan God has for your life?

What should I expect?

While no therapist can tell you how long you will be in counseling, there are some general guidelines you can use to evaluate treatment.   Several studies indicate that the greatest benefit of therapy is gained within the first 12 sessions, with steady progress continuing though about 24 sessions.   Beyond this, the work becomes much slower, and generally speaking is focused on both maintaining changes and providing longer term accountability.   If you do not feel that you have a solid direction and are making good progress in your therapy by at least the sixth session, discuss your concerns with your counselor.   It may be time to seek other help.

Referral Sources.

Finally, If you are interested in finding a referral for a competent therapist in your area who is also sensitive to your faith journey, there are several sources to which you may turn. provides a searchable database for local therapists who have demonstrated both professional and theological expertise.   Similarly, the Pastoral Solutions Institute ( has logged thousands of hours of tele-counseling, as well as referrals, for Catholics worldwide.     Check out their many services and resources.

Contact your local PaxCare Tele-Coach if you are still wondering if counseling is right for you or if you are still having trouble finding a faithful therapist to help you. Call us to get the skills you need to succeed. Faithful, competent help is available for you, now more than ever.     Remember, a journey of a thousand miles begins with the first step.   Pray that God will grant you the courage to step out in faith and connect with the help you need and the healing you deserve.

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