What is an LCSW? An LCSW is a Licensed Clinical Social Worker. The licensing
board in the State of California for an LCSW is the same board as the MFT
license. The difference between the licenses is small and primarily in the
education. LCSW's are educated with a more "macro" view in mind. They are
exposed to a "systems" approach to treatment.
LCSWs are not psychologists or psychiatrists. Many people get these professions confused.
A psychiatrist has been trained in medicine and is a medical doctor (MD)
with a specialty in psychiatry. They diagnosis mental conditions and are
licensed to prescribed medications. A psychologist has a Ph.D., a doctorate in Psychology.
Psychologists are trained in providing psychological testing and have a
longer education requirement.
The field of counseling and psychotherapy consists of many orientations.
Most therapists use a combination of modalities. I have included the
orientations that underscore my clinical approach and a brief description of
each. Also, I have included a brief case example of each.
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Intersubjective Psychotherapy = The main feature of
this approach is to create a "shared" environment between the
therapist and the patient whereby the interactions provide a new,
hopefully positive experience. There is some focus on "family of
origin" issues and integration of personal history. Trauma, whether
shock trauma or developmental (or both) can become a vehicle for
insight.
Case Example: A newly sober person has never trusted another person
with shameful experiences. Drinking and using drugs was a way to
self medicate the overwhelming feelings of anxiety. The
intersubjective process offers a "relational home" for sharing
these experiences, over time building trust, decreasing anxiety and
shame with the goal of creating a new more positive and lasting
relational experience.
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Cognitive Behavioral (CBT) = The focus of CBT is the identification
of thoughts, assumptions, beliefs and behaviors that cause
debilitating negative emotions and dysfunctional behaviors with the
goal of unpacking and rebuilding a more positive and functional
lifestyle.
Case Example: A substance abuser cannot seem to get their life on
track. They keep repeating cycles of substance abuse, sobering up
and then wondering why their life has stagnated or become more chaotic. The focus of the therapist would be to identify the dysfunctional behavior of substance abuse and the subsequent negative consequences. At the same time through
education, the therapist would explore the person's distorted belief
systems and perceptions. The goal of treatment would be to
restructure a life style that the individual could actualize their life
goals.
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Somatic Therapy = Integrating into the work a
focus on bodily sensations (felt sense) in an effort to help a
person "renegotiate" activated states in the body's nervous system
such as, anxiety, anger and sadness. The goal is to allow for highly
aroused energies in the body to be experienced safely and gradually
without re-traumatization.
Case Example: A person grew up with an abusive alcoholic parent.
They find themselves disassociating during specific stressful times,
i.e. conflict in a relationship. They are "hyper vigilant" with most
relationships. By focusing on the "felt sense" in the body, the
therapist can help the person unlock trauma in their nervous system,
slowly, utilizing the person's own resources to calm and discharge
the activation, i.e., anxiety. The goal of the treatment would be for the person to
experience decreased stress and anxiety in relationships and the
ability to tolerate conflict.