Skillful Means

My professors of Holistic Theories of Psychotherapy tell me that Buddhist Yoga practitioners…or possibly Yogic practitioners of Buddhism…use a phrase which has been translated as ‘skillful means’.  It is not enough to have good intentions, or even a good heart, or a passionate desire to help others.  One must also have the skillful means to accomplish that goal.

Presumably, that is why there is a requirement of a 60-credit master’s degree program with many clearly defined, nonoptional components before one can – at least in the state of Massachusetts, in the US, where I live – be eligible to take the exam which is one part of earning certification as a Licensed Mental Health Counselor.

So that’s what I’m doing. I’m in the second month of my first semester of this program.  I’m 43, and I’ve been working in the field of mental health as a milieu counselor* for most of the 14 years since I earned my Masters of Divinity and didn’t know what to do with it.  I’d discovered I didn’t want to be a minister, which is an awkward discovery to make halfway through an expensive, demanding, and highly educational program.  So I concentrated on counseling classes in the second half of my time in divinity school, and when I was done, started working as relief staff in residential facilities.

I was terrible at it.

I think that’s pretty much to be expected.  Over time, especially with each move to a new job, or a new environment, I became quite good at it.  I also became more and more frustrated with it.  I had clinical kinds of ideas.  I wanted a clinical kind of job.  Not incidentally, I also wanted a job that paid a living wage, but I wanted it in what I feel very strongly to be my field, doing the work I feel called to do.  I think it’s possible that one of the many important things I brought away from divinity school was a willingness to use terms like ‘calling’ and ‘vocation’ without squirming in my seat. 

So I have had some education in counseling, but never as part of a coherent, structured counseling program.  I have a lot of experience working in the field, but invariably either in situations where my ability to listen, perceive, think, and respond therapeutically was minimally valued, or, in a couple cases, where I was given a caseload of eight clients to counsel, with almost no supervision and no actual training at all.  I have all these bits and pieces.  Now I’m enrolled in a program in which I A: will have the chance to learn a lot more, and B: will hopefully acquire a better framework into which to set the inchoate jumble of experience and education I currently have, to see some more solid meaning emerge from it.

And really all that comes down to is that I want to counsel people, and I am going back to school to learn the skillful means I need in order to start.

(Only to start.  All the rest comes from a lifetime of actually doing it.  But the start is important.)
* ‘Milieu counseling’ is one term for a job that has a lot more different titles than it has significantly different responsibilities.  A milieu counselor is the person occupying the lowest-status rung of providers of mental health care in institutional settings: hospitals, outpatient programs, residential treatment centers, group homes, etc..  Milieu staff are the people who often have relatively little specific education and almost invariably have extremely little training for their work, who are paid badly, given almost no opportunities for advancement, and who spend by far the most time with the clients/residents/patients.  They are the ones whose job – and it is a job, not a career – is to be present with the clients/residents/patients throughout the day and night, making sure they are supported in getting from point A to point B in as therapeutic a manner as possible, trying to coordinate as a team, provide documentation which may or may not ever be read, be familiar with each client/resident/patient’s individual plan of care as determined by their therapist/treatment team and attempt to implement it.  In some settings – more often but not exclusively hospitals – they are responsible for running organizational, recreational, educational, and sometimes even therapeutic groups.  In general, however, their opinions are not sought and they are assumed to be either so limited in their capabilities or so unlikely to stay in the job for more than a few months that institutions do not find it reasonable to expect initiative or insight, or to reward it if it occurs. 

Yes.  I have opinions about this arrangement.  My second opinion is that it is structurally flawed in ways that the mental health profession could only benefit from addressing.  My third opinion is that I understand how it arose, and there is a certain logic to it, but not one I find satisfactory.  My first opinion is that I want out – which is a large part of how I come to be studying psychology with the intention of becoming an LMHC myself.

The others, you can probably infer.


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