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Sushama Kirtikar



The appointment is made for your first counseling session. A veiled case of the jitters is natural. The prospect of change brings hope, yet hard on its heels comes fear. Relax. This is not like taking an exam. You are not on trial either. At the same time, this is not a social chat, nor is it a perfunctory visit to satisfy your curiosity about counseling. Carry a fistful of sincerity. Try to have a topic of focus that you can present. Most first-time clients start with, "I don't know where to begin." That is common. Do not fret. The counselor will lead you. If you are uncomfortable, say so, and it is up to the counselor to create an environment of safety and comfort.

Second, it may be beneficial to take pen and paper to take notes. There will be suggestions made and homework assignments given on occasion that may be impossible for you to remember. Much to the chagrin of people around me, I am a copious note taker. Apart from my own penchant for it, I find my most successful clients are the ones who take counseling seriously. They are sincere about incorporating the insights and observations that come up in therapy. It is less about how much the therapist gets done in the hour and more about how much the client gains in that hour. So, do not hesitate to display a bold sense of ownership of the process.

Counseling attempts to establish a safe, supportive yet candid space where you can place your problems on the table and examine them through a new lens. Set concrete, achievable goals for therapy. You will be working towards a climate of positive change. Be attentive, ask questions, and answer honestly and forthrightly without holding back pieces of information. It is not for you to decide what is and isn't important. What you think is unimportant may actually be key to the shape of therapy to come. Leave it to the counselor to sieve through and separate the chaff from the grain.

Bear in mind, this is a collaborative process between the counselor and you. The therapist is the facilitator with theoretical knowledge and experience in the field. But you are the ultimate expert of yourself. It isn't fortuity when counseling works and reaps positive outcomes. It is you. After all, you are already equipped with a treasure chest full of inner resources. They just seem to be dull and tarnished, or fall short, or are misfiring. So it is about reviving what is innate but suppressed, as well as learning some new coping skills. Rather than being passive recipients of treatment, you get to be active participants in the psychotherapy process. The words 'active client' send electrifying surges of motivation throughout the body, do they not?

In the event you need medication to tide you over through a crisis, it may be appropriate to check with your internal medicine doctor. It is acceptable to have him/her prescribe medication on a short-term basis. However, some people need medication for a prolonged period of time. Many a client is complacent about having his/her family physician prescribe an anti-depressant or anti-anxiety medicine for years on end. That is worrisome. Would you be content receiving a calcium channel blocker or an antiarrythmic for your heart from your primary care physician, perpetually? I think not. You would be quick to seek out a cardiologist. It does not matter how much you perceive your family physician to be the cat's meow. If you need psychotropic medication on a long-term basis, then a comprehensive evaluation by a psychiatrist is a necessity. After that, ongoing psychiatric consultation is the only thing that makes sense. I cannot stress this enough. Be proactive with your own treatment.

At the end of the day, as O'Hara (1995) aptly states, "It isn't the technique, it isn't the therapist, it isn't the level of training, it isn't the new wonder drug, and it isn't the diagnosis. It is our clients' own inborn capacities for self-healing…." Armed with this self- assurance, walk in to a mental health professional's office with the resolve that you will work at self healing with proper guidance. The chances of a positive prognosis multiply tenfold, and the alacrity with which you are discharged from treatment also improves dramatically. Who would not want that?

Sushama Kirtikar, a licensed mental health counselor in private practice, can be reached at (813) 264-7114 or e-mail at

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Dr. Ram P. Ramcharran

There are many organizations in the Tampa Bay area that focus on helping special needs children but the one organization that everyone should know about it is STAND (Statewide Advocacy Network on Disabilities Inc.) This not-for-profit organization, which has been around since December 1996, was organized by a group of parents and attorneys to help educate people on their rights.

STAND's purpose it to inform the families of children with disabilities of their rights. It is dedicated to getting a child with a disability the right education that they are entitled to under the law. The three main laws that STAND is concerned with are: Individuals with Disabilities Education Act, Americans with Disabilities Act and Section 504 of the Rehabilitation act of 1973. It focuses on three topics: advocacy, legal rights, and above all, education.

This year, STAND will be hosting SPARC 2007 – Stand Pinellas Accessing Resource Conference. The organization’s goal is to provide parents, teachers, therapist and other professionals with resources that help children with disabilities make achievements in their life. STAND focuses on children with Special Needs and they take this mission very seriously.

This year SPARC 2007 will be held at Morgan Fitzgerald Middle School in Pinellas Park, on Saturday, Sept. 29, from 7 a.m. to 4:30 p.m. Morgan Fitzgerald is at 6410 118 Ave. N., Largo, FL 33773. Cost for the conference is $25 for pre-registration. That will include one entry to the conference, a lunch ticket and a program.

(Dr. Ram Ramcharran will be a guest speaker at the STAND event. He will be discussing how to better understand and deal with children with special needs. If you have any questions regarding this event, contact Melissa Tremblay, SPARC chairperson at (727) 784-8493 or visit

Dr. Ram P. Ramcharran can be reached at

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