If your church counselor tells you that gambling is a sin, not a mental illness, and if you believe such nonsense, then you are in trouble.

There are some born again faiths that even discourage mental health counseling altogether. You may be told, for example, that Jesus is the answer to all problems, or that Allah, the Muslim deity, demands complete obedience. Some of these faith-based counselors have no training beyond Bible school and are completely ignorant of the general health needs of their clients. They are always attempting to recruit new members to the church and they demand blind obedience to their dogma. There is no scientific basis for their work.

Especially annoying to some folk are members of self-help groups who found personal salvation in Jesus and now hold it their duty to preach religion as part of the Twelve Step program. Somehow, in their eyes, you will never be good enough; you will never really be recovering until and unless you join them in their evangelical faith. But, religion and spirituality can and do follow different and often very separate paths. Keep your eyes fixed on the real goal: a return to thoughtful spirituality, compassion, and fellowship with others. When religion takes choice out of your hands and subjects it to dogma or to religious authority then, I think, religion is a bad thing.

Shame and guilt. Maybe you do have a lot to be ashamed of, but seeking help for a serious problem is not one of those things. Your medical and therapy records must, of course, be held in the strictest confidence, and you might want to ask who will have access to your files and how they will be safeguarded. Your therapist will have to inform your insurance company about the diagnosis if you have health insurance, but there is no reason why your employer or others in your life need know. There are a few special cases such as when you have a parole officer or court appointed investigator following your progress; he or she would have to be told of the diagnosis.

If you are shopping for a therapist there are a few more general cautions to keep in mind. I use the word shopping to remind you that you are the customer. You certainly don’t have to take the first therapist you meet, and you should interview several, even if that seems awkward.

When I use the word therapist it includes psychologists, psychiatrists, clinical social workers, nurse practitioners, counselors, etc. In short, the word means anyone who is offering treatment or therapy for an addiction problem in exchange for payment and who has the appropriate advanced degree.

Qualification: Avoid any therapist who resents being asked about his/her qualifications or, on the other hand, boasts and makes extravagant claims. An ethical therapist usually displays diplomas and certificates in a prominent office location where they can be inspected. Take time to study these. It is perfectly acceptable for a prospective client to ask about experience, specialties, and training. You will be better served by someone who treats addictive behavior frequently and has earned the qualifications necessary for doing this work.

The office: Is there, in fact, an office, and how efficient does it seem? In general, therapists who practice alone out of their homes should be looked at very carefully. Practice out of a home may mean that you can’t contact the person easily, that billing may be inefficient, there may be not malpractice insurance, etc. A therapist who offers to come to your home may present similar problems. Unless it is a person you know and can trust, I suggest you look for a therapist in a group practice working out of a real office with clerical and professional backup.

Acceptance of self-help groups: Avoid a therapist who rejects the idea of self-help groups or knows nothing about them. Do not hesitate to ask for an opinion about self-help groups, but avoid getting into a debate. They have a right to their opinions just as you do. Some professionals ignore or even recommend against participation in self-help groups such as Alcoholics Anonymous. Keep in mind that those groups will be available to you long after your therapy is over. And they are free. There should be not sense of competition between the therapist and self-help since they usually work well in combination.

Quick fix, one tool therapists: There are endless gimmick salesmen out there offering herbal treatments, acupuncturist, age regression, magic touch, aroma therapy, etc. In general, avoid so-called New Age and alternative therapies. Also, chiropractors have little to offer addicts, in my opinion.

Excessive testing and interviewing: Walk away from the therapist who heaps psychological tests on you and then provides no qualified person to review the results with you. They are your test results, not theirs. Testing is not a bad thing when used as an adjunct to therapy, but this person may just be doing research, and if he or she is, they should be asking you for permission to include your information in their research. They should be asking you to sign an informed consent document. It’s possible that the therapist is just being cautions or has a healthy distrust their own casual impressions. It is also possible that the therapist wants to get a complete profile in every case since, as often happens, there may be more than one addiction or emotional problem. When in doubt, ask about the purpose of all the assessments, interviews and tests. The answers should be clear and logical. If you have legal problems, the testing may be done to support your legal case in court.