A Q&A on Counseling: Jamie Tworkowski


Jamie Tworkowski is the founder of To Write Love on Her Arms, a nonprofit movement dedicated to presenting hope and finding help for people struggling with depression, addiction, self-injury and suicide. He is the author of the New York Times bestselling book If You Feel Too Much. Below, we talk to Tworkowski about a new Barna study of Americans’ perceptions of and experiences with counseling. This interview, as well as the broader study, are featured in Barna Trends 2018. Purchase your copy here.

Though most U.S. adults either have seen a counselor or would be open to it, one in four people says they would never see a counselor. What are reasons people say or assume they never would be open to therapy? Is counseling for everybody?

The stigma suggests mental health is something we aren’t supposed to talk about. As for counseling specifically, being willing to go to counseling means being willing to admit there’s a problem. When we admit there’s a problem, when we bring that out into the open, then we have to deal with it. And we’re talking about things people are often afraid to deal with, because there’s often pain and shame associated and this stuff takes people out of their comfort zone.

To answer the second question, yes, we believe counseling is for everyone. It doesn’t mean every counselor is for everyone; it may take time to find someone who feels like a good fit, but we do believe counseling works. It’s not an easy step to take, but we do believe it’s worth it.

Barna research indicates that Elders are much less likely than other generations to have seen a counselor. Though a plurality is open to it, more than one-third says they never would consider this. What has changed over time? How have their circumstances been different, as well as the conversation or stigma surrounding mental health, when compared to younger generations, particularly Millennials?

Over time, I think people have learned that mental health is real and that seeing a counselor works. So we’re seeing younger people become more open, not only when it comes to talking about mental health, but when it comes to believing it’s OK to ask for help.

We believe honesty is contagious. We’re certainly seeing more and more young people speak openly and honestly about their mental health, and that invites other people to do the same. Also, a case can be made that Millennials have grown up in a world where it’s easier to talk about their feelings, because these folks have grown up with social media.

Only small percentages of people connect with a counselor either through their church or on a pastor’s recommendation. Why do you think this is?

The Church has not done a great job of leading the discussion about mental health, and the Church has not done a great job of pointing people to mental health professionals. As a result, it’s easy to think that if someone is struggling, their needs will simply be met by God and/or the people of the church. I think that when it comes to mental health issues, a lot of Christians think about taking their pain to God through scripture and prayer, but they don’t think about connecting with a mental health professional.

I tend to compare it to a broken arm; if your friend breaks their arm, it’s totally fine to pray. But your friend would probably like for you to pray on the way to the hospital, where broken arms get fixed. Mental health should be approached in the same way. When something breaks, you take it to an expert.

When choosing a counselor, people are most concerned about affordability—more than the therapist’s education, age, background, proximity and so on. What are some ways to remove this barrier? In addition, does the Church have a part to play in increasing accessibility and affordability of mental health care?

There’s certainly a need for affordable mental health care. It’s important to stay informed and to communicate with elected officials. Oftentimes, there are affordable options people aren’t aware of. People should start by learning what their insurance company covers. Beyond this, it’s important to note that many counselors are willing to work on a sliding scale. And mental health counselor interns are required to do hundreds of hours of free or discounted counseling as part of becoming licensed.

I love the idea of the Church being part of the solution when it comes to mental health. One example is churches designating funds to help people pay for counseling. In addition, I would love to see churches hire licensed mental health counselors so they can offer more than just pastoral counseling.

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