Why does the need for therapy in seminary or yeshivah overseas come up?

Therapy on the Go

Sarah Rivkah Kohn

Why does the need for therapy in seminary or yeshivah overseas come up?

Going away from home often brings up a cocktail of emotions for both parent and child. It’s often a stepping stone in the journey from child to adult, and can be rather frightening for some. For those young adults who have struggled in a particular home or school or social environment, being away for several months’ can give insight and perspective that opens up ideas and the need to work things through.

Alternatively, there is also the teen/young adult who was successful in therapy and could use the continued support, but whose therapist cannot continue seeing them while they’re overseas.

Steps for Success:

I spoke with a few clinicians practicing in Israel and these were pointers they shared:

• If your child is in therapy now or taking any medication, be sure to set up an appropriate arrangement before they get to Israel. Finding someone only once crisis brews is a surefire way to end up with the wrong person or to make the institution regret their decision to accept the student.
• Keep in mind that licensing terms and laws in Israel are very different from in the US. The word “therapist” is used much more liberally, and while most seminaries and yeshivos know to seek out licensed clinicians, not all are savvy or sensitive enough.
• It’s up to the client (or their parent) to ask: What are you licensed as? Where did you get your degree? There are many excellent licensed social workers, psychologists, and mental health counselors practicing in Israel.
• If your child is over 18, you will need a release to speak with the clinician, just as you would in the US. Once the client gives permission, they absolutely can do it. However, there are a few therapists who do not do this even when the client asks/gives permission.
  If the parent is the one setting up the therapy, it’s important to find out beforehand what the therapist’s policy is. If the school sets the student up with a therapist, and he/she is over 18, it will be up to the client to decide how much involvement from others to allow.

• If the young man/woman is transferring from a previous therapist, it’s often wonderful if there can be one conversation between the two. Many therapists like to meet the client once or twice before doing this so the therapist can form his own unbiased first impression.
• Should the administration know about the therapy? For the most part, it’s the wise and responsible thing to do. Having a child sneak out of the dorm or create cover stories is asking for disaster.
• That being said, if one is dealing with a school admin that is therapy resistant, or in the case of a bochur staying in his own dirah seeing a therapist on off-hours… there may be times when it will be prudent to find one responsible staffer to speak with instead of the admin.
• If the student will be doing therapy over Zoom, ensure that the hanhalah will provide a private, quiet space for this to take place. Not every school or yeshivah has the ability or willingness to make this happen.
• If a student will be working with a therapist in Israel next year… start looking for one now! Most therapists fill up quickly and many have no slots come August.
• Some Israel-based therapists will meet the client via Zoom prior to his/her arrival so they get a feel for each other and make sure this can work.
• Jerusalem is quite a big place. Make sure the therapist is close by so the student doesn’t waste an hour or more on commuting. This leads to so much burnout.
• Therapy in yeshivah/seminary generally winds down in March or April, when the students go home for Pesach, with just a few sessions afterward to tie things up. Starting therapy in September ensures the student will get at least six months in (and there are inevitably cancelations because of tiyulim, etc.).
  So beginning to look for a therapist in September often means only finding one in December and getting just three months in. Many therapists stopped taking clients mid-year for just this reason — they barely scratch the surface.
  If an issue does arise in Janurary/February, it’s often worthwhile to have the student begin seeing someone from the country they’re headed back to via Zoom, which will allow for continuity once they get home.

Sarah Rivkah Kohn is the founder and director of Zisel’s Links and Shlomie’s Club, an organization servicing children and teens who lost a parent.

Frog in Your Throat

Dr. Jennie Berkovich

While strep throat has always been a common diagnosis, there has been a staggering increase in concern about strep over the last few months. Strep throat, also known as streptococcal pharyngitis, is a common bacterial infection that affects the throat and tonsils. It is most commonly caused by Group A Streptococcus bacteria and is highly contagious, especially among children.

A sore throat is a standard clue that a patient may have strep, but fever, swollen lymph glands, tummy pain, and a fine, sandpapery rash can be present as well. Interestingly, the presence of a cough decreases the likelihood that strep infection is present.

What may be surprising is that strep throat will resolve without treatment. However, treating strep throat with antibiotics is important to prevent the spread of the infection to others and to reduce the risk of complications, primarily rheumatic fever, which can develop weeks after the initial infection. It’s important to complete the full course of antibiotics, even if symptoms improve, to ensure that the infection is completely eradicated.

It’s important to note that not all sore throats are caused by strep, which is why a diagnostic test is important. A rapid strep test is a quick and easy test that involves swabbing the back of the throat and produces results in just a few minutes. A throat culture involves sending a sample of the throat swab to a lab for analysis. This test takes longer to produce results, but is more accurate than a rapid test and is often used to confirm a negative rapid result.

Recurrent strep throat infections in children can be a cause for concern. While strep has never been resistant to penicillin, recent reports have surfaced concerning potential resistant strains. Since these still aren’t common in the general population, a penicillin or derivative of penicillin, like amoxicillin, remains the treatment of choice for strep, even if a child was recently treated with the same antibiotic.

Recurrent strep may warrant further investigation of carrier status or the need for surgical removal of the tonsils.

Dr. Jennie Berkovich is a board-certified pediatrician in Chicago and serves as the Director of Education for the Jewish Orthodox Medical Association (JOWMA)

Be Curious

Abby Delouya

Curiosity enhances relationships. When we first meet people, we ask questions to keep up a flow of conversation, or to get to know a potential friend, partner, or employee. While we should be sensitive to the types of questions we ask, being curious builds relationships. Why then, does curiosity sometimes wane in marriage?

Try keeping track of conversational patterns at home. Do you ask your spouse questions beside basic technical ones? “Did you go to the dry cleaners?” doesn’t help build a relationship. Even a question like, “How was your day?” can lead to a lackluster “Fine.” To build connection, ask questions that tap into understanding, empathy, and display real curiosity: “How did it feel to see your friend after so long?” or “Were you able to take time to take care of yourself today?” or “I saw you slept poorly last night, how did that affect you today?”

When we ask, we give our spouses the gift of being truly seen and known.

Abby Delouya, RMFT-CCC, CPTT is a licensed marriage and individual therapist with a specialty in trauma and addiction.

(Originally featured in Family First, Issue 845)