Adapting Therapy: The Amish

There are countless challenges that therapists and counselors inevitably face during the course of their professional careers. Ranging from the small and passing to the immensely difficult, these challenges help to shape not only the experience of the professional, but can shape the profession itself, as well. Jim Cates of Topeka, Indiana, is one mental health professional with a challenge that truly reveals the ability of psychotherapy to transcend traditional use and setting.

As Alix Spiegel of National Public Radio related this week, Cates has found that the majority of his clients are those belonging to the local Amish community. A group known for its reliably manual labor and farming, along with seemingly strict or outdated lifestyle mandates, the Amish would seem at the outset to be an unusual subject for psychotherapy. But Cates’ practice has been useful in treating Amish teenagers, many of whom are assigned to Cates after running into trouble with the law for drinking or other related misdemeanors. The Amish rite of passage known as Rumspringa allows teens approaching adulthood to break free of their traditional constraints and experience life as a “regular” American teenager. Often, the teens find that a return to their familiar Amish customs is a positive choice, but some find themselves caught up in the excitement and intrigue of alcohol, drugs, and other potentially harmful things.

Cates has had to adapt his practice — and his professional understanding — to suit the needs of this particular community. Often holding sessions in his clients’ homes, as the Amish tend to dislike offices, Cates regularly sees patients surrounded by their extended families. Coupled with the need for sessions that function beyond common forms, the reluctance of Amish teens to speak at length about themselves has been met with what Cates describes as a kind of feminist therapy, encouraging talk about others and eventually drawing back to the self. For mental health work that truly thinks outside the box, Cates is garnering a warm reputation among a community benefiting from his quality care.

© Copyright 2009 by By John Smith, therapist in Bellingham, Washington. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

  • Leave a Comment
  • Robin


    March 25th, 2009 at 4:24 AM

    At first this sounded a little strange- the Amish need therapy too? I did not know that people in this community would even be open to the concept of receiving therapy. But it must be something that many of their teens need especially after choosing to live like a normal American teen and then choosing to come back into the fold of the community. It must be rather difficult to make that choice to retrun to the Amish way of life after experiencing the many freedoms and technology that so many of us take for granted yet they are not allowed to have access to. It would be very daunting as a teen to learn all about what is really out there to experience but to then have to make the decision to continue to reap the benfits of these things or to return to their families. I think it is probably a healthier choice for them to go back home to parents and siblings because everyone needs that kind of support system but I cannot even imagine how difficult it would be to leave behind the cell phones once again!

  • Melanie


    March 26th, 2009 at 3:56 AM

    I thought it strange too that the Amish are willing to talk about their problems outside their Amish boundaries!! Forcing the younger generation to live within an unrealistic boundary is bad. Even in a strong culture blending is important. I am glad that openness is setting in.

  • Kelly


    March 26th, 2009 at 1:05 PM

    From what I undersatnd about the culture the Amish have always been open to allowing their young teens to learn about and experience what we view as a more traditional way of life but always with the hope that they will return to the fold. Maybe there would not be so many problems within the community after all of they were just never given the chance to experience that. They may think that our way of life is bad but you know that especially to a young person deep down inside they are craving some of the freedom that we easily enjoy and that they are not allowed to experience. Or once they have had that chance it is taken away from them again.

  • Jerry


    March 27th, 2009 at 12:29 AM

    Melanie I dont think you really know the Amish well. They are basically peace loving, conservative people. They are very well read and are quite open to allowing their teenagers to experience the world as we know it. They allow that with the hope that they will prefer their way of life to the disorder in the world. I guess freedom does spin anyone’s head especially when you are free all of a sudden from the only way of life known till that point.

  • Melinda


    March 28th, 2009 at 12:37 PM

    I grew up in an area of Pennsylvania when we would often see a lot of Amish families and looking back on it now maybe it would be nice to have a life as peaceful and worry free as what many of them now experience.

  • Brian


    March 30th, 2009 at 3:17 AM

    I think all of us love the quaintness of some people. I for one admire the Amish. To be able to live like that in today’s world is an achievement. The peaceful living that is practised like playing hoops is definitely worth all the sophistication of the times.

  • Sandra


    March 30th, 2009 at 11:35 AM

    Are there doctors in the Amish community who are allowed to delve into the realm of offering therapy or is this something that the culture does not believe in or support? Does anyone out there know the answer to this?

  • Celia


    March 31st, 2009 at 3:47 AM

    I found this very informative. I never knew that the Amish allowed their teenagers to experience life on their own if that was there choice. I can see why Amish teenagers would need therapy… All the uneducated people out there who don’t understand their ways, I can only imagine what they have to go thru in this society

  • Wiley


    March 31st, 2009 at 4:04 AM

    I would personally like to know more about how the Amish live. I have often thought that if we lived as the Amish we wouldn’t have as many problems today is trying to keep up with the Jones’ or freak out when we lose our electric for a couple of hours or days, but now I realize from this article, that they have problems just as we do.

  • Dina


    April 3rd, 2009 at 4:18 AM

    I often wondered the same think Kelly mentioned. Do the Amish teenagers desire to be on their own, to experience the world and be free? I’m sure many who do and go out to experience the world, end up coming back to a more peaceful place.

  • Ingrid


    April 5th, 2009 at 1:37 PM

    I agree with Brian…YOu have to admire the Amish for their way of living and keeping things simple. We all don’t have the same interests so why should we all live the same way.

  • Cammie


    April 9th, 2009 at 2:30 AM

    Amish are just like us, only they tend to live differently. They need therapy just as anyone else do because they are human and they do have problems just like the rest of us. I’m sure they probably take more crap from people because of how they dress, live, etc.

  • Louetta


    April 11th, 2009 at 10:19 AM

    I bet the Amish takes a lot of crap from other people in their society. I know they may dress, act and live differently , but I think they should be able to live their lives just as everyone else. Their people, we are people and I’m sure they have just as many or few problems as we do and they can benefit from therapy.

  • Byham


    July 16th, 2009 at 7:55 PM

    Thank You for that post! It’s been a long day and your info just set me right. Now I can see what other good info is out there. Cheers.

Leave a Comment

By commenting you acknowledge acceptance of's Terms and Conditions of Use.

* Indicates required field.

GoodTherapy uses cookies to personalize content and ads to provide better services for our users and to analyze our traffic. By continuing to use this site you consent to our cookies.