In order get the maximum clinical benefits from therapy (and save time and money), each session should be focused on the problem and potential solutions to the problem as outlined in your treatment plan. This doesn’t mean to say there is no room for serendipitous discoveries— however, it has been my experience that these discoveries happen as much during focused therapy as unfocused therapy, perhaps even more. Providing structure to therapy gives a feeling of support and safety and direction, enabling you to feel free to dig deep, express, and to allow you to explore thoughts and feelings that might otherwise be hidden, too painful, or overwhelming.
Perhaps it could be described thus; therapy as poetry. Some of the most beautiful poetry relies on a tight structure that involves one or more of the following: rhyme, rhythm/meter, number of syllables, strict number of lines, number of verses, and so on. Think the sonnet. Think haiku. And even free-verse requires the rules and structure inherent in the grammar, words, and individual letters themselves.
From the green armchair
She looks through spit-rain windows,
Sounding heart aloud
*The poet, Noa, is a former therapy patient.
Throughout Therapy Soup you will find reference to one of the most important ingredients in that “soup”, the mental health treatment plan. This is an introduction to the treatment plan but I’ll also devote several upcoming blog posts to the subject—perhaps not a glamorous subject, but a very important one.
After the evaluation, and the discussion of treatment options, the next therapy session or two will be devoted to the creation of a written treatment plan. It can take up to thirty (30) days to fully develop a complete plan depending on the complexity of the issues you face. In fact, over time, the plan will flex and grow as you do so expect changes after thirty days as well. A treatment plan is a living document—it will need to be referred to, checked in with, updated, and amended by you and your therapist, together.
“A treatment plan is a written plan created by a therapist and patient that is used as a guide to how therapy should ideally proceed in order to address clinical and any other relevant life issues. It is central to effective therapy.”*
I admit it. I’m goal oriented and I believe therapy should be goal oriented too. This isn’t to say that other perspectives aren’t valid—but my belief is that if you are spending your time and money on therapy, you and your therapist should be able to accomplish three basic therapy objectives:
1. Define what problems and issues you are facing and want/choose to work on
2. Decide what specific goals and objectives (related to these issues), will be set
3. Assess whether or not you are achieving these goals at a reasonable rate of progress
As a general rule: Therapy can and should help people develop strong interpersonal relationships, in part so that their relationship with their therapist doesn’t replace relationships with family, friends, and community.
Throughout my years in the mental health and addiction fields (and not just in times of economic uncertainty), one of the questions people ask me most frequently is: What can patients do to save money and time on therapy?
There are plenty of things patients and their families are able to do make therapy more cost-effective, time-effective, and just plain effective, but for now I’d like to concentrate on just one of the numerous suggestions from my book, Therapy Revolution: Ask your therapist for homework.
Why “write therapy down”? Many patients* keep a therapy journal (something I hope to be blogging about shortly)—it can help you understand and become more aware of the therapy process, it can help focus your objectives, it is simply a good way to share feelings that otherwise might not come to the fore, and so on.
Therapists, too “write therapy down”—generally, for each and every patient they see. I want to share with you why they do.
Evaluation. Yuck. Such a clinical, dry term, much like diagnosis, prognosis, and so on. But because evaluations are so integral to effective psychotherapy, I feel it’s important to briefly describe the process here.
When you go to a doctor (or a mechanic or even an accountant), the first thing he or she does is collect data—pieces of information—about you (or your car, or your tax situation). In therapy, this information is collected by a process called the evaluation. By asking directly asking you questions, observing you, and perhaps reading or speaking to others about your mental and physical health history a therapist can learn what he or she needs to know in order to begin working with you.
A mental health evaluation (like a medical evaluation) in part employs a process of elimination in order to arrive at a diagnosis. For example in medical treatment if you don’t have certain symptoms, but you do have others, proven treatments will be prescribed and employed for whatever your problem may be, whether it is acne, flu or gout.
It’s great to be blogging on PsychCentral.com–thank you all for your warm welcome. There’s so much useful information on this web site and such terrific bloggers representing so many different points of view. Naturally I’ve been thinking about what topics would be most interesting and helpful to readers (if you have ideas, questions, or comments, please comment or send me an email), and I decided I wanted to keep this space direct and simple. But a funny thing happened on the way to the keyboard…
The following is a brief discussion of some therapy-related ideas I’ve been thinking about, ideas that make a useful—though complex—jumping-off point for future discussions about more clear-cut topics. Therapy is about change. I wanted to find a way to briefly describe some basic aspects of what actually changes in therapy and the concepts “space” and “time” offered unique potential. Those who’ve read my book know that generally I use very simple language to describe therapy—this is a slight departure.
Here’s some unsurprising news:
If you want to achieve your goals you must set specific, measurable, and time-targeted objectives, at least according to goal-setting theory, an important area of study in organizational psychology (and Wikipedia).
Psychotherapy is one of the disciplines that can help people set specific, measurable and time-targeted goals and objectives—at least, it usually is. In interviewing numerous former and current therapy patients my colleagues and I found that a significant percentage reported that goal setting was not mentioned during therapy. Of course, this is not a scientific study, just anecdotal evidence, but I mention it because the results are surprising. After all, rating positive change can be awfully subjective if goals aren’t set and able to be measured. And of course, if change doesn’t happen in a reasonable time-frame, then who’s to say the change wouldn’t have happened without a specific psychotherapeutic intervention?
Welcome to our new blog, Therapy Soup. This blog will discuss all issues of psychotherapy and the therapeutic process, demystifying it and helping to answer your questions about it.
The blog is hosted by Richard Zwolinski, LMHC, CASAC, who is the author of Therapy Revolution: Find Help, Get Better, and Move On Without Wasting Time or Money. Richard is also an internationally licensed psychotherapist and addiction specialist with over 25 years experience as well as a consultant to organizations and companies in the fields of mental health and addiction.
Learn more Richard here.