Archives for Therapeutic Relationship

Communication

The Therapist That Didn’t Show Up For His Sessions

Recently we advised a young woman in her twenties to seek another therapist. We didn't make the suggestion on a whim, this was after consulting with her three times in six months.

Here's why.

Last summer, a friend of a friend (we'll call her Ann), called to ask us for advice regarding her therapist. She and her husband had been seeing him individually, and together in couple's counseling, spending nearly $2000 a month out of pocket. They had been seeing him for just under a year and felt they had seen little to no improvement. Because finances were very tight, they had been cutting back on everything, even basics, like groceries, to pay his fee.

After asking her about what went on in therapy this is what we learned:
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Addiction

Should Your Therapist Poke His/Her Nose Into Your Personal Business?

Good therapists are the ones who have the specialized knowledge to actually give you the key to your own transformation. They also have the sensitivity, training, and ability to work within the parameters of your belief system; not aggressively challenging, nor blindly accepting your conditional outlook, but gently helping you deepen your understanding of your life and your life’s purpose. They help you resolve to improve.

From Therapy Revolution: Find Help, Get Better and Move On Without Wasting Time or Money

Should your therapist "butt in" to your personal life?

Anyone who has ever been in therapy finds this question at once both ludicrous and apt.

How personal should therapy actually be?

There is no easy answer that holds true for everyone. If you are in therapy to work on a certain issue, such as anger, for example, you might be content to gain more awareness of your anger as it occurs in the present, and learn thought-based and behavioral changes to manage it.

Or you might yearn to find the deeper roots of your anger, how it might be related to your deepest fears, and spend a year or more analyzing every nuance of your anger-fear feelings.
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Communication

I Was Wrong About Online Therapy (With A Caveat Or Two)

Some years ago I was interviewed by a popular science magazine about what I thought of online therapy. At that point, online therapy wasn't exactly new, but it wasn't spreading like wildfire either.

I said that therapy in person could be supplemented by online therapy, but that a therapist can learn a lot about a patient by meeting in person. Body language, dress, and other factors were essential.

At the time I strongly believed that online therapy was a great solution for people who were isolated, whether because of location, disability, or other confounding factors, and couldn't make it to their therapist's office.
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Addiction

Advice About Therapy, Religion, And You

"...higher levels of belief in God were associated with greater psychological well-being," reports PsychCentral professional blog on a study about belief in God and treatment outcomes.
"Religious affiliation (eg, Catholic, Protestant, Jewish) had no impact on treatment response, and neither belief in God nor religious affiliation were correlated with the level of symptoms prior to treatment; in other words, belief in God did not “protect” against more severe psychiatric symptoms."
It was belief in God in general that showed improved treatment outcomes.

I'm not surprised.
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Depression

Contrary Mary & Denial of Mental Illness

Mary D., an incredibly intelligent, former high-school teacher, is in her early 50s and has been variously diagnosed with schizophrenia, bi-polar disorder, and anti-social personality disorder.

My evaluation showed that she indeed had a significant number of symptoms of schizophrenia, enough to warrant two previous diagnoses.

But Mary denies that she is mentally ill. And, she can, at times, convince others, even doctors, that she is fine, especially on what she will admit to are "good days."

Several years ago Mary stopped seeing her therapist
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Communication

Cliff Hangers & Therapy Don’t Mix

*No matter what happens during a session, whether or not you resolve an issue, as the end of the session approaches, your therapist should “check in” with you and make sure you are feeling okay.

He may ask you to summarize your session by talking about your progress, discussing the accomplishments you made during the session, or exploring what you have achieved over the course of therapy so far. He may also summarize the session himself. He may also give you homework, highlighting some skills that you can work on before your next session.

I like to give my patients a lot of homework–I want them to have really solid techniques at their fingertips to help them deal with both internal and external problems.

It is important that each session end on a positive, hopeful note. Above all, your therapist shouldn’t allow the session to end if you are experiencing any extremely negative feelings or thoughts which might cause you to have a crisis. Cliff-hangers and therapy DO NOT MIX.
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Communication

Something’s Holding Me Back In Therapy…

*Sometimes, a patient will feel apathetic about therapy. Assuming the patient is working with a good therapist, and one who is right for him, the feelings of apathy could be a cover for feelings of anger and fear.

Sometimes uncovering your problems and seeing yourself more objectively can be scary. You might unconsciously quash these uncomfortable feelings by feeling, or convincing yourself that you feel, apathetic.
If you find yourself feeling
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anxiety

Helping Children’s Emotions & Behavior With OT Miriam Manela


Pediatric occupational therapist Miriam Manela specializes in helping children and their families with behavioral issues. Occupational therapy may be utilized as part of a multi-disciplinary treatment plan or on its own to help with a broad spectrum of behavioral, emotional, and mental health-related issues.

Welcome, Miriam.

You work with many children with emotional and behavioral issues. The issue we’d like to start with, one that seems to be on the rise in children, is anxiety.

From the perspective of occupational therapy, is there a difference between anxiety in adults and children?

Yes, in adults you feel that anxious energy and you know that it’s not what adults should feel like. In children, you feel that anxious energy, and you may think, “Oh, this is just “kid” energy—they’re just being kids.”

So, it’s not always so easy to diagnose anxiety. Obviously a mental health professional will use specific diagnositic criteria.

From my perspective as an OT, behaviors are a manifestation of whatever is going on in the child’s whole system, not just his mind or emotions. If a child is biting an object or his nails, a psychotherapist might see this as a symptom of anxiety. I would evaluate the child differently than a psychologist would.
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