Archives for Therapeutic Relationship
A therapist I supervise came to me with a case: F. struggles with relationships and socializing. The sensory processing and cognitive issues she's struggled with since childhood cause her to misunderstand or miss social cues. Therefore, her responses to people's words, gestures, or tone of voice often were often wildly inappropriate and misfire. One of the biggest issues for her used to be her inability to read when someone was belittling or bullying her. Her social awkwardness made her an easy target. With the guidance of her counselor as well as support in developing a healthy response to bullying, she began to be able to assert herself and even stand up for herself, too. She learned about healthy boundaries and in cases where she used to get overly involved in other people's lives, especially people who were using and/or abusing her, she began to be able to recognize
It’s safe to say one of the main goals of therapy is to teach you how to help yourself so you don’t actually have to be in therapy, at least not for a moment longer than necessary. If you don't have a diagnosis which requires ongoing therapy, then ask yourself:
A clinical philosophy or style is the general approach a therapist subscribes to, believes in, and/or uses in treatment. Some common clinical approaches therapists may take include: reality oriented (therapy that focuses on counseling and problem solving in the here and now as well as offering instruction in how to create a better future)
Dedicated, skilled, and caring therapists will, together with you, discuss the right time to end therapy. Usually they'll discuss it with you in the first few sessions so you can be prepared for about how long therapy might take. They'll share with you possible treatment time-frames, and together you'll decide how to proceed. Your therapist and you will schedule regular progress check-ins, every few sessions or even once per session, and assess how effective the therapy is for you. If it isn't after a reasonable period of time, a responsive therapist will try other approaches with you or might even suggest a different therapist. But suppose that you decide your therapist isn't for you and you are planning to leave therapy, either to work with someone else or because you feel you no longer need therapy—what should your course of action be?
Does therapy absolutely require you to "talk about your past?" Do you need to "go down that road?" My answer, adapted from Therapy Revolution: Find Help, Get Better, and Move On, may surprise you. Your therapist will, beginning from the very first session, evaluate how you cope with problems and challenges. Where your coping skills aren’t as strong as they might be, a good therapist will teach you how to strengthen them. I believe that generally, only then, should your therapist ask your permission to go ahead and explore important events in your past.
A well-trained and dedicated medical doctor will consider whether or not there is an emotional component possibly triggering a physical issue, such as stress in the case of fatigue. But often, those in the mental health field, especially psychotherapists, might not evaluate and rule out medical or other issues in the case of a client presenting with a mental illness. In training sessions with interns and therapists-in-training, I emphasize the importance of doing a comprehensive evaluation before diagnosing—and doing therapy with—a client. I explain that when it comes to a mental health evaluation it is as vital for therapists to determine which factors are contributing to or causing mental illness, whether that mental illness is mild or more severe. Yet many therapists jump right into talk therapy at the first or second visit; not everyone in private practice examines medical records or asks their clients to get blood-work done.
We're talking with psychotherapist Tanchum (Tani) Burton, who is also a rabbi and educator, about his approaches to therapy and spirituality. Welcome. What do you believe is the interface between spirituality and psychotherapy, the spiritual nature of people and their emotional well-being? It’s harder to define “spirituality” than to define “psychotherapy”; spirituality means different things to different people. Psychotherapy, on the other hand, has certain basic defined elements, such as Rogers’ six conditions for therapeutic change--unconditional positive regard, empathic understanding, communication of that understanding, and the like. When these are in place, when the human connection between people in a therapy room is one of acceptance, and of a prizing of the individual who has come for help, I think that the groundwork for spirituality has been laid.
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:
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.