Tuesday, June 22, 2010

What is Therapy? Part II

Good afternoon all- I'm back with Part II of my "What is Therapy?" series. Today is Monday, right? :)

Today I will be discussing the roles in therapy- those of the therapist and the client. Like I mentioned on Friday, opinions about these roles may vary among therapists so this post will reflect my point of view. I'll start with the therapist.

The media has provided a variety of images of the therapists- they range from neurotic to pensive/quiet to Freudian (e.g., a couch and questions about the client's mother). I had no experience with therapists or therapy prior to beginning my master's and doctoral studies, and during my first couple of years of grad school I "acted like a therapist"- my version was pensive, quiet, staunch, and very neutral. I later learned to "be myself" as a therapist (go figure! novel concept!) versus trying to ascribe to a "type". Therefore, for me, how I present as a therapist is pretty close to how I interact with others in my outside life.

Moving on to what a therapist actually "does". First- it is true that as a therapist I listen to my clients- but that's not all I do. As I'm listening I begin to paint a picture of my client. I think that therapy- as the therapist- is like putting together a puzzle: I start with a picture of the person (e.g., how they look, the initial statement of the problem/concern that brought them in, and other demographic information) but must then put all of the pieces together. At my initial client sessions I like to draw a Genogram, which is a "family picture"- who is in the immediate family (e.g., a client's parents and siblings or a spouse/significant other and children) and how these members interact/get along with one another and the client. I believe that there are generational connections between a client's current functioning and past (and present) family relationship experiences. This is my starting point in therapy. So, while the client is sharing relevant information about his/her past I am piecing it together by making preliminary hypotheses about links to present behaviors/concerns etc. Sometimes the piece is a "fit" and other times it's not- just like putting together a puzzle.

After gathering background information I ask the client to share his/her goals for therapy. This is part one of the client's role in therapy. Sometimes clients have clear goals for therapy (e.g., to improve a relationship, to be less anxious or depressed, etc) and other times they are not sure- either is okay. I help the clients with clear goals break each goal down in a way that we may observe the changes (e.g., I will have fewer arguments with my significant other) and help those without goals formulate them. At subsequent sessions I ask that my clients come to session with things to discuss. I generally ask clients something like, "How have you been since our last session?" and let them go from there. While the client talks I keep the goals in mind and observe ways in which movement towards (or away from) the goals occurred during the previous week.

In summary, my role as the therapist is to listen and integrate and the role of the client is to provide us with a starting point at each session (e.g., "I had a good/bad/ok week").

I will probably have more to say about this over time. Look for Part III of "What is Therapy"- the title will be, "How long do I have to be Here?!".

Be well-

Dr. Stanley

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