The relationship between a client and their therapist goes a long way to indicating the chances that the therapist can make the difference needed to spawn recovery. Key to that relationship is the chemistry between the two and the subsequent trust that is produced. Anyone who has been in therapy will know that if that trust is not there, the client is wasting valuable time (and money). Trust is also an issue for the free flow of information needed to give a therapist the whole picture. Without this vital information, a therapist cannot hope to do his job properly. So you see, trust is a vital element in the therapeutic alliance. One would think that seeing clients in a “virtual” practice would bring added problems..but there are ways around this.
I am a regular reader of other blogs and especially posts regarding experiences with mental health and the professionals that deal with these issues. It is clear there are many hard-working, skilful but over-worked, disillusioned people working in this industry. I recently read a report (I can’t remember where) that the helping professions are losing thousands of trained professionals per year due to burnout and the limitations placed on them by managed care systems and insurance. Some complained that due to this, they “go through the motions” and find it hard to become “involved” with the client. This “involvement” is often the one thing that initiates the feeling in the client that they can actually “work” with this person. When you see a client as a “bum on a seat” and not as an individual or see helping him as “something you must do”, then it will be difficult to help. One can see the consequences of this because one thing that comes up quite often in posts I read is that people make statements after an event like “not sure if I should tell my therapist or not”. The answer should always be an emphatic “YES” and if you are in doubt, perhaps the whole relationship needs to be reassessed with the reluctance to share information with a therapist the key issue.
I also believe that some therapists (and this is often borne out in many posts) could try to help the process. Starting therapy and facing issues, some of which have been hidden away for years is difficult. What worse after finally plucking up the courage to do this, you are met with someone who appears on the surface to want to quickly write a prescription and get you out of the door. Believe me, I have had painful past experience of this. I have had therapy a few times in my life..at times as part of personal development for my job and once or twice for issues going on im my life. The standard of care ran along a wide spectrum from fantastic (one case), mediocre (in most other cases) and terrible (in one case). What made the difference? The fact that the therapist saw me as a person within a system of interaction with other people and she tried to have an influence on that system too. This is where a therapist can truly have an impact and such an impact that it initiates change. This takes time and effort and long working days ( and weekend work too).
When I have a new client, online or face-to face, many of the initial questions I ask are designed not only to reveal belief systems and the way the client sees the world (this is common with CBT therapists) but also to give insight into the world around them. This means living circumstances, relationships past and present and especially interaction with family and partners. I see these issues as key to paving the way towards recovery working on the feeling that it makes no sense to put a “recovered” client back into a dysfunctional system that will cause relapse. I try to become involved in areas where the client is having particular problems. This means sometimes talking with other family members and partners (with the client’s permission, of course) and maybe inviting these people to become more involved in the overall process. One thing I maintain is that clients can have contact with me via mail or phone between sessions. I set aside time early in the morning to answer mail and I return calls as quickly as I can if I am in session. This is also true, especially, for the online clients who see the intensity of our contact as vital.
So you may be saying to yourself at this point, how the hell does he do this and why don’t the others do it? I can’t answer the second part of the question but the first part is clear. When I take on a new client, I see that as a commitment, a commitment to be part of changing their life, to show them that the world outside the scary world they have built for themselves is not so frightening after all when they take the chance to step into it. Yes, it calls for long hours and effort but I would not want anyone to think that my work-life balance is all work and no life. I have enough recovery time and my day is fairly well-balanced. I just believe that “extra mile” is the one that makes the key difference.
Dr. Nicholas Jenner is a Counseling psychologist in private practice working with individuals, couples, groups and companies. Apart from seeing clients face-to-face, Dr Jenner also runs a thriving online therapy business bringing help to those who are housebound or located in rural locations where therapy is difficult to find.
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