In part one of the post on the Therapeutic Relationship, I answered common questions about subjects such as boundaries, determining if a therapist and a client make a good fit, and whether or not there are off-limit topics in the therapy session. Now let’s take a look at the client’s role in therapy. Look out y’all – this is gonna be blunt!
I have heard people say that the work done in therapy is half therapist, half client. I have heard others say that the client should be doing 80 percent of the work and the therapist 20. I agree with the 80/20 view: you, as the client, should be doing the majority of the work. Think of your therapist as your co-pilot, whose tasks include:
- Providing a clean, safe and comfortable space in which to conduct sessions.
- Listening intently to you, asking questions to clarify information as needed.
- Being mindful to the “music behind the lyrics,” in other words, what is at the root of the issue?
- Getting to know you to determine how to best meet your needs.
- Offering whatever services we have been trained in and depending on your need (i.e., cognitive behavioral therapy, hypnosis, etc.).
- Being ethical with you. If the therapist is not trained in the specific issues that you need help with (such as something specialized like Schizophrenia or substance abuse) the therapist has a responsibility to refer you to a therapist who is trained in those areas.
- Providing complete confidentiality – whether in the confines of an office or exposure therapy outside the office, walk and talk session in the park, etc.
- Conferring with colleagues (NEVER using client’s names or other identifiers) to get other perspectives on what might best help a client.
- Continuously educating ourselves.
The Client’s Role: What You Need To Know
The above description barely scratches the surface of what entails the therapist’s role. What about the client? Perhaps you are reading this because you have been frustrated with therapy and are wondering why you aren’t getting better. Maybe you’ve been considering entering into therapy but haven’t yet pulled the trigger. Perhaps you just dig these groovy blog posts. Either way, read on – shit’s about to get real.
Know what you’re getting into. Let’s liken entering therapy to taking on the responsibility of a new pet. You are making a commitment that is going to take effort, time, nurturing, work, and money. It is going to be frustrating and fun and sometimes you will have to clean up some poop. And much like having owned that pet, when you graduate from therapy – despite the pain, hard work, and strain on the wallet – after all is said and done, you know that you wouldn’t trade that experience for anything. Therapy is sometimes a slow, expensive process. But it’s a drop in the bucket compared to the costs – financial, emotional, physical, etc. – of say, a divorce or time off from work due to serious health problems. This isn’t Staples and there is no ‘EASY’ button. But if you come ready to work, it may prove to be the best thing you’ve ever done for yourself.
Communicate your needs to the therapist. Some clients want a therapist who discloses (shares) things about themselves and is more conversational. Some clients want to know as little as possible about them. Some days the client may need to sit in silence and simply be in the present moment with their therapist. Some clients prefer the safe container that the office provides; others prefer to get out in nature. Every client is different and every session is different. If you are getting frustrated with something your therapist is or isn’t doing, tell them. Your therapist will work with you as much as possible to resolve the issue, but they need to be made aware that there is an issue. We don’t bite – I promise!
Show up to sessions. If you can’t make it or don’t plan on showing, at least text, email or call. Put yourself in your therapist’s shoes: imagine waking up at 6:30 am, getting dressed and sitting in rush hour to get to the office and make sure it is ready for your first client of the day. 9 am comes and goes and they don’t show. Now imagine your next client isn’t until noon. This happens to every therapist. Not only is it frustrating (we could have slept in, enjoyed time with family, watched Stranger Things, had coffee, or perhaps most important, given another client that time slot), but it can be damaging to the therapeutic relationship. Your therapist should not fall asleep during session, that’s pretty much a given. But you have responsibilities as well, such as showing up on time, not playing on your phone during your session, etc. Bottom line – if you’re not coming to therapy, you’re not in therapy.
Pay on time. If you pay by card, please keep it current and update the information with your therapist as needed. This is another loaded topic and it can get uncomfortable for both therapist and client. The policies regarding payment are made clear by most therapists at the beginning of the therapeutic relationship. At Deepwater Counseling we get payment out of the way at the beginning of each session. It can be an awkward moment at the beginning, seemingly cold even, but it’s better for everybody involved. Here’s why: consider a client (we shall call her Rose). Rose comes in for issues regarding having survived a massive sinking ship. As session goes on it’s revealed that Rose is really suffering from guilt. She had fallen in love with a young man, Jack, who taught her to live and love and helped her survive the ship’s plummet into the water. Rose and Jack had found a door floating in the ocean, and Rose realizes that although they could have both fit onto the door, only she took the door, leaving Jack in the water, doomed. He held her hand as he froze to death. Rose discloses that she is traumatized by her last few moments with Jack – vigorously prying his corpse off her while telling him she’ll “never let go” and flinging him into the icy water. As Rose is sobbing uncontrollably her therapist notices that time’s up and says “that’ll be 90 dollars please.” Awkward!
Okay, so a good therapist will be more tactful than that. As a therapist, I do what I do because I love it and care about people. The charge for sessions allows me to help people but also pay my rent, car, and buy groceries. As a client you are paying for self-care and a relationship that will challenge you and foster growth in a way that a friendship won’t. We aren’t and do not work for Tony Soprano; we don’t want to repeatedly call or text you for payment.
Do the things. Embrace the cheese. If you experience severe anxiety, your therapist may encourage you to practice breathing exercises or do daily meditation. They may suggest you keep a journal detailing when anxiety hits and at what time in the day it occurs most. If you experience depression, your therapist may suggest hypnosis, daily walks, or taking up a new hobby. All too often clients come back week after week, still feeling the same, but haven’t tried any of the suggestions. I encourage you to embrace the suggestions, no matter how cheesy they seem. We understand depression is hard. We know anxiety is frustrating and debilitating at times. We know living with ADHD is frustrating. And we are happy to sit with you week after week and be your sounding board but you must take steps to facilitate your growth and healing. We care and want you to succeed, so do the things; embrace the cheese.
And on that cheesy note, stay tuned for part three of the Therapeutic Relationship: Deepening the Relationship.