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This blog is about---You! Each and every post is about you. Use it to challenge your usual patterns, as a tool for self-discovery, to stimulate your thinking, to learn about yourself and to answer your questions about others.

Wednesday, December 5, 2012

The Best You

Is therapy for problem-solving only?

This post is prompted by a reader's comment.  This person was looking for two things from their therapist that the therapist did not want to offer.  One was reassurance that the relationship was fine and in good condition and the other request was that the therapist, in addition to pointing out problems, highlight for her some of her positive attributes.
When I conduct therapy, I go into it looking for the positive characteristics in the patient; that belies an assumption that there, of course, would be some good qualities in nearly anyone.  And I do enter each new relationship with that assumption.
First off though, we want an honest relationship and a true process.  So, here I am not talking about social niceties.  I am not talking about flattery.  Unless it's sincere, I don't mean just throwing in a compliment here and there for good measure.  
What I mean is looking for that individual's real assets and sometimes speaking about them.  I think that honing in on a patient's strengths and bolstering those positive traits should always be a part of therapy.  The purpose of therapy, in my book, is for you to become the best you possible.
But, not all therapists agree with this and so, once again, I remind you that if you want a solution-focused therapist or, on the other hand, if you want one who will try to include all parts of your character and personhood, you must search until you find the right match.  As you can see, if you are looking for one of those styles and you land up with a therapist of the other style, it's going to be a rocky road.
In this case, the client who wrote in also asked for some reassurance from the therapist, specifically about the therapy relationship.  Personally, I oftentimes ask clients to tell me if there is a certain way that they want me to work with them, if they have been in therapy before and have found things that are helpful to tell me about that, as well as to say if something isn't working and to express their wishes.  I expect our therapy  to be a collaborative effort and process.  I also ask, periodically, for feedback on how the therapy is going in the patient's view and often do a year-end review.  All therapists are not going to be of this mind-set.

When you read the post, Making Mistakes, you saw a list of some of the helpful things that therapists have to offer in their skill set.  That list is mostly about problem-solving and promoting growth which is, perhaps, the arena in which the reader's therapist most liked to work.  Indeed, this is the majority of what we do.  People usually come to us with a problem.  Or, sometimes they are having trouble with their own inner life, or their personal functioning.  So, indeed, therapy is not just about ego-boosting.  But, at the same time, I don't think people come to a therapist to be only told what's wrong with them.  It's best to have some balance.
Seems to me if you want a balanced outcome, there ought to be some balance in the process.  If the focus is only and always about problems and what's wrong, the implication (subtle message) is that the client is just a bundle of problems with no good side.
(One little caveat; it must be mentioned that each case is different, i.e. in one case lots of positive feedback and encouragement might be just what's needed and, in another, it might be the worst thing for the client.  Therapists have to make these determinations.  This post is about the development of the therapeutic alliance and collaborating on creating a working style.)  
Nonetheless, if a patient asks the therapist for something, it seems the least the therapist could do is explore with the client what that request means to them, what it's about. 
In addition, generally, I think that courtesy, respect, and a little encouragement on the part of the therapist can go a long way toward providing a welcoming, accepting situation in which the client can openly
share and explore their personal issues.
 
Sometimes I write about the work of other theorists. Sometimes I do synopses of research I hear presentations on or from seminars I attend.  But, usually when I write here, it is my opinion I am expressing and this post would be an example of that.
Other therapists, please weigh in.
It would be great to hear other ideas about this, whether you have an opposing point of view or are in agreement.
Comments on this topic are welcome.

7 comments:

  1. People probably feel problematic enough coming to therapy - it's wonderful to be reminded of one's own strength. For me, the biggest benefit from therapy is that it reminded me of my own strength!

    You write really well and I enjoy your blog! It's hard to read with a center-justification, though. It looks nice but is hard for my eyes to follow!

    -PJ

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  2. Yes! And also, use line breaks in between paragraphs! The white space helps guide the eyes!

    Blocks of texts are scary and intimidating!

    -PJ
    (former blogger for a news organization, had 1 million page views!)

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  3. I know personally, my therapist is not going to problem solve for me. She's not going to give me answers outright. At first, it was hard for me to get used to, but now I appreciate her approach. She's more about prompting me, and responding to my questions with questions back, unless I'm in a crisis. That said, she knows my limits, and is ALWAYS supportive. I'm feel like she's helping me learn how to live!

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  4. Hi, as a therapist, I have to agree with everything in here Paula. I practice at a non-profit agency in CT, and I really find it exceptionally helpful to ask new clients about previous treatment experiences. I find this helps to really build some trust within our relationship, and allows for them to know right away that I'm open to catering my style to what will be most helpful to them. I also find that a healthy balance, highlighting one's strengths as well as one's problems is always vital.
    Great blog!

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  5. Hi Paula. I work primarily as a Person-centred counsellor and I, almost invariably, point out to clients that I do not give answers or suggest solutions.

    I think the key point you make is that one should work with "what that request means to them". If a client asks for something, that request sits between you and your client: it's there; it has happened; it can't, and shouldn't, be ignored. The fact that the client asked for something suggests a need which can be acknowledged and explored with them. They will get much more out of that than they would if you were to answer their question or to satisfy any of their requests.

    I do, also, use Solution-focused Brief Therapy, an approach which places considerable emphasis on helping clients to identify the resources which are available to them, both within themselves as well as in their immediate environment. As you say, this should not be "flattery"; wherever possible, it should be elicited from the clients themselves. If they can identify their strengths, talents and abilities, it will mean much more to them and will be much more real.

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  6. These comments are illuminating. Thank you. They highlight several points; I like the use of the word "resources" for individual strengths-says a lot.

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