Blog 114. Therapy Part D: Finding A Therapist, The Therapist, How Weekly Sessions Are Arranged And Paid For, But What If Things Go Wrong?
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Finding A Therapist:
Tao Te Ching once said that “When the student is ready the teacher will appear. When the student is truly ready… The teacher will disappear.”
This is often the case and it one to try to live by: Just as you begin to think you need help, hopefully out of the blue a good friend or trusted colleague may recommend just the right person whom you may need to see. It might not be someone with the skills which you think you want, however it might be the right person with the skills you need.
Recommendations are often the best way. It means someone has done the legwork and you can be reasonably sure that whoever it is, they will be at least good enough for what you want.
Also, different countries have different systems, different support groups and different methods of finding a therapist. Sadly, some areas or countries have less therapists available.
Alternatively, you can approach your doctor or you can even search the Internet for someone who may work in your area. If you do find someone on the Internet, please do make sure that they have trained and received their qualifications from a recognised college or university. This ensures your safety and it ensures that the correct boundaries are in place.
The therapeutic process is complicated and therefore it takes at least 4/5 years of rigorous training to master all that it involves and even then, it can take many more years for a therapist to find their specific way of working.
And couple therapy requires a few more skills. It involves two people and their relationship. Many find this extra requirement too demanding, as it requires a different kind of attention and training, than just seeing one client on their own.
Either way, a therapist will ‘bring themselves’ to the work and sometimes the ‘client therapist fit’ may not always be suitable and in which case – you are always welcome to find a more suitable therapist. However, sometimes you get from a therapist exactly what you need even though it may not feel this way initially. I remember whilst I was training, I would select certain hours to see clients. Even under these restrictions, nine out of ten times, I got the right clients and they me. Upon discussing this with my colleagues, I realised that they found this serendipity to be true too.
Some therapists don’t speak at all. Others are more proactive and some prefer to challenge clients whenever necessary:
However, therapists vary in how they work and this will also depend on their training. If you find yourself unhappy with what you thought may work for you, you are welcome to leave so that you can find someone more suitable to what you expect or need from therapy.
Once a therapist is chosen and the therapeutic relationship develops, it must be remembered that whatever gets said is kept confidential.
A therapist has a supervisor that serves as an objective guide, because sometimes even the therapist may overlook certain aspects that may be beneficial or indeed crucial to the client or couple’s therapy. During this process, particular issues are discussed and the therapist makes sure that none of their own issues get in the way of the client or the couple’s therapy. It is a responsible task and it needs to be carried out with utmost vigilance.
After each session, the therapist will reflect upon the issues or what was brought to the session. Important questions that are generally asked are:
- What stood out from what was said or not said?
- Was there any unusual behaviour from either clients or the therapist and why might that be?
- What was the dominant theme of the session? Or what are the recurring theme/s or pattern of behaviour that keep repeating?
- Are partners beginning to miss sessions or has a partner begun to attend the couple sessions?
- How is the client/couple progressing or are they regressing? Why might this be?
There are of course many more questions relevant to each couple and the type of questions asked, will change as therapy develops and more issues emerge.
Asking these sorts of questions allows the therapist to prepare for the next session because certain issues or indeed, further insights may need to be discussed or addressed. Sometimes this is impossible because the client’s may bring something completely new to the next session. Either way it helps the therapist keep the focus, even if whatever needs to be addressed, has to wait for another session.
A Client Joins Their Partner Later On:
Also note that point 5, refers to a client beginning to attend a couple session after the partners have already started seeing the therapist. (I have written about this previously from the third paragraph in Part B: The Process And Results Of Relationship Therapy). Usually this is welcomed because seeing both partners in a couple is always useful for a relationship therapist to get a better picture of the issues at hand.
Weekly Or Fortnightly Sessions?
An important question that clients or couples ask is, “Why do they need to see a therapist every week. Why not every fortnight or whenever they have time to come to therapy?”
Continuity is crucial and showing a commitment not only to yourself or your partner, and indeed to your own therapy is crucial in the healing process.
Most importantly though, if a client has intimacy issues as a result of an absent parent or as a result of a lack of good parenting, then experiencing the commitment of weekly sessions is crucial. It helps a client understand and mourn what they may have missed so that they can begin to repair and learn a different pattern of behaviour if they so choose.
Arranging Your Regular Weekly Session:
Sessions usually occur once a week. The therapist and client/couple will decide on a regular time and day each week that will suit everyone involved.
Once this is arranged and agreed upon, then the chosen time becomes a regular slot that a client or couple attend. This helps to keep continuity and it creates a good support foundation for any client.
The therapist should never give your agreed upon time slot to any one else. It is your time and your time alone. And you pay for that time each week whether you attend the session or not, whether you go on holiday or not. Doing this honours the therapists and your time. And it is also up to you to arrive on time, so that you can make full use of the time you are paying for as well as getting all the benefits of what that time can give you.
If a client insists on seeing me every fortnight I get suspicious. Often this shows intimacy, commitment, control and even money issues:
1) Firstly, it has been proved that people start forgetting what happened two weeks ago, let alone a fortnight ago. Worse still, with all the daily information that we are now expected to read and absorb, many cannot even remember what happened a few days ago. So this is not recommended
2) Via my training it was suggested that any client insisting on fortnightly sessions will land up drawing out their sessions and then years later, they may still be in need of help. In other words, in the long run it is not an effective way of working.
3) But most importantly, it shows a lack of respect for the therapist’s time because what are they supposed to do with the hour when a client isn’t there? This is because they can’t give it to another client – so they land up out of pocket if indeed, this is the therapist’s allotted working time.
4) Also, if a client cannot honour this arrangement this usually means that they are also unable to honour other such arrangements in other areas of their lives – and colluding this way is not helpful to a client.
5) But also, it may not help a client especially if they have money, generosity, debt and payment issues that either consciously or unconsciously have caused a client to request attending therapy every other week.
6) It also suggests control issues. In other words, by forcing a therapist to break the rules and to only earn every second week, the client lands up in control. If the therapist colludes with this, then once again this is not helpful to the client in the long run.
Fortnightly sessions therefore – do NOT benefit the client and as a result, I always refused to work this way.
You either want to do the work, show that you are committed to doing the work and I will do the same. Anything less, is not worth the agony especially, as it often leads to many more missed sessions and plenty of unnecessary hassle and excuses.
Sessions Should Never Be Re-Arranged To Benefit Other Clients.
Some therapists are able to be a little more flexible. When a committed client has an important meeting and so on, certain therapists try to be flexible so as to help their clients not miss their weekly session.
However, contacting a clients and asking them to shift their session is highly irregular. What this suggests is that one client is more important than another and although it may seem like an innocent enough request, it can produce resentment and even anger, even though it may not be articulated.
How Does Payment Work? Who Pays When A Client Goes On Holiday? Who Pays When A Therapist Goes On Holiday?
You pay for every session you have missed including if:
1) You are ill.
2) Your children are ill.
3) You have an important doctor’s or dental appointment.
4) You have to attend a funeral.
5) You have an important business meeting.
6) You go on holiday.
7) And you also don’t get a discount if you are late. It is therefore in your best interest to arrive on time for each session, so that you can take full advantage for what you pay for.
However as already stated, with prior notice, sometimes certain therapists may be able to be more flexible, especially if they work from home.
You do not pay if your therapist goes on holiday.
Also, a therapist must also remember that although they will be earning money from clients, this should not be their main preoccupation. Keeping a client for longer so as to pay a mortgage is unprincipled and will lead to trust, boundary and reputation issues.
A therapist needs to just trust that if they are good enough, each client will refer them onto their next client. This is the best solution. It builds trust and it maintains a good reputation.
What Happens If Things Go Wrong?
How a therapist responds to what is happens during the therapeutic session often depends on whatever the issues are. Unfortunately, sometimes things can still be misunderstood and the client or indeed a couple, may go away feeling unhappy. It is always suggested that the clients or couple return to the therapist so they can resolve any issue that may have emerged – which usually lies within the therapeutic process anyway.
I usually warn my clients from the beginning that any negative emotions that they may feel towards me may be part of their therapy and that exploring this with me is crucial, because just leaving, often means that an important aspect of an issue may get buried or lost and then repeated elsewhere, if not fully understood.
But why can this happen?
If you go back and reread the questions a client may ask after a session you may realise that sometimes a therapist or indeed, the clients too – need to reflect upon each session. Sometimes it is only after a session that certain things are realised or picked up and possibly even felt – which then need to be brought to therapy the following week so that they can be explored.
I constantly had to remind my clients that every single thing that happens or is felt – is part of the therapy. If clients become sad, or angry, or disappointed it is usually part of what needs to be worked through.
Unfortunately, this doesn’t always happen and some clients may leave feeling unhappy. Why?
This is sad because usually it is a missed opportunity for clients and the therapist to work through whatever emerged, especially if clients harbour anger towards their own parent’s for either choosing their siblings over them, abandoning them or being either physically or emotionally absent in any way.
When difficult feelings emerge, sometimes it can be easier to blame the therapist for being say, the bad parent. And leaving or refusing to continue seeing a particular therapist can sometimes be a symbolic attempt of trying to discard or cut away that bad parent and all the negative feelings they may represent.
This of course is not the only reason why clients may leave disgruntled and unhappy. Sometimes it is easier to run than to work through whatever has emerged during therapy. This is sad because often, although the emotion may get felt, it may also get buried almost immediately. This pattern of feeling and running away, may be a habit that the client will continue doing until the behaviour gets finally addressed.
I therefore urge any of you who may be in therapy to remember that if you ever feel like ending your sessions, try at least to work through the issues if this is the reason for you wanting to leave, because unfortunately, issues never go away and they may get worse until you finally deal with them. And this often just wastes time.
Better to keep at it, so you can move on.
If you have not ‘moved mountains’ within at least the first few months of seeing your therapist – please find another:
If you have not ‘moved mountains’ within at least the first few months of seeing your therapist – you may want to find another. Why?
If you have been seeing a therapist for years, you may want to start questioning why. Why do you still need a therapist? Surely after a while, you will have worked through your issues sufficiently not to keep on needing your therapist? Surely after a time, you will have developed all the emotional tools required in order to become a fully functioning independent human being? Although, every now and again, you may want to continue working on a few more issues that could emerge over time – but holding onto a therapist and seeing them weekly for years and years – may not actually be in your best interests.
And therapists should not hold onto their clients either. They should not use clients to line their financial pockets or pay their mortgage. It is unethical and clients are never helped when this unknown truth sits between the client and their therapist.
Therapists should trust that if they provide a good enough service, clients will continue coming and this will certainly get mirrored in their referral rate . Therapist should however never hold onto a client beyond what is necessary. If they are doing so – then they may be in the wrong profession.
And as you are the paying client, you are fully entitled to move on if you so wish.
You can find out more by reading, Blog 115. Therapy Part E: The Process And Results Of Relationship Therapy.
© 2019 Deidré Wallace All rights reserved.
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