Therapy Basics for Clients/ep19 Show Notes

Updated: Mar 27, 2020

EXPECTATIONS OF BASIC THERAPY

First, “good” therapy means legal, ethical treatment AND compassionate treatment

You can be a crummy therapist and still be legal/ethical
Confidentiality
Informed Consent

Appropriate therapist behaviors

Nonjudgmental
NO giving advice!
Present
Actively listening
Respectful of client's: time, boundaries, pace and process

The focus must always remain on the client, not the therapist

Personal stories - NOPE
Telling you their problems - NOPE
Doing any other activity - NOPE
Ex: snacking, changing clothes/shoes, phone calls, napping,

Things to expect

Trust
Safety
Connection
Reliable communication
A system for welcoming feedback during and after the session

In looking for the right therapist

It’s important to be assertive about identifying what you need
This can be difficult to do
It's okay to try more than one therapist
You know what you need/what will work for you better than we do
Ask all the questions you need to ask
It needs to “fit”
Initial sessions always feel a bit awkward, but you should feel a connection in some way, even if it’s something small
Hope, some relief, some clarity can happen in the first session

Ask the therapist about:

Therapy style

Therapeutic orientation
Timeline for treatment
Perspective on medication
How therapy helps
How their role is different than someone else

WHAT HELPS IN THERAPY

It’s not the modality. Not the technique. It’s the quality of the therapeutic relationship.

You can do the EMDR finger stuff or the Brainspotting wand stuff or the DBT self-regulation stuff or the Somatic Experiencing energy discharge stuff, but if the client doesn’t neurocept safety with you, it won’t help

And we know from Peter Levine that to discharge the stuck energy, you need a safe person and a safe environment

Therapists have to have to have to be neurocepted as safe. There are links in the description with some studies on this

APA Paper - “Factors that influence client outcome can be divided into four areas: extratherapeutic factors, expectancy effects, specific therapy techniques, and common factors. Common factors such as empathy, warmth, and the therapeutic relationship have been shown to correlate more highly with client outcome than specialized treatment interventions. The common factors most frequently studied have been the person-centered facilitative conditions (empathy, warmth, congruence) and the therapeutic alliance. Decades of research indicate that the provision of therapy is an interpersonal process in which a main curative component is the nature of the therapeutic relationship. Clinicians must remember that this is the foundation of our efforts to help others. The improvement of psychotherapy may best be accomplished by learning to improve one's ability to relate to clients and tailoring that relationship to individual clients.”
Society for the Advancement of Psychotherapy say these two things in particular are demonstrably effective - Therapeutic Alliance & Collecting Client Feedback. They also say - “Efforts to promulgate best practices or evidence-based practices (EBPs) without including the relationship are seriously incomplete and potentially misleading.”

There is hope here on a bigger scale:

Generally, clients don’t know the process of therapy
You can educate yourself and we hope this is a solid start
Bad Therapists should be scared right now
You’re paying them. You can vote with your feet and move on. You can report unlawful behavior to schools and licensing boards.

We’ve included a link below with information on how to contact the state licensing boards of the U.S. If you are outside the U.S., you can try googling information about your area’s licensing board or governing body.

You’re a consumer buying a service, just like ordering food at a restaurant. There’s a minimum standard you will deal with. Therapy is a service. We are beholden to you and that’s it. Don’t allow therapists or psychiatrists or any “helpers” you work with 1:1 to take advantage of your trust and need for help