zenda

I mean .... How?

Introduction
I'd touched on the question in another thread. Amonkie mentioned it was a topic of general interest and could be useful as a separate thread. This could, therefore, be a place for people's answers to that question, and also for your experiences and anecdotes.

The subject is close to my heart. From 1989 until 2003 I was working with the British government and a disparate array of therapy/healing organizations to create national standards for accreditation and accountability. These did not diminish the likelihood of any particular therapist assisting or screwing up the clients' attempts to achieve their outcomes. They did serve to give the clients a sense of security and subordination in the therapist's office, but had little bearing on whether the therapist would actually do good work. The dream had been that a standardized and well-monitored system of accreditation would protect clients. The reality was that, as with any well advertised product - many of which are backed up by official-sounding labels, the potential client needed, additionally, to learn the skill of conducting their own assessment.

A client's first contact with a counsellor/therapist is typically when a problem has been identified and is approaching 'amber alert' status. Often a sense of shame can delay someone's seeking to hire the services of a psychotherapist or counsellor until well into the 'red' stage. This can be a difficult time to make wise employment decisions, and is therefore especially important for roadmaps and guidelines to be ready and available.

This thread could become a knowledge-base to resource individuals when they are about to pick up the phone to contact and hire a counsellor and decide what, if anything, they want to do. I will start the ball rolling with my own angle:


My Perspective
If you're looking up some names in a directory, then it's great if you can talk about specific counsellors with any of your friends who might have been to one, that would be good. I'm not talking about "Oh, my therapist is Sooo good ... I've been seeing him/her three times a week for the last 6 years .... he/she's Sooo supportive, and is evening finding time to fit me in for a fourth sessions per week." ... noooooo not that. Such therapists do exist, and they have good pedigree and can provide good justification. When it's Problems which actually Bring us to a counsellor, typically they'll have some time-basis and need to be sorted soon, because people are hurting NOW. The consequences of NOT solving it are piling up now.

A better reference could be something like "I saw them for a few months and am now feeling more like I know what I want to do and how to do it. Initial sessions were twice a week for a couple of weeks, but rapidly went down to once a week and then once every two weeks. After three months, we agreed that I should see how things go and make an appointment in three months time for feedback and debriefing, though I was free to call to ask questions if need be." Also "The therapist and I discussed what I wanted to achieve, What EVIDENCE would count as success at different stages ..." This is the kind of evidence which, as early as possible, would let me know a: what progress meant, and b: the extent to which I was progressing." This is important, so you know whether to go back for the second session and for each subsequent session.

The therapist should be willing to sort that out in the first phone call, or, during an arranged phone call or meeting BEFORE money changes hands. Indeed, my personal insistence takes it further than some therapists would be comfortable with: The therapist should provide some demonstration/advice/intervention which the client may take away for a few days to find out how well it works for their problem. That is what is needed before agreeing paid work. My view is that YOU are interviewing a future employee, and they have to have ways of satisfying you that they can do the specific job you will be paying them for. The kind of counsellor I reckon is needed is one whose keenest intent is that you will find your 'best thinking' and your 'strongest feeling' so YOU may make YOUR best decisions, and that you may have the clarity and discipline to follow those decisions AT THE SAME TIME AS being very sensitive to feedback ... ie what specific effect it has on each person concerned - including you.

Beyond that, evidence of progress must be available, week by week, to both parties for the purpose of checking worth of continuing sessions. Some outcomes might take a long time, however, in that case, they need to be chunked down so the roadmap has plenty of rest-stops and check points. There are some outcomes ... eg spiritual questioning, or unfocussed mid-life crises whose progress is difficult to assess week-by-week. For those, I recommend special attention be given to chunking down to observables.


Conclusion: A call for many perspectives.
Well, I've given you some of my perspective. I look forward to your adding your perspectives and questions, and with the kind assistance of Amonkie, present the following questions for those who may appreciate some points of focus, stepping stones and springboards into this discussion.

I'll be interested to hear from people who have not had counselling/therapy - what are your thoughts and feelings?

I'll be interested to hear from those of you who are involved in the psychotherapy/counselling field or have had counselling

When did you first seek it out and why - Ie Dr required, self choice, marriage counselling as last resort?

To what extent did you seek it remedially - to solve a problem, or generatively - to evolve to embrace future possibilities?

How did you select your psychotherapist or counsellor?

What concrete help, if any, do you feel your sessions actually provided?

Having considered the above, what advice would you give someone? What would be the very most important things they need in order to make their wisest choice?

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ZENDA