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I spend some time online in areas where people are looking for support or answers regarding mental health. My function is generally one of reassurance and encouragement to seek out help. I’m a believer that almost everyone who is questioning whether they should be in mental health would probably see benefits.
One thing that I see a lot online are people who have had bad experiences speaking very broadly about the negatives of mental health care. I read these generalized statements about the mental health system, medications, and different forms of therapy. It is hard for me, as a therapist who has seen so many instances of remarkable progress, to keep finding individuals showing real interest and concern being met with such negativity.
It is important to remember that there are many treatment stories, but only one is your own. Whether someone else fared well or poorly with a certain medication or approach does not dictate how you will do. It is also worth noting that we are often more vocal about what we see as negative, as opposed to touting the positives. Generally, there is a very low risk in trying – maybe you find that you don’t click with the therapist, you give up a few hours to treatment you don’t find very beneficial, or you have a side effect from a medication that you can then stop to remove the effect. The risk is low, but the potential for benefit is great. I have seen for myself how fully lives can be changed with the right approach, therapeutic alliance, and sometimes right medication.
Not every therapist is the right fit for every client. Not every technique will be as effective to each person. But if we focus on our own stories, and use others’ only as guidance (as opposed to taking them as the rule), we can find what really allows us to feel best.
For the past three years I have been working in a clinic in Rochester, and for the last year I had been doing this as well as private practice. I worked my last day at my clinic today and saw my last client there. It sparked a long train of thought that I've been coming back to throughout the day.
During my session today, my client asked me to be honest about whether I actually thought it was possible for him to feel happier, reach his goals, and let go of a lot of the negative self-talk that has been so common for him. It was an easy question for me to answer, but it sparked me to think a great deal about myself as a therapist and my perspective. I certainly do see it as possible that this person could feel better if he continues to work. More than that, I see it as probable.
What I started to think about after the session was about how genuinely I do believe that people who are willing to work are going to see improvement. I think I wouldn't be a very good therapist if I felt otherwise. I was reminded today how important my function is in being a believer in the people that I see. Now, unless the person is mandated to attend, there is pretty much always some part that is at least hopeful that things can improve, otherwise, why even show up? But I, on the other hand, go beyond hope. I have confidence things can improve. My job is to find that confidence in my clients, build it, and be able to let it take the wheel.
I've been told by more than a few clients that it seems like I love what I do. And they're right. I realized today that a big part is that I love watching clients turn into believers for themselves and their futures. I understand how reasonable it can seem for people to turn to feeling hopeless, so I'm glad for all the opportunities I get to help challenge these thoughts.
Many therapists will use homework to support treatment goals. I am certainly one of those therapists. Homework can come in a variety of forms and should be specific to each individual's needs. Sometimes homework will be to practice a skill, other times it will be to engage in a challenging behavior or to visit a certain place.
Generally my "homework assignments" come organically in session and are essentially small goals for the following week. If I just reviewed the basics of deep breathing, your homework may be to practice this through the week. If we are discussing communication skills, the assignment is likely to be to use these skills with the appropriate people. Some counselors will assign homework that relates to session topics but are an expansion based on what the therapist thinks will be helpful. They may provide you with their suggested homework during or at the end of session. These may also be practicing skills, taking time to think about a certain prompt, or avoiding a behavior.
Hopefully the concept of having therapy homework makes sense to you. It operates on the same premise as the homework we have all had to do in school - by practicing throughout the week, it supports and expedites the therapy process. If you are only going to therapy once every week or two, there is a long period between appointments that should be used to help your progress. If you only do your thinking and practicing during sessions, progress will be slow and likely unrewarding. If you follow through with homework established in sessions, you can expect to experience stronger and quicker results than only doing work in therapy sessions.
If you are getting assignments from your therapist that you don't feel are helpful, are too easy or hard, or otherwise don't seem beneficial to your treatment -- talk to your therapist! All therapy is dependent on collaboration between client and therapist, and you should feel comfortable asking questions about homework (and techniques in general). Sometimes you may need to push yourself try some homework that you aren't so fond of. Your therapist may have some insight that will truly be beneficial and can only be learned by your follow-through. Keeping a dialogue going about what you feel is helpful, confusing, or detrimental is important to your overall progress and happiness in therapy.
In this third installment of Learning the Basics to Being Better, I relate depression (and other mental health concerns) to being wrapped up in a less-than-satisfying blanket. I discuss the struggle to make the effort and take the risk to search out a better, happier blanket. I hope you'll watch and that the video offers some encouragement for you to upgrade your own blanket!
To continue the series Learning the Basics to Being Better, I present this video explaining my frequently used analogy about needing to understand where you are starting from in order to use your directions. I hope you'll watch the video and take some useful encouragement from it to examine where you are and where you'd like to go.
The first step in the Learning the Basics to Being Better series is starting to set a foundation to work from, with making small changes to eating, sleeping, and moving. Watch the video for tips about these three topics to work on identifying what you need to practice to start the cycle of feeling better!
As I mentioned in the video, I use a calendar to track success with small, daily goals. Here are blank PDF and Word versions you can print off (or put on your smartphone or save to your computer, whatever works for you!) to track your own successes. Make it visible to help remind you, then start racking up the check marks!
All therapists are going to approach the initial phase in their own ways, but many are offering consultations to get an idea of why you are seeking therapy, what you are looking for, and to offer a chance to assess how their style might fit you. Of course, you can't get a full picture of how a therapist will operate based on a consultation, but it can give some helpful clues as to whether you think it will be a good fit.
Don't worry about being particularly prepared for the consultation. All you need is to make the initial phone call, email, or online appointment. Once you have your consultation appointment, the therapist will take the lead. Personally, I'll ask about what has been going on for you lately, how long this has been a concern, and what you types of goals you have. Plenty often clients don't know their goals right away, so we can spend time in the first few sessions identifying what will be different when the presenting problem is gone or better managed.
In this consultation, we are able to assess whether our therapy is likely to be right for you. If not, we can help link you with more appropriate resources. This might mean a different type of mental health (such as me referring to a clinic for those that aren't Skype-appropriate) or to community resources, like recreation centers, town supports, and self-help groups.
So, the most important message is, try not to stress yourself with expectations for the consultation. You don't have to direct the conversations, just answer questions to the best of your knowledge. Don't worry about if some of your answers are "I don't know." And don't worry if your answers aren't the most eloquent, we understand!
Just getting started in therapy can be anxiety-provoking enough to completely avoid it. Even if you don't suffer from social anxiety, just having to make the first phone call, or even email, can be too overwhelming. There are so many questions we end up asking ourselves when we are nervous, and sometimes we know they don't even make sense, but we ask them regardless. Here are a few of what I expect to be the most common, along with some rebuttals to hopefully help you feel ready to try!
What if I am so nervous that I make a fool of myself when I call?
What if I am not right for therapy or if the therapist can't help me?
What if I don't like the therapist or have had a bad experience in the past?
What if I have something embarrassing to share?
about the Posts
In these posts and videos I share information about my own practice, therapy in general, and skills you can use in your daily life.