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No guarantees in therapy

shutterstock_105731375Therapy is an investment of time and of money and it’d be nice if it came with guarantees but it doesn’t. There are just too many variables to make any promises about how therapy will work for any individual but there are some things you can do to get the most out of your time in the counselor’s office.

  1. Find the right counselor. Remember your progress comes down to the therapeutic relationship that you build with your therapist. If you want a more touchie-feelie counselor or a less touchie-feelie counselor then go find that person. Whether you want someone with lots of fiddle toys in a comfy overstuffed office or one who keeps everything streamlined and clinical, then go find that person. There are lots of different counselors in the world because there are lots of different people so when you call someone to check them out, don’t be afraid to ask them any weird question you feel you need to ask to feel comfortable.
  2. Leave the wrong counselor. If you’re working with someone and you just don’t feel comfortable or safe, switch. It’s ok. You’re the client and you get to decide what works for you.
  3. And if the counselor is almost right? Help them become all the way right. If you have an issue with your therapist and are afraid to bring it up, please give it a shot before you quit therapy. We therapists aren’t psychic so if we’re doing something that isn’t working for you we’d love for you to let us know. I know it’s scary but remember what I said, you’re the client and you get to decide what works for you. Besides it’s good practice for asserting your needs in the rest of your life.
  4. Show up. Sometimes we have to miss our therapy appointments because our cars don’t start or our kids spike fevers or our bosses move up our deadlines. That’s all true. And then sometimes we miss our therapy appointments because it’s just easier not to go. But therapy only works if we get ourselves into the office and into that chair to talk and listen so even when it’s hard — especially when it’s hard. And you know, you can tell your therapist how hard it was to get there that day; she’ll appreciate knowing.
  5. Stick to it. Speaking of how hard it is to come, please don’t drop out completely when therapy becomes tough. Sometimes we have to feel worse before we feel better. Growing is hard and sometimes it’s painful, which is why so many of us don’t do it. But you know what? It’s really worth it. I promise.

Leave it Here

gift-insideAbout twenty years ago I went to a training at the Legacy Emanuel Hospital in Portland presented by CARES Northwest about interviewing children as part of a sexual abuse assessment. During the second half of our day we watched videos of the practitioners interviewing the kids. I remember one child’s story in particular because it was a very hard story and because at the end, for the first time, you see one of the interviewers crack. The boy, who was about ten, asked her about what would happen at the end of the day, what would happen to the interviewer. The woman conducting his assessment started to choke up. We could hear the tears in her voice as she told him that at the end of the day she opened up all of the windows in that room and let the wind blow away all of the fear and sadness so that the space could become peaceful again and ready for the other children who would come there and need to tell her their stories.

That’s stuck with me over the last two decades.

Once a client said something to me that wasn’t so bad but to her it felt very bad to say it and after she said it her eyes got wide and she clapped her hands over her mouth.

“I can’t believe I said that,” she said behind her hands.

“But you did,” I answered.

“I did,” she said. Then she put her hands in her lap and we spent some time talking about saying it before we talked about what she said. But she left it at the office that day. That’s where she left it to be considered and examined and she did not feel the need to pick it back up again in her everyday life.

I think of my office as sacred space and as safe space. I want my clients to know that they can say whatever they need to say — whatever they’re most afraid to say — and they can leave it there. If they need to, they can leave it there and pick it back up at our next session or they can leave it there and let it go. I will hold it safe for them until the fear and the shame and the sadness are no longer so powerful and then they can set it free and know this secret — whatever it is — is no longer more powerful than they are.

Musical Offices

shutterstock_2448579At the community mental health agency where I work part-time people are assigned offices on the basis of hours. The more clients you see, the more permanent your office. Full-time people have their own offices (although they share with the rest of us), which they can decorate and personalize and then we contract workers play catch as catch can. Because my hours were lowest among the Family Program staff, I was used to not being sure which office I’d be in until I arrived for my shift and checked the big white board behind the front desk. Now that I’ve increased my client load I get the same office every time, which has made my life a lot easier and likely has made life easier for my clients, too.

Especially for the kids, moving offices depending on the day and time of the appointment can be disconcerting. There are some children on my client roster who have seen me in four different offices, some more child-friendly than the others. I keep toys in the trunk of my car but rotating around sometimes caught me off-guard. I’d show up with playdough only to find out I was in an office without a table where we could work with it or I’d wrangle the marble run out of my trunk and up the stairs on the day when I was in a fully-stocked office and didn’t need it.

Now I know where I am every time, I know which toys I have available and which I’ll need to bring from my private practice and things are so much easier.

Still I didn’t mind my time moving around. Working in different offices decorated by people with different sensibilities (and in offices that were under- or over-furnished as full-time clinicians moved in and out) gave me the chance to see how space impacts the therapeutic hour. I learned how to get creative when the toys were missing or space was inadequate. I learned how to recognize when clients felt off-kilter in our space, how to address it and how to figure out ways to make the room feel more comfortable by moving a table, a chair or turning lights on and off.

Other things I learned:

  • A big office isn’t necessarily better than a small office. Furniture placement and lack of clutter makes a bigger difference than size.
  • The quality of toys matters more than quantity.
  • A visible clock for both my client and me makes life oh so much easier. I’m pretty good at knowing when our time is up but not enough to go entirely clock-free.
  • It’s nicest being in the offices where we don’t have to sit too close to the door since clinicians and their clients are sometimes chatty in the halls.

I also learned how much easier it is to do therapy when you’re not fighting against your environment so as much as I valued my time jumping offices, I’m happier knowing where I’m hanging my hat every shift.

My Counseling Office Journey So Far

calmempty-insideI’ve been spending the last few months looking for counseling office space to launch my private practice. I had one lined up, a shared office in a very nice location. But I work with kids as well as with adults, which means I need somewhere to store play therapy toys and a waiting room that’s welcoming to children.

Unfortunately the shared office wasn’t going to cut it. I realized this when I came by to talk to the owner and took a closer look at the waiting room, which I’d noted was bright and sunny and spacious but neglected to recognize the safety issue of having an open landing to the stairs.

Office space is interesting. You have to get a good location, of course, and ample parking. You want to find a place with character and appropriate square footage and a decent lay-out. If you’re lucky you’ll get a view and natural lighting and clean carpet. But unless your budget is limitless (mine isn’t) you have to make compromises and figuring out how and where to compromise has been my challenge. It’s certainly been fun looking and imagining; it’s a little like house-hunting but it feels a lot less stressful.

I think I found the right place. It has a lot going for it, most particularly the location. It’s on the bus line and very near shops and eateries and the library. The downsides (no view and on the lower-level) are liveable. I’m very pleased that there will be room for all the toys and even enough square-footage to run small groups or workshops.

Another advantage to going out on my own is that I won’t be restricted by someone else’s hours. I want to be able to be flexible while I figure out what works for me and for my clients.

Now the fun will be to set it up just the way I like it or at least as close to how I would like it. It will take time to figure out exactly what I need and then I can’t afford every little thing I’d like (one day I want to have two counseling rooms — one for play therapy and one just for adults but for now it’ll be all in one space). But even if space is a little tight, it will be nice to have a chance to use the tools I’ve been gathering over the years in preparation for my own practice.

Once I’ve moved in and set it up I’ll be having an open house and I hope you locals will come by and take a peek. (You can subscribe to the newsletter to get a heads up!) I’ll also be sure to post pictures. Right now I’m enjoying myself by looking at paint chips and room lay-outs and getting ridiculously excited!

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