There are two aims in any conversation: unambiguous expression of your own position and complete comprehension of the other person’’s views. We should always remember that neither of these aims is a realistic goal.
A client told me of an ante-natal appointment at which her midwife said “So, your first child was deformed and your second child was killed: let’’s hope it’’s third time lucky, shall we?”
While it is difficult to imagine anyone not being offended by such insensitivity, it is equally hard to believe that the midwife was being intentionally cruel. If she thought at all about her comment, she may have imagined she was being warm & humorous: rapport-building.
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Be on time for your appointments & consultations. Punctuality conveys professionalism, respect and allows you to address & manage possible resistance on the part of the client.
There’’s a Catch-22 type joke (at least, I thought it was a joke) about clients” attendance at appointments:
If they”re early, they”re anxious; if they”re on time, they”re obsessional; if they”re late, they”re resistant.
Therapists, by contrast, seem only to have two modes: on time (rare) and late (mostly). Lateness on the part of therapists is usually due to an excessive workload and so is likely to be forgiven—or at least tolerated—by NHS clients. The implicit message, that the therapist’’s time is more valuable than the client’’s, doesn”t make for a good start to a session, however.
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A blog focussing upon cognitive behavioural & psychodynamic techniques & issues “in the room” rather than case or theoretical discussions.
Chris Allan is a Clinical Psychologist and Director of the Psychology Clinic at the University of Wollongong in New South Wales, Australia. His weblog In The Room addresses a range of therapeutic issues and the related literature.
Each post illustrates a problem encountered by therapists and offers insights into this problem, often with extensive quotes from relevant textbooks and journals. As a round up of “therapy tips & techniques you will find in your textbooks”, In the Room should be of use to any psychological therapist and is well worth a read by physical therapists also.
Treat others as you”d like to be treated is a universal principle. Therapists who avoid working with other faiths and cultures can be assured that there is common ground to work from.
Working with people with different beliefs can be challenging, especially for psychological therapists. By definition, every client holds some beliefs differing from the therapist’’s but there is something particularly daunting about codified cultural and religious belief systems.
Clients will often seek out therapists of a similar culture or faith, fearing (sometimes correctly) that an ignorant or antagonistic therapist may question basic beliefs which they do not wish to examine.
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Set clear limits on diary-keeping and other journals. By asking for the minimum amount of information necessary, you increase the chances of obtaining reliable data.
Journals and other records kept by the client are a useful adjunct to most therapeutic approaches and an integral part of some, such as Cognitive Behavioural Therapy. Daily or hourly data points can be invaluable in establishing patterns and tracking progress.
Diary sheets may be handed out automatically at the beginning of therapy, in the expectation that clients will keep reliable records which can be used as the basis for therapy. Presenting clients who are already struggling to cope with another responsibility may not be the wisest move.
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Sooner or later, one of your clients will die. Waiting until it occurs to consider how this might affect you would be unwise.
Death of clients might be inevitable (f you work in palliative care), an acknowledged risk (if you work in psychiatric settings) or very rare. The cause of death may be deliberate action, accidental or ambiguous.
However hard you strive for “professional detachment”, the need to establish a rapport with your client means establishing a bond for which you may grieve when it is irrevocably lost. Inevitably, junior staff have more time to form such a bond, but have less experience to draw upon in dealing with the consequences.
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