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Clients are likely to have questions about our services. Some may be asked, others may remain unspoken unless raised by the therapist.
No information sheet can answer every question our clients may have. Even if one did, some wouldn’t read it and others might be unable to either read or comprehend the text. You should therefore be ready to answer, and in some cases, pre-empt clients’ questions.
As a supervisor, I have asked my trainees to explain the difference between a psychologist and a psychiatrist before ever meeting a client. Most have managed a reasonable explanation. The learning point was not the quality of the explanation but the confidence with which it was delivered: everyone was caught off guard by the question and so came across as unsure, defensive, even shifty.
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The Miracle Question can elicit negative responses from some clients. These negative reactions can be avoided by rephrasing the question without the miraculous element.
The Miracle Question is used by Solution-Oriented Therapists to elicit the conditions which would lead the client to consider their problem solved:
Suppose that one night, while you were asleep, there was a miracle and this problem was solved. How would you know? What would be different?
The client’s answer generally contains the seeds of their own solution and can be used to set treatment goals and propose strategies. Used properly, the Miracle Question can be a powerful therapeutic technique, but it has several liabilities inherent in the phrasing of the question.
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A compendium of relaxation techniques. This book supports the clinical practice of physical and psychological therapists seeking to explore the field of relaxation training or to tailor their approach to individual clients.
There are many different approaches to relaxation training. If this book doesn’t have them all, it certainly contains the vast majority.
First publshed in 1995 and now in its third edition, the book covers the physiology underlying tension and stress together with physical and cognitive approaches to relaxation. Each chapter expands on one approach, detailing the theory (if any) behind the approach, then offering scripts, variations on the main approach and benefits and pitfalls of the approach.
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Uninvited use of a client’s given name can impede rapport in a number of ways. Moving from a position of formality to informality and intimacy is easier than backtracking.
A therapist’s first encounter with a client usually requires the use of their name, if only to ensure that you haven’t picked up the wrong person. The usual practice is to use either the client’s full name (as given on their referral letter or case file) or their title and family (last) name. Some therapists attempt to establish an air of informality by using the client’s given (first) name, but this is a risky practice for a number of reasons. In decreasing order of seriousness:
The client’s given name is first and most commonly used by their parents and siblings. Being called (without invitation) by one’s given name can throw the client into a child role with the therapist as parent (especially if the therapist then goes on to introduce themselves by their title and family name). Depending upon the client’s experience of childhood, this might be reassuring or anxiety provoking. It is definitely disempowering and may be seen as patronising.
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Speaking more slowly can improve communication between therapist and client. Slow speech is more comprehensible and more considered.
Anxiety is characterised by rapid speech. Therapists, especially trainees, may be anxious in sessions, but may also feel the need to speak more quickly in order to pack more into the time available. This can backfire by making the therapist seem anxious.
Following rapid speech demands greater attention. When listening, we are attempting to make sense of what is being said. The more time we have to consider what is being said, the more likely we are to understand what we are hearing.
Clients are by definition functioning less than optimally. Anxiety, depression, pain, fatigue and medication effects can impair concentration and therefore affect clients’ ability to follow and make sense of what we are saying.
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A collection of exercises for developing therapists. The insights to be derived from this book should improve the practice of any therapist.
Somewhere there’s a book that all the experienced therapists know about and it’s not about how to do therapy, it’s about how to do therapy better. It’s got all the secret little extra tricks they know about that aren’t in any of the models and that they forget to tell you about in class. And they won’t ever tell you where that book is - you just have to figure it out.
As Margaret Rambo admits in the introduction, Practicing Therapy doesn’t contain many secret tricks, but it is a book about how to do any therapy better.
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