Tuesday, October 31, 2006

The Co-Investigator

I was called to consult with another therapist about a patient I didn't know the other day. The case was interesting, but I sensed the therapist was working way too hard. I thought it a valuable lesson for all of us involved in any way in this work.

The doc was really anxious to have the whole family figured out RIGHT AWAY. I flat out asked him why he needed to solve the whole thing so fast, why it was necessary to know EXACTLY what was going on so soon. He'd only seen the patient three times.

He said that he thought therapy worked that way, that you do the assessment in a couple of visits and then get to work. Fix people.

So here's how I see it. It’s true. Therapy docs, all kinds, can get a LOT of information in a few visits and can see the writing on the wall, even pictures in their heads, about where the case might go, what changes need to be made, what has gone wrong and what it will take to correct things.

Some cases, be they individual, couple, or family take longer than others. Either way, I don't see that the doc should be doing all of the work.

Indeed, it is the patient’s perception of the problem, the patient’s perception of changes, the patient’s level of awareness of the issues/problems and the patient's willingness to entertain new ideas from a TOTAL STRANGER, that will make all the difference in the outcome of any strategy or intervention.

It's not only that it's your nickel. A therapist is really a CO-INVESTIGATOR and a patient a CO-THERAPIST in the treatment process. You do have to help yourselves. The suggestions and responses that I get from my patients add immeasurably to our success.

Notice I said OUR success.

So don’t hesitate to give your opinions, peops. I know it's hard to confront an "authority figure." And I also know that many people go to therapy precisely because they have difficulty communicating what they feel.

But try, try, try to speak up if you think your therapist is off his or her rocker (or simply completely off base) in an assessment or regarding a suggestion for treatment that you just know won't work.

We rely upon you. You’re the boss. Don’t let us get away with a bunch of nonsense. The data we work with has to come from you. All we do is re-spin what we hear.

Copyright 2006, TherapyDoc


Anonymous said...

I think some of it comes down to media portrayals as well. Based on the media we think that therapists have all the answers and are the ones to give advice. Clients have been trained to take a passive approach and rather then confront the person that is seen as the expert it's easier to stop treatment. I've been on both sides of that fence.

Currently I actually work in troubleshooting computers. Well my actual job title is "performance coach." I listen to calls and evaulate it. The reason I mention that is that there is a parellel to therapy. All too often I see what we call "shotgun troubleshooting" where the agent thinks thinks they know what the issue is and run with it. They might even resolve the issue out of blind luck but because they weren't confirming things with the customer they might have been off base.

Likewise, in some therapy situations the therapist might dominate the sessions and not be involving the client.

I like the way you said it was "our success." That's really the way it should be.

therapydoc said...

Sure, I can talk the talk. . .

But it's hard for docs to refrain from overthinking and advising and taking over.

That's why I'm publicly telling people to get involved and stay involved in their own therapy.

It's all about you, after all, or should be.

Anonymous said...

I really enjoy your blog.

I've noticed with the doctors and nursing staff I work with, many don't understand that change/success isn't all about diagnosing and getting an individual from A to Z. A great success may occur after a therapeutic alliance is made and can be as awesome as going from A to B.

Anonymous said...

You know I've often wondered if a therapist can see through a "victim" for lack of a better word. I am thinking specifically about two of my sisters who are similar but very different.

I know each one has been in therapy and one of the sisters had her therapist tell her she couldn't do anymore for her. Woah.

I asked my own therapist about that statement and she suggested (based on examples I had shared) that my sister sounded like a borderline personality and those folks can be black sucking holes. That therapy would go for a life time in the therapist let it.

So I guess my question is two-pronged. First, have you ever had to tell a patient, there's nothing more for me to do. If so, how did that go.

And secondly, when you have a person who is a woe is me victim, can you generally see through that? These are the people who trouble follows. They tend to create their own trouble, strange as that may seem. Have you run into one of those and how do you deal with that?

Hey not to tell you how to run your own blog, but that might make an interesting post.

therapydoc said...

Both good questions. How about I post them?

depression cure said...

interestiong, I like this idea of co-therapy, the problem is nowadays, either the doctors talk too much or the patients cant stop talking, lol