Relationship Therapy How to Identify a Good Therapist

This week I'm going to talk about how to identify a good relationship therapist. What are the qualities you should be looking for and how does a well trained relationship therapists approach a session. What does a good relationship therapist focus on. What are some questions to ask to determine if you have found the right therapist for you, who can help you achieve a positive outcome for you and your partner. The reason I'm writing this week's blog is because last week I heard a few stories which were a bit disturbing in regard to couples seeking a relationship therapist and finding something which could not be defined as a good experience. There are many counsellors who believe that all therapy is relationship based. I would agree with this assessment starting with the relationship that you have with yourself. How we relate to others is pivotal to our happiness and it determines how we travel through our lives. The old adage is true in this case "at first you must love yourself".

As with most counselling, couples tend to come along when they have run out of options. It is often the case that couples are really seeking separation counselling. They have had enough and have one foot out the door already. Finding the right therapist when you are in this heightened emotional state is not an easy thing to do. The temptation to google "Relationship Counselling" and go to the first
 organisation that pops up is high. However, I would urge you to phone around a bit. Just like there are bad doctors, bad mechanics, bad plumbers and bad nurses there are also bad therapist. It pays to shop around. Therapists have different approaches to relationship therapy, it is always good to have this in mind. There are also therapists with personalities that might clash with your own. As I have said earlier in previous blogs the biggest factor to successful therapy is the relationship between yourself and your therapist. How well you and your partner get on with the therapist is crucial to the success of the therapy. That's why choosing a therapist is so important. Last week I heard three stories of people who went to a therapist who they didn't like and decided never to go back to any therapist ever again. This is a real shame that one bad experience can result in someone determining never to seek counselling ever again. *Take note therapists*, you hold a great deal of responsibility when your client walks in the door. Not only are people trusting us with their life stories, we are also responsible for how they view therapy as a whole. Try not to give us all a bad wrap please. I  always reiterate to clients that if they don't feel comfortable with me that they can choose another counsellor and I won't feel offended. My major goal is that my client receive the best quality therapy this can only be achieved if the client feels comfortable and confident in me. This is crucially important as I am still in the training process as a counsellor. There has to be the right chemistry between the clients and the counsellor. This can be complicated in couple therapy both parties have to feel comfortable with the therapist. If you can agree upon which counsellor you choose then you are halfway to making a huge difference to both your lives.


What are the key factors to relationship therapy and what makes a good relationship therapist. Firstly, both parties have to feel comfortable with the therapist. Secondly, the therapist must remain impartial. This second point is very important. Therapist should not be taking sides with one partner or the other. Both clients should leave the therapy with a feeling of being heard equally. The therapist's aim should be on hearing all sides of the story in the first session. It is also the role of the therapist to assist the clients in hearing each other. Relationship therapy might include one on one counselling with the therapist. The therapy space should be a safe place for couples to talk. A good therapist will not attribute blame to either party. A relationship therapist should moderate discussions so that conversations stay on track and don't turn into a he said she said. A good relationship therapist keeps the focus on the relationship not the individuals within it. A relationship therapist might look to the past to see how the couples are modeling their own relationship. A good relationship therapist will look to the strengths within the relationship and build on these. The therapist might offer up information such as good communication techniques or recommend books and videos on how to build on the relationship. Relationship therapy is complex and many therapist steer away from it as it is daunting.

As with any therapy it's a good idea to shop around for the right therapist, who uses a model that you can relate to. In previous blogs I've talked about the different types of therapy; Narrative, Cognitive Behavioural Therapy, Existential Therapy and Acceptance and Commitment Therapy to name just a few. In this wonderful age of the internet we can research the different models of therapy to see which one might work for us. When you are shopping around here are some things to think about. A good question to ask is;"What Model of Therapy do you use?" Most organisations have a "Mission Statement", have a read of this. Many therapist have websites now in which they post blogs similar to this one. You will get a good idea of the therapist by reading these blogs. There's a lot of therapists out there, this is a great thing for you because, you have a lot of therapist to choose from. You might like to use the same approach that you would choosing any person who is providing you with a service. Get three quotes, at least. If you do use a big organisation like Relationships Australia and you have a bad experience with a therapist, it really is so important that you report back to the practice manager. Another counsellor will be assigned your case. If you have a bad experience generally you can report this to Australian Counselling Association, PACFA or the Board of Psychology. Another thing that you can do is say something to the therapist themselves. I know I love to get feedback good and bad. I make an effort to ask my clients how they are going with the therapy and if they have any feedback for me. It is completely ok for you to say to your therapist "I really didn't like that session, I felt like you weren't hearing my side of the story." It's really important that a relationship therapy session provides an opportunity to talk honestly not only with your partner also with your therapist. Your therapist can take this criticism to their next supervision session which will make them a better therapist in the long run.

Relationship therapists often set up a verbal contracts, sometimes a written contract which outlines some guidelines for the session that go along the lines of good communication. This enables couples to practice these in the safety of the therapy room. If your relationship is in need of an impartial view and some tweaking to improve your life and general happiness go forth and seek out a good therapist. In the meantime I have put a few links below for you to have a look at regarding relationships. My favourite is John Gottman and I long for the day that I can get enough cash to do one of the Gottman Institute Relationship Counselling Courses. I have also included some links to Relationship Counsellors who you might like to check out that are Narrative focused, Existential Focused and ACT (Acceptance Commitment Therapy) Focused to start you off on your research. My last request is that if you feel like your relationship is in trouble go early for therapy rather than later.  You will hopefully benefit from this experience.

Helpful Links

Seven Principles from John Gottman

Four Horsemen from John Gottman

Therapist

Narrative Therapist Helen Larkey works primarily as a Narrative Therapist yet moves to other modalities as required.  Helen works with Skype and Phone Counselling so it doesn't matter where you live you can access counselling with Helen.

Existential Therapist Charmaine Roth has completed level one training with the John Gottman institute. Charmaine offers a variety of counselling modalities for couples, existential being one of them. Charmaine offers Skype Counselling which means that you can receive counselling with Charmaine wherever you are living for face to face Counselling you need to be in NSW.

References

Berrison, G. (2007). Making Relationships Work. A conversation with Psychologist John M. Gottman. Harvard Business Review, 45-50.

Gerald, D., & Gerald, K. (2001). Basic Personal Counselling. Frenchs Forest NSW: Pearson Education Australia.

Gottman, J. (1994). Why Marriages Succeed or Fail and how you can make yours last. NY: Simon & Schuster Paperback.

Conflicts, Communication, View of the World and Personal Peceptions

This week I'm going to talk about a few of the things that I think might cause us to seek out counseling. We form our view of the world based on a bucket load of perceptions. We receive these perceptions from a variety of sources. These might include family our parents and grandparents, teachers, the church we attend, the social structure we grow up in, the experiences we have throughout our lives, the conclusions we draw from all of these things inform our view of the world. Our world view can sometimes be flawed or perceptions of the world may be based upon these flaws. The collection of perceptions we have about the world can be seen as subjective making the flexible and changeable.   For example as a child we may think that our parents view of the world is absolutely accurate when we are adults we may see our parents view of the world as rather limited or even false. We may never question our parental view of the world throughout our entire lives therefore this view will be passed along to our own children. This might become part of your family culture.

We don't just live within our family unit, we get to a certain point where we are exposed to other influences. We come across people who present their view of the world or elements of their view of the world which conflict with our own view. We might communicate our view of the world or try to apply our perceptions onto other people we meet. An internal conflict may arise where a question is raised in our mind we may gather evidence from the external world which confirms our world view or it may create further questions and exploration. This is why some of us are drawn to philosophy or seek answers to our questions in religiosity. The questions may only led to more questions and provide no answers.

When two people meet and marry or decide to share their lives together either in a marriage or even as friends our world view may be challenged. I know when I met my husband the first few years of our marriage were filled with conflict because our world views were so different.   Our family cultures were very different and our perceptions of our experiences varied so greatly that in the end the marriage failed. This is why people who choose to be with another person who comes from similar background to themselves, who share the same world view who perceive the world in the same way are more successful in their marriages. This doesn't mean that you can't have a wonderful relationship with someone who has completely opposing views. There, in fact, might be a greater opportunity to develop a very meaningful relationship with a person who has different views to you there might even be a greater opportunity for personal growth in a relationship where there is a great deal of conflict. This may become really doable if that conflict is conducted with great communication.

In order to achieve great communication it is ideal that we are open to suggestions to taking on board the other person's perceptions of the world, their internal world. Achieving this great communication might not come naturally to us. This is where we might want to have relationship counselling or we may want to learn more about the world in general making communication work for us to learn and grow. If we are interested in personal growth we might find ourselves seeking out opposing views which challenge us. Instead of birds of a feather that flock together we might want to experiment with thoughts and concepts outside of our normal experience. I believe part of good communication is accepting that there are many views of the world and everyone is so unique that it really is worth my while to hear all about these different views without imposing my own view upon others however, I do sometimes challenge other people's views and my own. This is to encourage personal growth.

Having said all of this it is also sensible to know when the difference is too great that growth is not happening. In order to communicate well you really require both people to be motivated toward making things work. If both people aren't working together to find a middle ground then this is where a lot of psychological harm can occur. You really have to know your limits this to is where you may seek the counsel of your friends, family or a professional counselling. To learn when to let things go or to develop a different kind of relationship as I did with my former husband of co-parenting and a friendly workable relationship. Finding the boundaries of your own limitations and other people's limitations is very complex it's not surprising that we need help sorting it all out. We go to our friends for assistance with this because they know us well. We go to counsellors because we require objectivity because they don't know us well. They do know all of the tools you might use to assist you in reaching a decision. We bring all that we have learned at University within the framework of our own lives. It is not a coincidence that many of the great psychologists and counsellors have overcome a great deal of personal challenges.

References

Berrison, G. (2007). Making Relationships Work. A conversation with Psychologist John M. Gottman. Harvard Business Review, 45-50.

Corey, G. (2009). Theory and Practice of Counselling and Psychotherapy. Belmont CA: Brooks/Cole.

Gerald, D., & Gerald, K. (2001). Basic Personal Counselling. Frenchs Forest NSW: Pearson Education Australia.

Gerrig, R. J. (2009). Psychology and Life. French Forest NSW: Pearson Education Australia.

Gottman, J. (1994). Why Marriages Succeed or Fail and how you can make yours last. NY: Simon & Schuster Paperback.

Yalom, I. D. (1980). Existential Psychotherapy. New York: Basic Books.

Do you have to be mentally unstable to see a counsellor??

There's a lot of stigma attached to mental illness and also to counselling. There's a belief that if you are having trouble with your life or your emotions that you are mentally unstable. If you are seeing a counsellor that there is something "wrong" with you. Perhaps this stigma is partially responsible for people hesitating before going to a counsellor and waiting until their whole lives are unravelling before them before they consider seeking help with getting things back on track.  The truth is mentally stable people seek out help for themselves if they find themselves struggling with issues in their lives. Mentally unstable people rarely seek help or if they are in counselling it's been mandated by the courts. They are mainly at counselling because somebody else has identified that there maybe a mental health issue there. However, this is not always the case. Having times of instability is part of living and seeking help when that instability is impacting your life in a way that results in feeling out of control is completely fine.

What is mental instability or mental illness. I think most people experience some kind of instability at some stage in their lives. Having feelings of confusion and uncertainty isn't necessarily considered mental instability. Having periods of great sadness isn't necessarily depression. Having fluctuating moods isn't necessarily bipolar disorder. Emotions are not always going along in a flat line. Sometimes sadness is the appropriate response or anxiety may be warranted given the surrounding circumstances. It's not your job to diagnose yourself. It's not even the job of a counsellor or GP to diagnose mental illness as I have said in the previous blogs. Getting help is important, how you get help and who you get help from is really irrelevant. In the long term your life will improve if you are no longer struggling or you learn something about yourself having overcome that struggle.

Mentally aware and emotionally aware people seek help when they feel they aren't coping. They do this because they have a high level of self awareness.  This is a thing counsellors are looking for in the assessment of their clients. Do they have a good understanding of themselves? are they internal thinkers or external thinkers? We like to see internal thinkers because they are most likely able to see their part in their current circumstances and are more likely to take part in any interventions. Their problem is taking on too much responsibility and the solution for them is as I say "pass the responsibility back to the appropriate person, like its a hot rock".  As counsellors we love to see people who are keen to do some homework are able to contribute to their own wellbeing. It's much harder to work with external thinkers because these people are normally telling themselves that there is nothing wrong with them it's everyone else's fault their life has turned upside down. Their solutions usually involves other people doing things for them rather than them doing something for themselves. However, often external thinkers will have moments of clarity where they might say "I don't know why I can't do...." quickly followed by "it's  probably because my wife/husband..."

Another common thing I see around University and also in my various work places is calling someone "a victim". External thinkers may be labeled in this way. They are being a victim therefore I can't help them.  This whole victim thing annoys me no end as I see it as an excuse professionals use to shut down and not help people. I've heard it said so often that if I had a dollar for every time I heard it I would totally be a billionaire now. The truth is that people do learn to be helpless if they have been victimised. Then they have some professional or well meaning friend wack the label of "Victim Mentality" on them. This then makes the client shut down and a victim again of poor professional management. The fact of the matter is that often these people have suffered terrible abuse or have constantly been attacked for their inability to change things in their lives. Sometimes people really are victims and they need to be heard, once they are heard they are able to move on.

I would ask that if you, as a professional, find yourself popping the "Victim Label" on your clients to take another look at why you have done that. I would be asking myself how can I approach this client to get the best results. This is why we have supervision and why we should always be looking toward how we as professionals can grow from the experience of assisting everyone who comes to us no matter what label is put upon them. There's always referral if you aren't able to help someone and pointing the finger at the client is not a good idea under any circumstance. It's ok to be a victim. There are actual victims; victims of cancer, of child abuse, of permanent physical disabilities. It's completely ok to have moments of sadness about being harmed and being a victim. Life gives us these things that are out of our control. Victims become survivors. It's the job of professionals to give people every opportunity to move through the process to become a survivor.

The facts are that not everyone is a fully self actualised human being, who is totally centered in the world around them, who is able to move through their life without being a victim or a perpetrator or having any number of problems. It shows great strength to be able to admit that something is wrong and that you need help from a professional. It is a great joy to see my clients move through the process of counselling to become a bit closer to being the best version of themselves. It's really a huge thing. To answer the question: Do you have to be mentally unstable to see a counsellor? The answer is no. All you have to be is a human who is perfectly imperfect seeking assistance in getting the best results for yourself.

References

Corey, G. (2009). Theory and Practice of Counselling and Psychotherapy. Belmont CA: Brooks/Cole.

Gerald, D., & Gerald, K. (2001). Basic Personal Counselling. Frenchs Forest NSW: Pearson Education Australia.

Gerrig, R. J. (2009). Psychology and Life. French Forest NSW: Pearson Education Australia.

Brief Counselling

In today's fast paced world everything is aimed at how quickly results can be achieved. Everything is fast. We want our food fast. We want our needs of every kind meet quickly. The emergence of speed dating, hook up apps, to find our lovers fast. The big emphasis on contract work or casual employment are also evidence of the fast and temporary nature of our fast growing fast moving society.  Living life in the fast lane is part of modern life. Therapy is no different we want our therapy fast 6-10 weeks is the normal length of therapy these days. 

There is plenty of research based around the effectiveness of brief therapy. Some counsellors can achieve a lot in that one hour of counselling time. I came across an organisation that offered brief counselling. It specified that one counselling session was offered with a referral system available for those who feel they require ongoing or further counselling. In actual fact one therapy session can often be enough for some people.

It is true that some problems only need one hour of mulling over with a counsellor. An example of this could be employment or career counselling. In this case the person may have a number of options available to them and be struggling with which option to choose. It may be a matter of saying what is in their head out loud to another person. Laying things out before you often helps you see the obvious path. Brief counselling may be useful for a number of problems that are similar to this in nature. The types of therapy that work best in these cases are Motivational Interviewing, Solution Focused Therapy and Cognitive Therapies can also be brief. A number of other modalities are adapting toward streamlining their style of delivery such as Brief Psychodynamic counselling which incorporates the old style of psychodynamic counselling with a more direct approach by keeping the counselling sessions to a minimum.

Brief counselling has a lot going for it. The cost involved being one. There is more and more research that points toward the harmfulness of over analysing life events and the benefits of looking forward rather than back through our hardships. It does make sense that too much delving into past trauma could end up being harmful. The shift toward looking at strengths that we developed overcoming past hardships and applying these to a solution focused future seems to be well intentioned.  The idea that we are re-traumatizing ourselves when we talk about our history has been the subject of few research papers. Particularly if the trauma is significant.  The Port Arthur tragedy found that people who had counselling recovered more slowly than those who didn't. This sparked research in Australia regarding how to approach trauma counselling.  We understand now that we cannot apply counselling methods that work well with clients generally to those who have suffered extreme trauma.   Trauma counselling is a very specialised field these days. Lessons learned here have been applied elsewhere. This is why often counsellors won't focus too much on past trauma rather focusing on how a person is coping day to day and giving strategies for management of life now.

Solution focused therapy is the most well known counselling modalities that uses brief therapy.  This type of therapy is strength based and focuses on clients resourcefulness, it tends to look toward clients natural coping skills that are healthy and build on these while diminishing the client's coping mechanisms that may not be healthy for example drinking excessively. The counsellor looks closely at aspects of the client's life that show their capabilities. Often people are not aware of their strengths or their positive attributes. Everyone has positives attributes and coping mechanisms that get them through life. It's the job of the solution focused counsellor to bring those to the attention of the client and build upon these strengths and healthy coping mechanisms. For example if a client uses smoking to calm their nerves. I might ask "what are the elements of smoking that calm your nerves" The client may say "I go outside, I take a cup of coffee with me, I sit by myself and I smoke my ciggy". There's a few positive aspects to these actions. The person in removing themselves from the stressful event, they are taking spending time in a peaceful location and they are self soothing. The only negative aspect to this scenario is that they are filling their lungs with carcinogens which will eventually kill them. The solution is to withdraw that one element. You can find out more about Solution Focused Therapy here.


Motivational Interviewing is also a type of brief therapy in which the negative aspects of an unwanted behaviour for example drug taking are looked at in equal proportions to the positive aspects. This is a collaborative form of counselling which is person focused. The aim of motivational interviewing is for the client themselves to name and identify alternatives to the negative behaviour by rationalising their action such as the above example of smoking. The Motivational Interviewer might allow the smoker to discuss all the good things about smoking and then all the bad things about smoking allow the client to weigh up the pros and cons and decide for themselves that filling their lungs with chemicals that will eventually kill you probably isn't such a great idea in the long run. This is a very powerful method of counselling as the client comes to the realisation themselves and is more likely to be motivated to change their behaviour. You can find out more about Motivational Interviewing here. This is another strength based counselling. I'm sure Carl Rogers would be very pleased with these therapy types as they come from the perspective that everyone is basically good and have the requirements to make their lives better.

If you are interested in getting some training in Motivational Interviewing or Solution Focused Therapy the links are below. The youtube lecture this week is very good I do hope that you listen to it. Next week I will be debunking the myth that to get counselling you must have a mental illness or a weakness.

Training

http://www.pacificcmc.com/online.html

http://www.briefsolutions.com.au/btis/training.html

Counsellors

http://www.counsellingathome.com/counsellors/

http://www.logancounsellingservices.com.au/

References

Corey, G. (2009). Theory and Practice of Counselling and Psychotherapy. Belmont CA: Brooks/Cole.

Fields, A. (2006). Resolving Patient Ambivalence: A Five Session Motivational Interviewing Intervention. BookSurge.

Gerald, D., & Gerald, K. (2001). Basic Personal Counselling. Frenchs Forest NSW: Pearson Education Australia.

Ratner, H., George, E., & Iveson, C. (2012). Solution Focused Brief Therapy 100 Key Points & Techniques. Taylor and Francis.