Best Advice for a Therapist

When you think about what is the best advice you can be given as a therapist, what comes to your mind? Something non-specific like be patient? Or something extremely specific like a particular type of therapy? In this article, several therapists will tell you that it is somewhere in between, the best example being “treat every session as if it’s the last to make the most difference”.

Before you go deep into your thoughts I’ll tell you what most therapists/psychotherapists and psychologists see as their number one piece of advice. It is to imagine that your are seeing your client for the last time every time you see them, even if it is not the last time.

People working in this field explain that most of them and especially those with little experience often try their best to be careful to be gentle, kind and accommodating. Despite this being a positive, it causes a lot of them to stop striving to make progress with the client each session. This is why, to truly make a difference they have to strive to make progress every session as if this is the last.

Most didn’t think being bold and incisive could work alongside being careful and comforting to the client, but now that this fact has been revealed it is obvious how you can make a lot more progress with your client in a shorter period of time.

But this advice, despite being a cornerstone for most clinicians, is only about how to make progress. Next, we will talk about how to thrive in your work, to remind yourself that you are important, to initiate exploration in your sessions.

Work with clients you are comfortable with

“Most clinicians try and do it all and diversify their client base as much as they can, while ignoring who they actually can be comfortable with. The truth is you can only bring your best self to an environment where you are comfortable, so if you want to make a real difference you have to work with clients that you work best with, be it those who take the lead, or those who let you take the lead.”

– Ann Woo-Ming Park, M.D., Los Angeles metro area, CA

Remember that you are important

“The truth is, for a lot of people it isn’t a given to have someone to listen to them, so by just being there you make a transformative experience for them. This is because a lot of the time you are the first person they have ever told their true story. This is why you should not underestimate your work just because it might seem like you haven’t done much.”

– Lauren Dennelly, Ph.D., LCSW, Allentown, PA

Incite exploration

“Google exists and so our clients have already found all the information they could need a lot of the time. They already know what makes them feel good and bad. What they truly need most of the time is help with understanding why can’t they get out of the cycles they are in, be it addiction, negative self-image or the like. So instead of offering them information, give them an environment in which they can explore how they can change.”

– Emily Kline, Ph.D., Boston, MA

We need more than ideas

““The patient needs an experience, not an explanation” are the words sometimes attributed to a German psychiatrist Frieda Fromm-Reichmann that connect to our previous point. Clients don’t need information, ideas fall in the same boat, this is because people rarely change as a result of hearing ideas, they change with experience. In the scene of visiting a psychiatrist or the like they gain experience of feeling heard, seen, loved or witnessing their experience at a deeper level. This leads to them stretching past what’s comfortable and seeing more than they have before.”

– Russell Siler Jones, Th.D., LCMHCS, Asheville, NC

“Wow”

“Sometimes after being told something by a client, you just need to pause, a great way is to just say, “Wow”, it can work in any context, positive or negative. This lets the client have a minute to collect their thoughts and add more context if they feel the need to.”

– Diane Solomon, Ph.D., PMHNP-BC, CNM, Portland, OR

Learn to sit with the silence

“It makes sense that in therapy sessions silence is important, however, realising just how important it is, is hard. To make it easier we can compare it to fishing, silence in therapy is just as important if not more important than in fishing. This is because like in fishing if you make a lot of noise it will scare away the fish, in therapy, if you interrupt the silence, you won’t allow the thoughts and emotions of your client to come to the surface.”

– Yvonne Castañeda, LICSW, MSW, Arlington, MA

Learn to guide

“Leading and trying to “save” a client comes from a place of compassion, which even though admirable, isn’t helpful. This is because it takes the power away from the client and doesn’t let them learn to work through their own issues. It can also lead to burnout in the clinician which does not help the situation either. You should make sure you “don’t work harder than your client”, and instead you guide them in the direction they established. This helps the client to instead become more resilient and self-efficient in the face of challenges they face. The best way to describe the role of the therapist in the life of the client is as a lantern that lights up the path in front of them without imposing about where to go.”

– Carolyn Karoll, LCSW-C, CEDS-S, Baltimore, MD

Interruption can be a form of compassion

“In most cases interrupting a client is not the best idea, especially without a rationale. However there are cases in which interruption can play an important role of redirecting their attention. A good example of this is when a client is distressed and due to the racing thoughts, their speech also starts to race, making them feel a loss of control. At first the client might try to persevere through the interruption, but not long after they will realise that you are interjecting their uncontrolled venting and feel themselves regain their control, leaving them feeling much better as a result.”

– Levi Riven, Ph.D., C. Psych., Ottawa, Ontario

Sometimes there’s even room for humour

“Therapy isn’t just an action of receiving; it is a complex relationship between two people one of which is there as an expert who helps guide the other through their issues. Within this relationship there must be established trust and empathy which if you want to build you need several points of connection. One of which we will talk about is humour. Even though it is not often appropriate since therapy includes a lot of heavy and serious topics, sometimes, especially if initiated by the client, it can play an important role in reducing anxiety and creating an empathetic bond, the sharing of which will make the client feel less alone. As a therapist you still have to be mindful about where it is appropriate and where it is not since it can either add or take away from the therapeutic discourse.”

– Samuel Pauker, M.D., New York, NY

Therapy can’t do everything

“The truth is, therapy cannot do everything, every person is different in their own right and for some, therapy will be the most helpful while for others it will be solely medication, while some will need both to feel their best. This is why sometimes the best thing a clinician can do is to find a psychotropic medication that helps the client.”

– Clifford N. Lazarus, Ph.D., Skillman, NJ

Have trust in the process

“After remembering all the previous points, another thing that it is imperative that all clinicians understand is that you must trust the process. Since every person is different and is at a different stage in their life, they will progress differently, and the process will also look very different. It is normal to strive and feel pressured to “do something” but sometimes you just need to sit with the clients issues and pain to eventually have the path forward present itself.

“Another thing to add to this is that a lot of the time the elements that move forward the process are the information within the content rather than the content itself, this is important because to understand this and take a closer look you need to sit with it, only then will you be able to put the puzzles together to try and understand the whole situation and help guide them through it.”

– Noam Shpancer, Ph.D., Columbus, OH

Accept “Thank you”

“It is natural as a novice to feel as though if you accept the thanks you give, you are taking away from the work that the client put in to initiate their own progress. However, the truth is that it only causes uncomfortable moments for both you and the client.

“When the client is expressing gratitude, they don’t mean that they feel in your debt but rather they are showing that they cherished the authenticity, insight, care and guidance you demonstrated and accepted from them. They also use this to show you that your collaboration with them has been internalised and is healing them as a result. That is why instead of dismissing their gratitude you should accept it and say “You’re welcome”.

– Afshan Mohamedali, Ph.D., Oyster Bay, NY