You would think a therapist would have all the answers about therapy. Sounds true, but it's not. The person who knows the most about the therapy is the person IN therapy. The client. You.

Yep. You. So you can ask me questions, and I can answer them. And I can pretend I know everything (I don't, but don't ever let my clients—or husband—or kids for that matter—EVER hear that !) but really, I believe that my clients know best about their therapy. With me. Or without me. Yes, YOU.

So I am going to answer the questions about therapy that came in to the LINKS office. But just know that if I am answering a question similar to one that you have and something I say doesn't feel right to you, trust yourself. You are probably right and I am probably wrong. Maybe not for everyone who is reading my answer, but wrong for you. Okay? That straightened out? Great. So, now I can start without being totally nervous that someone is gonna listen to me instead of to their own smart self. Because in case you don't know, even my kids think they are smarter than me. So if they can think that, so can you. Because you probably are smarter than me. Especially about stuff that is about YOU. YOU are smartest about YOU. And don't let anyone (not even me) tell you otherwise.

So one person write in to LINKs that nobody thinks she needs therapy. “My family tells me they think I am nutty for even considering it,” but she says that somehow, without knowing why, she feels she would benefit from therapy. That without knowing a specific reason for going, she really has a gut feeling that she should do it before getting married because it will make her a better person.

Hey, I like this girl! She listens to herself even if nobody else is!

If you think you need therapy, then even if you can't put your finger on the problem, you should definitely go for it. But! Within the first 3 sessions of therapy, you should be able to work out with your therapist what exactly you hope to accomplish in therapy, and what may be the reasons you think you need therapy to do that work. If a therapist cannot help you understand your motivations and reasons for going, then it may need to find a different therapist. If you problem is that it is hard for you to talk, and that is why you and your therapist can't figure it out, then that inability to talk is enough of a reason for you to understand why you feel therapy is necessary before getting married.

And then you have another girl who writes what a hoooorrrribbble experience she had as a teenager with the school guidance counselor who she saw for therapy not only in school but also in private practice. And she feels utterly betrayed by this counselor who blabbed her private stuff to members of the school faculty. So now, even though she wants to go to therapy, she's wondering how on earth she can ever trust a therapist again.

Oh man! This is an awful situation! So listen up about school therapists. And kids under 18. So you can not only decide if you want to see the school therapist, but how to protect yourself if you do from something like this happening.

School therapists work with a child, the parents, and other members of the school to help a child navigate her school years successfully. It's a team effort. The parents have signed permission for exactly this. So the school therapist is going to talk to teachers and other people on the faculty as part of this contract with the parents and principal. It's a little sticky. A little tricky.

I am sorry you feel betrayed, but it may be worth going back to that guidance counselor and getting some sort of explanation, some sort of closure. It may be she actually did a great job helping you through school. It can be she messed up. Or a combination of both. And she may explain. Or apologize.

But here is what you need to know now. If you are under 18, ask your therapist how she will protect your confidentiality BEFORE you tell her anything. If you are over 18, even if your parents are paying, she is legally not allowed to contact your parents and if she does, you can report her to her licensing board. So talk to her about this legality. If she is trustworthy she will give you the name and number of her licensing board. If she does not treat your concerns seriously, find someone else.

“I know I'm giving therapy ONE chance to work,” says another LINKS girl. “What are the ways I can figure out how to get it right on the FIRST try? Are there questions I should be asking the people who referred me? Questions I should be asking the therapist?”

What an excellent question! And the answer is: maybe you won't get it on the first try and so what? But of course you should be asking questions so at least you can give it your best shot.

I would tell you to first think about the stuff that's important to you. Does your therapist need to be young and cute? Single or married? Have an office really close to your house? Really far from your house? Ask yourself what matters in her frumkeit, personality, or looks. Can you afford to pay or is money always going to be a problem? Because if yes, then go to an agency where the therapist will be paid from your insurance and that takes away that stress. Very important!

Another girl asked what's the difference between a social worker and psychologist. There is a difference, in that their training focuses in slightly different things. But really, this training is not as important as the personality click that needs to happen. Therapists, whether social workers, psychologists, and other types of therapists who are similar but with different trainings (for example, nurse practitioners and mental health professionals) take additional training after completing their Masters Program. You may be want to know what these trainings are. How many years they are in practice. And very important—if they go for supervision. Therapists must always be learning more and be in supervision. So these are the types of questions you can find out. But all of this is worthless if there is no personality click. So don't get hung up on the idea that you are only giving this ONE chance. Therapy is like a shidduch. It would be a pretty dumb thing to say to your parents, “I am only giving marriage ONE chance. Choose the right boy or else I am NEVER getting married.”

I made you laugh. Good. Now go ask those questions!

“Does it make sense that since I started therapy I can't sleep and am feeling basically ten times MORE anxious?”

Oy vey. Yes. It does make sense. Because you are dealing with things you have been trying to ignore until now. Talk to your therapist about it. You need to figure out ways with her to help you manage this increase in anxiety. She can teach you all kinds of techniques to self-soothe. She can help you find resources and support systems to access. Make sure you share this with your therapist. Do not suffer needlessly.

And then one girl is kinda surprised that her therapist, who she is seeing for six weeks is recommending that she come twice a week instead of once. “One part of me thinks she's right, but the other half of my brain says she's just trying to make more money off of me,” she says. And she is curious to know when therapists want to see their clients more often than once a week.

Ouch.

Money is always a touchy subject in therapy. It's like, “How can you [the therapist] pretend to care about me when I have to pay you? If I don't pay you then you don't care about me anymore?”

I have not found a good way to help my clients navigate this confusion. That I can care about them and yet get paid for my time with them. It's like a teacher loves her students and yet gets paid to teach. Even though the boundaries during school, after school, and even years after a student leaves her teacher's classroom, are so much more flexible than the therapeutic ones. So it's not the best answer or comparison. And yet, despite this paradox, this seeming contradiction, both statements are usually true. A therapist [me] really cares about her client [you] even if she [me] gets paid for their time together.

So if you like your therapist, feel a connection and hope that therapy can help you, if you are comfortable with your choice of therapist, then I would encourage you to share your question with the therapist herself, including your suspicion that she wants to make more money off of you, and see what she says!

Because if she is sincere, she will engage in a conversation with you. And there may be issues of trust that you need to work out. She may need to explain. You two may need to explore. But if she gets on the defensive, your instincts about her may be accurate. And either she is human, or new at therapy, or simply wrong. Either work it through with her or find someone else...

And then there is termination. How to know when to end therapy, when it's time to move on to a new therapist. Because here is the last question: “I love my therapist's personality but I honestly don't see my relationship with my surviving parent changing (which is the issue I went to her for). I feel like leaving therapy—I've been there for a year. How do I tell my therapist I am done with her?”

Before moving away or on, it's always best to have an open conversation with your therapist. To discuss termination. And what you want to tell her is exactly what you said in your question. How much you like her but feel you have not accomplished your goal. And then the conversation may be exploration as to why your goal has not been accomplished. Things about you. Things about her. She may help you see ways in which you have reached parts of your goal. The two of you may decide to figure out ways in which therapy can be helpful. Or the two of you will agree it's time to move on. And she may be a good person to help you with a referral.

Therapy is about you; not about your therapist. So if she is someone who deserves your respect and love, then I trust she will act appropriately in your best interests. So don't feel uncomfortable or weird or scared to tell her the truth. She may even feel the same way and not as brave as you to let you know for fear of hurting you!

And if I am the therapist you guys have been writing about; you know, that one who is not helping you, or not sure if it's good or bad that I am a social worker instead of a psychologist, or who wants to see you twice a week because you think I am money hungry....ya know, just bring in this article and say, “Hey Mindy, we gotta talk.”

And I will say, “You go, Girl!”

 NOTE: THIS ARTICLE WAS ORIGINALLY PUBLISHED IN LINKS MAGAZINE, PUT OUT THE LINKS ORGANIZATION THAT OFFERS SUPPORTIVE PROGRAMS FOR CHILDREN AND TEENS WHOSE PARENTS HAVE DIED

 

 

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Check out my book THERAPY SHMERAPY,  available in bookstores and through Amazon

 

Browse through my previously published articles on my former blog Therapy Thinks and Thoughts at frumtherapist.com/profile/MindyBlumenfeldLCSW

Read current articles in my bi-weekly column THERAPY: A SNEAK PEEK INSIDE in Binah Magazine, available on newsstands every Monday.