Monday, April 20, 2015

In-Session Paperwork

     Therapists talk a lot about having an idea about where they should be going with therapy. We should know why we are questioning the client as we are. Random questions should not be discouraged, but should be minimized so as not to confuse the client (or ourselves, for that matter). To some degree, we want the client to see where we're going; we want the client to be able to understand the topic enough to foresee where the conversation is headed.
     Therapists need to be able to have their end idea in mind and ask questions in order to sustain, or to throw out, their hypothesis. 99% of the hypotheses will be incorrect and that's OK. Even incorrect hypotheses give one at least two pieces of information: 1) They allow a clinician to rule out that idea and 2) they allow more information to be gathered that could lead to the genesis of a new hypothesis. Of course, there are some phrases said by clients that require a specific response at that time, even if it is not a question or a statement that lends itself to the hypothesis.
     It can be easy for a clinician to become fixed on a certain hypothesis. This could happen in any number of ways, I suppose, but two come to mind at present. The first is that the clinician believes that their hypothesis is the only correct explanation for the behavior that exists. This means that whatever signals the client sends are discarded by the clinician and the client saying, "THAT'S NOT IT AT ALL!" might be seen only as denial. The second type of hypothesis fixation is when any outside comments are not taken into account and will not dissuade the clinician in finding out if this hypothesis is correct.
     A good note sheet could look something like this:

|     Client's Name                                                                                      Working Hypothesis         
|     Date                                                                                                     New Hypothesis                
| -------------------------------------------------------------------------------------------------------------------------
|     Topic:                                                                      Intervention:                                                  
|     Information:                                                                                                                                   

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