I've been thinking a lot recently about why therapy works (or doesn't) and what each individual's role is in therapy. I've also been thinking about how to ensure that individual knows what their role is and how to address the situation in the moment.
A good therapy session requires a good therapeutic relationship. This almost goes without saying, but I think that it continues to be a statement that must be reiterated from time to time for personal clarification. I don't want to go into this subject, as I have talked about it earlier. I do think that both sides have certain roles that need to be present and acted-out for the session to be called a success. Upon writing this, I am thinking that the last sentence was somewhat directive. I do not want to continue that thread, as all I am saying is that there are certain things to do and certain things not to do in therapy on both sides. I guess the first thing to say here is that each side has certain roles to fulfill that will increase the chances of a good therapeutic effect.
So what are these rules, roles, or obligations? I would like to start to talk about this topic on the side of the clinician, as that is where I am currently. What are the clinician's responsibilities? I ask the question because I am looking around me and seeing multiple avenues of practice. Some of these avenues are directive, others are not so directive. It is my view that a clinician is not necessarily a teacher. A clinician is more a guide. As such, a clinician is not present to instruct the client on what to do, but is rather there to help sift through all probably options with the client and create an atmosphere in which a client can come to their own conclusion as to their course of action. It is not the place of the clinician to add new knowledge to a client (normally), because I think that many clients already have an over-abundance of information, which can lead to their anxiety or depression.
It must be said that sometimes teaching must occur. Some clients do not have a set of skills or an understanding of their situation that is helpful. In this case, it is more the how of the teaching that is the key to the situation, rather than the why. Giving a client options is a very good way for them to learn positive skills. Better said: Giving a client a buffet of choices will lead to hearty discussion about the positives and negatives of each option, why the client chose a certain option, the evaluation of that option with the help of the clinician, and a creation of a plan to implement that skill, if desired.
The client gains much when a therapist does not choose their path for them. They learn the skill of decision-making and some self-confidence. Understand that a client will want to engage in a path/plan that they have created themselves. It means more to them (hopefully), thus making them adhere to it more than if it were created by the clinician. When a client creates some path, it is the therapist's job to help the client to ensure that the path is going to a positive place, that the end result is a therapeutic one. A path, being made out of stones or objects of some kind, should be examined by both members. Each stepping stone is another sub-goal or experience that must be processed by both members. It is the client's place to attempt to process; it is the clinician's place to encourage such processing and, if it deviates from a positive path, to attempt to correct it. The therapist does not exist to create and maintain this; such a thing is more in the realm of the client
Some clients do not know how therapy should work, so it must be the role of the clinician to guide them.