Wednesday, December 16, 2015

What Is the Role of a Therapist?

     Why go to therapy? What do you hope to achieve? Why can't we just do therapy by ourselves? What function does the therapist serve? Why can't a person just talk themselves into a better state? Why can't they talk to their mother, friend, or a stranger and be in a better state? What about a real therapeutic encounter helps people? Again: What is the role of the therapist?
     To some degree, I see the therapist as a "nudger." In a perfect therapeutic situation, the therapist's job is to course correct with the client, identifying  negative behaviors, thoughts, and expressions with the client and discussing more positive behavior. Instead of giving advice, the clinician is tasked with taking information given, evaluating it with the client, and coming to a good conclusion as to its validity and place in the client's life.
     The therapist provides outside perspective. That is one of the main reasons to go to therapy. As such, a therapist must ensure that he or she is very unbiased. While we have previously thought that children are tabula rasa, in this case, it is the therapist who must shut off his or her previous actions and become a reflective surface, on which the client might see the person they are and make corrections needed.
     I think that I have said this before, but part of the significance of the therapeutic encounter is the setting in which it occurs. Just as the therapist must be ultimately objectively subjective, the space in which therapy finds itself should allow for minimal distractions or means for negative transference. Some decoration, or course, is needed, but not so much that the client thinks that he or she is impeding on someone else's territory. That said, I don't think it horrible for the clinician to provide some kind of backsplash on which a client might throw their personal dirt. That is having some objects in the room(s) that create conversation might push deeper understanding on both sides.
     A note that I would like to make is to say that therapists do not say what is correct and what is incorrect. That decision is fully on the client's shoulders. It is the clinician's role to help the client to figure out what is correct and incorrect of them. Of course there is an objective right and wrong and the hope is that a client's subjective right and wrong are similar. When the two are strikingly dissimilar, coordination between the two parties must occur, sometimes requiring a more directive or psychoeducational session on norms of right and wrong, consequences on actions, or a very MI-based discussion on ideas behind these thoughts.
     Were someone to say that a therapist is a guide, I would not wholly disagree with them, but rather ask them to qualify the parameters of the word. That is a therapist is a guide to a person's inner self, not a guide to the outside world. That latter work is the work of a skill-builder specialist. A therapist's bread and butter are a person's inner-most ideas, motivations, feelings, and thoughts. Frequently, a person's own self gets in the way of their path forward and it is the therapist's job to help a client to figure out the possible paths and then their choices. They are not a guide in that the therapist does not do much (if anything) for or to preempt the client.

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