An obvious way to try to improve client outcomes, used by many mental health professionals, is to invest more time and more money into more therapy models.
The therapist’s job is not to solve the family conflict, nor to take the moral high ground. Clients do not come to therapy for judgement or even moral guidance - they come for understanding, acknowledgement, help, transformation.
There are moments in therapy when you feel it in your gut: it’s time to be direct- even confrontational - with a Client. Your hands sweat. Your throat tightens. A quiet fear sets in. You dread these moments. And your mind isn’t always your ally: What if I damage the relationship?
A clinical pathway shows you how to keep your feet moving in the right direction, but the speed of your steps and where you pause are unique to each client.
Private practice is the ideal - bringing autonomy, flexibility, and the ability to shape your own professional journey. But, behind the freedom lies a challenge that creeps up on us and makes us question the choices we’ve made about how we work.
“Low self-esteem” is a very common phrase. We hear it said about children and adults. We use it personally and professionally. Therapists say it a lot, clients say it a lot, and the culture uses it as an explanation for all sorts of personal difficulties. But what does it really mean?
We all might admit that we have spent a lot of time pleasing others and trying to be better, or even perfect. But as you get older, you’re in a better place to give yourself permission to focus on you.
The only psychological place where you can shake off other people’s perspectives is when you’re totally grounded in YOUR perspective – that place where you just feel like you.
I never believed I would go to University. None of my 10 siblings, nor any family relation I had ever known had ever been there, so I had no reason to want to go.
There is a common misconception that talking comes naturally and psychological therapy is a rather straightforward process of adding interventions into otherwise naturally flowing dialogue between two people.
In therapy, one of the most profound moments is when a client begins to catch glimpses of a life that could be different. They don’t have a fully formed vision yet, and neither do we, as therapists, but something starts to shift.
Therapy is, fundamentally, a human service, person-to-person. There is a natural assumption, therefore, that both parties should be of equal value and importance, worthy of mutual respect. But that is far from the truth on both sides.
Some feelings are simply daunting. They can become overwhelming, and the moment they hit, however that happens, your life can get pulled off track. Feelings are powerful. They can put your life on hold or take it in a direction you don’t want.
Outcome data has many elements that make us feel uneasy and reticent. It can feel reductive or even mechanical, and we question if the numbers truly capture the deeply human process of our clinical interactions.
In Process-based Behaviour Therapy (PBBT), we have made the deliberate choice not to describe our clients as ill or sick. This is not a matter of political correctness. For us, it’s because calling someone “psychologically ill” is not only scientifically questionable, it’s deeply harmful.
