Tag Archives: Psychotherapy

Psychotherapy and Psychology

Knowledge, Skills, and Abilities of Successful Psychotherapists

Grandeur Peak

I have borrowed the phrase “knowledge, skills, and abilities” from the human resources field. Here is a discussion of the attributes that set successful therapists apart:

Collaboration: Competent therapists see themselves as working alongside their patients; effective therapists do not see themselves as applying treatment to their patients. Successful therapists view the patients as equal human beings, worthy of full respect and dignity, who have been entrusted to their care. These concepts take in Carl Rogers’ principles of empathy and “unconditional positive regard.”

Genuineness: Successful therapists care only about their individual patients during the sessions and convey that caring to the patients. Outside the sessions, competent therapists think about their patients respectfully and consider it an honor to work with them. Competent therapists never discuss their patients with others in a disparaging manner even if their identity is not betrayed. Sadly, I have encountered a few therapists who have spoken of patients in terms of demeaning nicknames or made fun of supposed foibles. Fortunately, therapists do not have to be models of behavior to be successful, but they do have to care deeply about their patients and about the the therapy process both in and out of the sessions.

Ethical Principles: When asked what the first principle of ethical behavior is, most therapists immediately say, “Do no harm!”; Actually that is second. The first principle is informed consent. Successful therapists assure that patients know the potential consequences desirable or not, of all aspects of therapy before participating. Just as psychotherapy is a powerful force for getting unstuck, it has the potential for miring patients even deeper.

I sometimes encounter patients whose stated reason for therapy is to work through a problem with a difficult situation at their employment, say, an abusive supervisor. During the course of history taking I might discover some significant childhood maltreatment that is not particularly distressing for the patient now. The treatment for resolving that trauma will unleash considerable upset before resolution. Because the patient is not asking for assistance about the trauma and the trauma is not an important factor now, I will let it go. Possession of a tool is not sufficient reason to utilize it.

Personal Success in Accepting Transitions, Loss, and Death: In the prior post I stated the goal of therapy is to get people unstuck. The experiences which get us stuck are denying the reality of transitions, loss, and death. By clinging to the past we cannot move into the future. Because successful therapists have a history of getting unstuck, they are further down the road as able companions to their patients during their adventures. In the end successful therapists have confidence in the process of getting people unstuck and convey that confidence to their patients. Competent therapists are enthusiastic about helping, and they do not shrink from the process or the patients.

Recommended Books: Here are three books which I consider essential reading for any therapist or aspiring therapist.

  • Emotional Intelligence by Daniel Goleman.
  • Give and Take by Adam Grant.
  • In the Company of Women: Indirect Aggression among Women: Why We Hurt Each Other and How to Stop by Pat Heim, Susan A. Murphy, and Susan Golant.

I like these books so much that I have both hard and digital copies. I recommend these three titles and authors exactly as I have written them above. In my opinion authors with similar titles provide incomplete reflections of the brilliance of these books and may be capitalizing without adding value.

Ending Thoughts:

  • It is worth repeating that ultimately patients heal themselves. Therefore, the mission of a therapist is to facilitate progress.
  • Successful therapists come to the field already demonstrating requisite knowledge, skills, and abilities. Graduate school, internships, residencies, fellowships, lifelong continuing education, and most importantly patient success enhance the knowledge, skills, and abilities. Being a successful therapist is not a threshold where one rests on one’s laurels.

I invite your comments.

Warm regards,

Dr. Michael

(The featured image is Grandeur Peak as seen from Sugarhouse Park in Salt Lake City.)

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Psychotherapy and Psychology

Psychotherapy: An Introduction

Green Door at Tulloch Castle

What is psychotherapy?

Psychotherapy is the process of patient and therapist working together to get the patient unstuck. When I first saw patients 48 years ago, I realized that therapy was bigger than I was. That realization remains valid today. I have witnessed the power of therapy thousands of times.  I began providing therapy in my twenties and still lacked many relevant adult experiences as result of my having been cloistered in Catholic priesthood seminary and in graduate school. In spite of my inexperience, the patients achieved their goals and enhanced their lives by therapy. These patients were often older than I and were married with families. Many had lived through wars, on the home front or on the battlefield, and had weathered economic recessions and even the Great Depression. They struggled under clouds of despair, anxiety, memories of domestic terror as children, psychoses including schizophrenia and bipolar disorder, and substance use. And as a result of therapy, they discovered their paths forward; they became unstuck.

So, what is psychotherapy?

Providing psychotherapy is an art that requires a myriad of explicit and intuitive skills. Those skills are acquired through individual study, classroom training, providing therapy under close supervision, and listening to patients. The classroom training is intense during graduate school but must be continued yearly throughout one’s career. Looking back I think I was a “good enough” therapist early in my career, but my proficiency has continued to grow. In spite of all, I have occasionally encountered gaps in my knowledge and struggled to get back on track with certain patients.

What is the role of the patient?

Although I take pride in my work, the patients are the stars of therapy. They bravely flounder in a state of beneficial uncertainty for weeks, months, and even years. Here is the secret: Patients ultimately heal themselves. My job is to set up a healing environment. The courageous work on the part of patients account for my early “successes” in providing therapy as well as my current satisfaction in still practicing.

What are my allegories for patient-therapist cooperation?

I use a metaphor and a story to illustrate the therapy process to my patients. First the metaphor: Needing therapy is like being lost in the middle of a tropical island jungle. Safety requires reaching a beach. The therapist has been parachuted into the island at the patient’s location. Neither the therapist nor the patient knows the way out. Each has knowledge, skills, and abilities that complement the other’s. Working together, they find the beach. In the next post, I will elaborate on the knowledge, skills, and abilities of a competent therapist.

Another story that illustrates therapy is the 1976 episode, titled The Hunters, from the Michael Landon series, Little House of the Prairie. An old blind man played by Burl Ives and the 9-year-old Laura played by Melissa Gilbert find themselves in an isolated mountain range. The old man and the little girl have to find a doctor to save the grievously wounded Charles Ingalls, the victim of an accidental gunshot. The old man had not been off the mountain for 30 years. By teaming up, the old man with his keen sense of smell and hearing rekindling his memory and Laura with her agility and eyesight find their way to help.

When I tell these two allegories to patients, they listen grimly but don’t object. When I try to lighten the mood by giving the patient the choice of roles in the second scenario, I am always assigned the role of Laura.

What is the mission for future posts?

  • The next post will address the characteristics of effective therapists.
  • Subsequent posts will highlight posttraumatic stress disorder (PTSD), autism spectrum, happiness, cognitive behavioral therapy (CBT), mindfulness, and beyond.
  • I expect this blog to have two types of posts, those pertaining to psychotherapy and health and those pertaining to scientific psychology. Spoiler alert: Scientific psychology is a hard science and much more than psychotherapy.

What is my invitation?

I eagerly look forward to your comments, questions, and suggestions for further posts. Of course, I would be honored if you signed on as a follower.

Warm regards,

Dr. Michael

About the featured image: A gate at Tulloch Castle on the Scottish Highlands. (Photograph by the author)

 

 

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