Saturday, July 18, 2009

The expert & novice client

Is it better to see a new client who has never been to counselling before or see someone who has been counselled before?


Initially with the novice client the out come is far more unpredictable. People go to counselling for a whole variety of reasons and thus one first assess which ego state has motivated the person to attend counselling. Is it a Parent reason or are they coming because the Child ego state is in pain and wants something different.


Its easier to work out the motives of

some clients than others


The person needs some ability and willingness for introspection. For instance some people enter counselling with a change others contract. “How can I make my husband love me”, is a change others contract and it can’t work because the husband is not there. The wife needs to be willing to look at herself and how she contributes to the presenting problem because she can do something about that. Thus she needs to be willing to be introspective. If they are not then the counselling probably will be short lived. It seems more likely that a person who has had counselling before will be willing to be introspective and thus will not leave after just one session.


The expert client will know what to expect at least to some degree and has a willingness to seek change of a psychological nature. This of course is a good thing but it can also be a bad thing. The client knows what to expect and will have played out in their mind what will happen in the session coming up. This is not a good thing and reduces the impact of the counselling.


Clients come in all shapes and sizes


As I have said before you need to keep the client on the left foot. If the session goes as the client expected then their Free Child is not being touched or shaken up. For more see this Video. The therapist needs to ‘touch’ the Free Child of the client at least once in every session. With the novice client this is easier to do because they don’t know what is going to happen.


At times I will ask an expert client after they have presented their contract, “What do you expect to happen now?”. At the end if a client reports that the session did not go as expected then that is a good sign. If it goes as expected they probably have done the therapy in Conforming Child which is by and large ineffectual.


Do it different


With the client discussed in the previous post she knew what clients are suppose to do and say because she had some considerable experience as a client before. This shows another problem for the experienced client where the therapy starts to become part of the problem. This is inevitable for the ongoing (expert) client and not for the novice client. If a client says something like, “And I think I suck at therapy, so it just confirms my feelings that I'm a loser”, the therapy is being used to support the feelings of not OKness.


As I said before this is inevitable and not a condemnation of the client. If I was a client I would be doing the same as well. With the expert client one needs to be doing therapy with them and making sure the therapy is not supporting the problem. Freud discovered this a hundred years ago and coined the term, “The transference neurosis” to describe it.


I had a client recently say to me, “I’m trying to work out why you gave me that homework”. To which I responded, “Stop trying to work why I am doing it and just do it”. I will tell him why next week. Unfortunately sometimes I have forgotten by then. He had been saying how he felt bad towards his ex-fiance who dumped him in bad circumstances. I told him to ring her up and just have a conversation with her. Not telling her off or expressing anger at her. Just a catch up call to find out what she had been doing in the last few years as she had played a major part of his life. He agreed to, so I will find out next week if he did.


Why?


Or I get bulimic clients to contract to throw up at least once this week. Or get clients who have panic attacks to have one in front of me right now. Or I get clients to do drive byes of those who have spurned their affections in the past. I don’t do this to be unexpected but to disempower the problem being presented but they are also contracts that the client is not usually expecting. This is more necessary for the expert than novice client. The problem is, the unexpected then becomes expected. But that is another post and I can’t let all my trade secrets out of the bag.


With experienced clients one can sometimes get the comment, “You are so much better than my previous therapist”. That immediately gets the alarm bells ringing because (yes you guessed it) how long will it be until they are saying that about me to their next therapist. Also, of course one never besmirches a previous therapist or therapy with a client. That is a most unwise thing to introduce into the therapeutic relationship.


However by far the main advantage that the expert client has over the novice client is the relational. As we know the main factor in psychological change comes from the relationship the client has with the therapist. The novice client obviously can’t benefit from this whereas the expert client can.


Graffiti

38 comments:

  1. Perhaps if you want a client who has panic attacks to have one in front of you, then you should find out what their trauma is and then deliberately do something reminiscent of it to trigger their panic. Brace yourself, though. A hapless therapist could meet a demon that way.

    :-)

    ReplyDelete
  2. Hi Anon,

    I never know what those things mean. Can you tell me what this means,
    :-)

    I couldn't do what you suggest to a client anon as that would be retraumatizing them. but as we both know anon, panic attacks are grossly over rated.

    And as we both know who you are anon why don't you just state your identity? Or are you a bit of a demon but as you know anon I like meeting demons.

    Graffiti

    ReplyDelete
  3. Oops! This was suppose to go with this post.

    1] :-) Kind of looks like a smile to me - Eyes, nose and smiley mouth. *Shrugs* Maybe?

    2] “You are so much better than my previous therapist”...
    "you are so much better than my last boyfriend"
    "you are so much better than my last piano teacher"
    "you are so much better than my last best friend"
    "you are so much better than my last foster mother" - Yep.

    3] “Stop trying to work why I am doing it and just do it”.
    I can't seem to talk to the dark person. Really - i can't talk to it kind of in the same way that i can't remember my dreams.

    I would much prefer to practice telekinesis or make an energy ball. I can't do either of them but its easier to put the time and effort into it.

    Yeah... i know...

    4] "As we know the main factor in psychological change comes from the relationship the client has with the therapist."

    I can't see why.
    Well...
    Why a novice won't benefit from the relationship where a trained client will.
    Why?

    ReplyDelete
  4. "Permissions" are a great detachment tool for disrupting the neurosis Grafitti. Therapeutic too.
    kenoath

    ReplyDelete
  5. Good point Kenoath,
    nothing better than a disrupted neurosis

    Graffiti

    ReplyDelete
  6. Some times you are just a bit too cryptic for me Roses, Maybe you do cryptic crossword puzzles,

    But I can respond to point 4.
    It takes time for the therapeutic relationship to develop and thus by the time it has the person is no longer a novice client but an expert client

    Graffiti

    ReplyDelete
  7. fish and chips are better than a disrupted neurosis Grafitti

    k

    ReplyDelete
  8. Tony,
    Yeah... I assume lots most of the time. AND, I don't do cross word puzzles.

    1] But - you can't see the smiley face? Never mind.

    2] I'm glad you said that. It rang bells that called a heap of stuff i've heard before and it was good advice to not say much when such a statement is spoken. Also, i realise the next person down the line is going to hear the same thing about me - yep, makes a lot of sense and great advice!

    3] And I’ve not had any results from trying to do the 2 chair thing with the dark person in my childhood dream.

    4] Oh thank you. That makes sense now. Q? How long does it take to become an expert or trained client?

    ReplyDelete
  9. they are indeed Kenoath
    I might have them for dinner tonite

    ReplyDelete
  10. I don't know how long it takes to become an expert client Roses.
    Zyloga and Harriet seem to know.

    be the dark person Roses and feel what it is like to be it

    ReplyDelete
  11. I don't think you understand, but i will genuinely give it a go none-the-less.

    ReplyDelete
  12. I have clients as young as 12 who are expert clients. Some say they will blame me rather than accept their plight. Pretty smart!

    kenoath

    ReplyDelete
  13. Good on you Roses, to give it a go and look into the dark person inside you. I hope you tell me about it when you have felt it and learnt some about it.

    Draw a picture of it (I know you are good at drawing). Give it a name what age and sex is it assuming you draw a person

    Stay well Roses

    Tony

    ReplyDelete
  14. Yes I know some of the young clients you have kenoath and they do seem smart!! And you seem to handle then well indeed

    Graffiti

    ReplyDelete
  15. I reckon I did most of my therapy in conforming child. I guess I am good at conforming.
    Well in certain situations.

    I wish I had more free child. But nice free child. Not depressed free child.

    ReplyDelete
  16. I have always been warmed by your free child Kahless.

    kenoath

    ReplyDelete
  17. Some times I feel that with you kahless,

    I wish you a little bit of FC, but as I say that I also agree with Kenoath that I know I have had enjoyable exchanges with you. Warmed by your FC as he says.

    Maybe it is more about the FC discarding those pictures from the walls of your childhood home

    Tony

    ReplyDelete
  18. I don't know how long it takes to become an expert client. Some people are quicker learners. Some put up fewer barriers.

    My therapist would say I'm a great client - I always show up on time, I only cancel if I'm going on vacation, I pay the day I get the bill, my checks never bounce. It's just the therapy part I have trouble with. I'll never be an expert client, no matter how much time I'm given. Maybe because my therapist is supporting my problem? Hmmmm......it's nice to be able to blame someone else, maybe I'm not a loser?

    ReplyDelete
  19. Thank you Tony. Geez your a suck up! I'm not a good drawer - i just have nice memories of drawing. But i'll hold you to that pineapple juice and Tim Tam picnic though!

    Perhaps...

    I don't know how someone else feels. How can i know what the dark person feels? How can anyone know what someone else is thinking? I will attempt to imagine what the dark person is feeling and thinking but i won't KNOW the thoughts and feelings - it will all be imagined. Does that help you to understand what i mean?

    Whatever...

    Harriet, thanks for that last comment.

    ReplyDelete
  20. Well I cetainly don't think you are a loser Harriet and I think you make a good point that some people become expert clients faster than others. Seems reasonable.

    Not too sure what you mean by saying its just the therapy part you have trouble with. If you have established a workable relationship with the therapist then that seems like a significant part of the therapy that you have successully mastered?

    regards

    Graffiti

    ReplyDelete
  21. Roses, Knowing how to suck up to people is one of the first skills a therapist has to learn.

    I know you can do it Roses, you area good drawer, so just let your Free Child go and draw the dark person.

    Tony

    ReplyDelete
  22. Oh no! I have to learn to suck up? I have to learn that FIRST!? ...
    ...
    ...
    ...
    ...
    ...
    Ok.
    Yeah...
    I think i can do that.

    I'll draw the dark person... and give it a name... i don't know about the age and sex though.

    I have to learn to suck up. Maybe i'll practice on the dark person.

    ReplyDelete
  23. Thank-you very much Kenoath. That was a really nice thing to read when I woke up this morning and checked my mail.

    ReplyDelete
  24. Cheers too Tony.
    I am not sure I understand your last para though? Could you please explain as I want to understand.
    And its a shame I have only got the one about my conforming child now after I quit therapy.
    Maybe I will write a post tonight on my FC.

    ReplyDelete
  25. Oh and when is FC not RC?

    Cos I am sitting here right now and I have this strong urge to get some gum and stick it to the wall. That would be fun. But I have never done that. Would that not be bad RC rather than cheeky FC?

    ReplyDelete
  26. Kahless,
    Every time i've done the gum - wall thing, it just comes right off. A bit like bluetac. Give it a go, yours might stick really well. I don't know what to do if it sticks. I think - like under the desk at school, it just kind of sets hard and eventually it just chips off. I wonder if that pulls the paint off the walls when that happens? *Shrugs*

    I have no idea why i'm raving again. Have fun with the gum!

    ReplyDelete
  27. Tony?
    If I used the adjective “powerful person” when talking about someone – like, just in passing or something like that – what would you immediately think about the person I’d been describing?

    No… hang on…

    When someone says the words “powerful person” what comes into your mind. Are you able to define a “powerful person” in your point of view? If not then, just generally – how could one define a “powerful person”?

    ReplyDelete
  28. Hi Kahless,
    the last paragraph relates to those photos you showed me.

    yes do write a post on your FC. Theoretically Kahless, FC and RC are quite distinct. RC is a reaction to some percieved authority. The person is motivated to act because of what some authority said or will do in reaction to.

    FC is not that and is not any kind of reaction to some thing external to the person. The motivation to act comes from within because one is hungry, thirsty or hasn't had it for a while. So in this sense it is far more of a self involved part of the personality.

    In reality the theroy may not be as clear. For example people can be in two ego states at the one time or people can shift at times very quickly between ego states. So one may be in RC and then very quickly shift to FC and back again and so forth

    Cheers

    Tony

    ReplyDelete
  29. Just like a person can shift from being a Victim in life and then to Persecutor Tony.

    kenoath

    ReplyDelete
  30. Yes kenaoth

    that is a good example as well

    Graffiti

    ReplyDelete
  31. My definition of powerful person = Roses when she is in Grrrrrlll mode!

    Tony

    ReplyDelete
  32. 'Because one is hungry...'
    YES Tony. Thank-you for bringing it to life for me.
    YES, I have a hunger. A deep unsatiated hunger.
    I will post tonight probably.
    I will describe my hunger and ignore all the oher voices.
    (((Hugs)))

    ReplyDelete
  33. that sounds good kahless.

    I look forward to reading it

    (((((( Tony)))))

    ReplyDelete
  34. Tony!

    We slept in our new/old renovated house last night! It was wonderful even though i didn't sleep very well. So exciting!

    Going away for a few weeks soon. You'll enjoy the peace - as will I.

    Cheers... roses

    ReplyDelete
  35. The picture of Mr Soprano at the therapists office is a good one Tony. Do you think his therapy was portrayed to help him? I think in some ways therapy did help but his character never really swayed.

    kenoath

    ReplyDelete
  36. Kahless,
    I don't know about anyone else, but i read it - your post that is. She's a beaut!

    Gosh, Port Macquarie is such a lovely place and the apartment we have is so beautiful we've booked it for another 5 days (7 days in total). I'm actually hoping that we get to stay here for another week, but i think that's pushing it. Perhaps we may need to travel for the other 2 weeks *Shrugs*.

    I guess at least while we're traveling i can get a heap of reading done.

    Happy week everyone!

    PS, sorry about the broken 'peace'. I just can't seem to help myself also - instead of asking for 'leave' from the uni studies i've taken on 2 more subjects so i have to have access to a computer internet termimal some how. There's one here in the lobby. So nice.

    Cheers... roses

    ReplyDelete