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Case
Consultation for Therapists:
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In most other
fields of endeavor, (teaching, medicine, construction), people work
collaboratively. In private practice, it can be very helpful from time to
time to have a trusted colleague to think with you about the goals for the therapy,
the stuck points, and what may be getting in the way.
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Some of the ways
I have been helpful to people in the past include: how to read the content
of a session to understand how the client may be feeling, but not able to articulate. What is getting in the way in the relationship
between the two of you?
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I am highly
skilled at helping people who are struggling with an addiction to decide
what they need to do about it to move back into alignment with their own
personal integrity. Facing shame is often a huge obstacle for people in acknowledging
how powerful a dependency has become. Sometimes, people need to develop
parts of themselves that can contain the addict within, before they are actually able
to progress to the point where a cessation attempt can be sustained over
time. Generally,
people suffering from addictive behaviors are deceptive to others because
they are trying not to acknowledge the truth to themselves. Counselors walk
a narrow path between colluding with a client’s denial, by not asking about the problematic
substance use often enough, and, pushing too hard, forcing the client into a
shame spiral which can be detrimental to the therapy relationship. When people are
engaged in self-destructive behaviors, it can be difficult sometimes to just
be a container and let the client make the changes.
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Crisis
Management:
How to be there in a way that is truly helpful
to the client who is in crisis. What level of availability is required from
you? How to organize a support team, as needed, so that you don’t feel burdened by the responsibility we all carry for those
who are fragile and dependent on us in profound ways.
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Fees:
I usually charge therapists whatever your average hourly client fee is, for
the consultation. There are two ways to structure the interaction between
us: (1) talking about the case with you; (2) using process notes as a tool to
read unconscious content being provided by what is talked about and by your
reaction to the material.
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