I expect some visitors to my site to be a little wary about CBT & therapy. Let’s be honest – you’ve visited this site because you want to make changes and you see real value from investing in yourself, and you feel really motivated to get on with it.
But… there is probably a nagging thought along the lines of what if it doesn’t work, and how that seeing a therapist could be an expensive mistake that will make you feel a bit silly.
I have many clients who come to see me who have seen a therapist before, with no success. I really empathise with people in that situation, and rather than deny that people sometimes don’t get a result, I will explain reasons why 90% of the time this happens, and how I address these issues.
This article is not to bad mouth individuals and other therapists, (there are some extremely good ones in Sussex) rather to explain what tends to go wrong and how I work to avoid this and what I think you need to be aware of, whoever you choose to see.
1. The Outcome Disregards Experience
This is the biggest stumbling block for my clients. I think the trend of “change everything overnight” thinking by therapists has come from the field of coaching and motivational speaking.
For example, let’s say I have a client who wants to become more confident and social around new people.
Now a traditional approach is to use therapy to let the client imagine feeling calm and confident around others and feel at ease – to remember and draw on calm and peaceful times and to remember themselves when they had previous experiences of being social and how they wish to be in future.
This might work for a few weeks, but there is something crucial missing from that – gaining experience. The outcome is based on a brief past experience and imagination, and no solid foundations. This isn’t really going to hold up if they go into a social situation and make a social blooper and feel bad about it afterwards. In this situation the change can unravel very fast after a big test.
A great deal of clients I work with who have social anxiety problems aren’t used to conversing and mixing around people outside of work, family and close friends.
Often they have felt uncomfortable and even avoided meeting new people so it will take experience to build up their social skills and work their way to greater social confidence and a larger social circle.
A more realistic approach could be to work on the fear that has been stopping them from taking the first steps and trying new things, and showing them how uncomfortable their present comfort zone really is.
This can pave the way to the client finding comfort when experiencing new social situations, expanding their comfort zone, building momentum and moving towards their bigger goals.
By working in smaller steps rather than taking a giant leap, then by it’s nature the work we do will be provable and self reinforcing. Remember – the first steps are important and they will get you to your goal. If you don’t learn to walk, you’ll never travel far.
2. Working Too Fast
Early in my training I noticed the “industry standard” of how therapy sessions should be run tended to be three sessions over three consecutive weeks before reaching a “guaranteed outcome”. We were told that CBT & brief therapy was supposed to be quick and this is what clients expected…
This then, and now seems absolutely nuts. Above all else clients expect a solution to their problem or steps taken towards resolving it and the underlying issues, not to fit conveniently to the therapists schedule. Could you imagine a surgeon or other health care professional behaving in such a manner?!
Working with a client effectively is not about dropping them into a new outcome, because as I mention above in point 1, that is going to deprive them of valuable experience they really need. You need a bit of time for your comfort zone to shift and for the changes to become your new, familiar reality.
This is why you may have heard people try therapy, say the changes worked well for two or three weeks and then it unravelled. They probably needed a session or two more over an extended period of time (i.e a month or two) in order to really cement the changes and ensure they stick.
Any therapy work should be about a therapist assisting their client and leading them into a new reality and new outcomes, and by doing this, giving the you the client something really valuable. It also means it might take a little time and I think most of you reading this would rather I work with you for as long as it takes, rather than abandon you and cut you loose too soon.
3. The Problem Not Being A CBT Or Brief Therapy Issue To Begin With
CBT can help deal with many personal problems, and when used effectively can produce profound changes. But for all it’s uses, sometimes it’s the wrong tool for the job.
In therapy there are two main ways of working with a client:
1. To offer help & support
2. To facilitate change
CBT practitioners & brief therapists fit in to point 2 – to facilitate clients and help them make changes. This is to change established behaviours, habits and thoughts which have been, and continue to be obstructive and problematic. For example anxiety disorders, jealousy issues, addictions and guilt.
Help and support issues, point 1, are dealt with by counsellors and psychotherapists. These are issues which are at crisis point and developing in the here and now. For example a recent bereavement, the days after a accident or recent personal trauma.
Before working as a CBT practitioner I trained and worked as a psychotherapist, helping and supporting young people and to this day I still see clients who I work with from a help and support perspective, and if required, move to change work when the client is ready.
Sometimes people do visit CBT practitioners and brief therapists when they need help and support, not change. I can’t comment on why they aren’t referred on, but sometimes the therapist continues when it’s not appropriate.
This is damaging for the client as they go through the ordeal of seeking help (and I know it takes huge courage for some to pick up the phone or send the e-mail and get in touch) and then make no progress, feel no better and often end up very embarrassed.
Even worse, they often feel that they are beyond help and stuck with their problem which makes seeking further help harder, if not impossible.
A good therapist will be able to tell within minutes of the first session beginning whether they are in the right place.
My personal way of dealing with this situation is to tell the client ASAP if I notice this is not an issue that CBT can help, and that I’m willing to work with them from a help and support perspective, or refer them to other people who can also help. I would never consider charging for my time if this were to happen and they wished to go elsewhere.
And it does work both ways – many people have gone to see a counsellor or psychotherapist and not gotten a result because their problem actually requires change, not help and support.
You don’t tend to hear about it as much as fewer people talk about going to see a counsellor or psychotherapist than seeing a CBT practitioner, but it does happen. Examples of this mix up can include anxiety problems, eating disorders and low self-esteem / issues around self-confidence and OCD.
I hope you have found this information useful, I’d be happy to hear any feedback you may have. Please feel free to contact me if you have any questions about this topic, or to find out more about how I help you with change and self-improvement.