If you could teach...

If you could teach the next generation of T’s one thing what would it be?

Mine would be the use of therapeutic touch.

The second one would me an office interior design to optimize outcomes class.

I'd give them tips on handling avoidant people like myself who constantly shut down. I can't imagine how frustrating it must be and I think they get to a point where they don't know what to do. I know what helps though, so I'd let them know

The touch was a nice idea. For me with long term T, it was the most healing thing in my entire life... but now without him, I miss it so much it's sickening so there's downfalls I suppose

What is outcomes class?

Some T’s just throw furniture in a room, make it look like an office and call it good.

My T has obviously spent a lot of time setting up his office intentionally to help clients feel safe, progress and achieve their outcomes. First session you can sit directly in front of him on a couch and his chair is centered facing the couch. There is a chair without arms facing the door if you feel trapped. There is another chair opposite where he sits at his desk (it is L shaped) if you need to put something between you and him. The pictures all have meaning. Where every piece of furniture is set has meaning. There are three books on his desk.. the only ones in the room and they are not about therapy per se. it is a good emotional working space, clear, clean, bright, welcoming. And T has thought out everything even down to how his office smells.

An old T was always between me and the door, all chairs were sideways to the door or back to the door. All chairs were recliners with wing backs. No couch. The office was dark and smelled slightly stale. There was a bookshelf loaded with books. Only one picture (her and her H). A basket of old toys... everything was dark, stale and dated. There were no places in the office that felt safe or relaxing.

So I would like to teach T’s how to set up an office that promotes healing in their clients.

But wouldn't that depend upon the client? I don't really notice much about their offices other than that I like them to stay very far away from me. Others seemingly want the therapist closer. I want a large piece of furniture between me and the therapist. Others don't. I would prefer a conference room with a lectern for the client rather than a sofa or chair. And definitely I prefer chairs over sofas. I never noticed their pictures, books etc. I don't think they had any but they might have - I really did not pay much attention to how they decorate. Apparently others care very much.
And so on.

I don't want to spend my time teaching a therapist anything. I think those people need to learn to explain what exactly is supposed to be happening. What are they doing at the client at all times and how is it supposed to help.

I think there’s much to be said for the office space. My current T’s office is an absolute freaking disaster which actually doesn’t bother me too much but I can see how it would bother other people. He used to rent an office space that was cold, echo’d, sterile. I hated going to that space and only went twice. His current office, while it looks like a tornado whipped through, is significantly warmer.

I also like the idea of healing touch. There is so much fear in the profession about touch - Ts are the first people who need to learn that not all touch is inappropriate or sexual. If they can’t model that, how are we, as traumatized adults, supposed to learn?!

I would also teach ts more about the therapeutic value of touch. I agree with stopdog that they should be straightforward in explaining what they are doing and why. My T has been pretty open when I ask her, but only WHEN I ask her. I also think they should be taught more about transference and attachment. Some Ts understand but many don't. They don't get how devastating it can be when we are extremely attached to them! They should also learn how to manage email and text better!

About trauma, which I think therapists are under-educated about, and especially the complicated dynamics that are part of the original experience and often have lasting remnants in interpersonal relationships. I think the most important part of being a therapist is being willing to listen to people's pain, no matter whether it is trauma with a capital T or anything else.

Exactly! One of the reasons I love my T is if you want to be far away there is a choice for that, furniture between you and T? He has that option, close to T he has that too... want T to your left or to your right? No problem. Want to be closer to the door than T no problem! Love him!
I have been to SO many T’s that make the office comfortable for THEM and don’t take their clients comfort into consideration.

I know you said one thing, but...

I would want them to stop developing stupid therapist voices. Talk like a normal person ffs.

Also, stop with all the lies about being superhuman in their ability to withhold judgement. They judge clients all the damn time and they're only marginally better at hiding it.

Related to the first point, also no more making weird faces at the client and doing manipulative/bizarre mirroring.

Those would be my preferences.

ETA: Also, their missteps should be referred to as "acting out."

@susannahsays I couldn’t stick to one either. And I totally agree with ditching the T voices!!

Big one:

-When a client finds the courage to confess strong feeling such as “ I think I love you”, it is never okay to reply in a way that references other clients I.e. “I care about all of my clients”. If you don’t feel comfortable replying equally, talk about the strengths of the person sitting in front of you. Keep the rest of your caseload out of the conversation.

Also:

-If you’re not experienced with trauma clients and cannot reference out a trauma client, learn to recognize traumatic responses and avoid shaming, blaming, expressing anger or judgment, or using the opportunity to try to label a client when they are in a triggered state. Someone in the room needs to stay balanced and in control.

-Never disbelieve a client’s self report about how much pain they are in. Sarcastic, condescending or mocking comments have no place in therapy.

Educate them about the emotional impact of poverty. Give them an experience of living in social housing. Give them the experience of budgeting food for one week on the money that they charge for one hour. Test them, Break them, Find something enduring called human integrity.