On Sunday, I will be attending the New Jersey Counseling Association’s (NJCA, the NJ chapter of the American Counseling Association) annual counseling conference. This will be the second year that I will have attended. Last year, I was struggling with finding post-graduate placements and attending the conference really helped. Just being around fellow counselors and seasoned counselors who were willing to share their experiences and struggles within the field made the conference that much more valuable. In listening to these nuggets of wisdom, I was reminded that therapy is really what we make it. We can utilize all the theories that we were taught in school – or that we read about for research or for continuing education credits – but the therapeutic relationship really is king in therapy. I have definitely learnt this lesson over and over while talking with my supervisors about various clients that I feel that I am struggling with but yet, the clients are consistent in attending the sessions. One supervisor pointed out that, sometimes as therapists, we think we know what will connect with a client and what will not, the reality is that we do not always know. We are there to be open with our clients and to try to add value in some way to those clients. The issue is that we do not initially always know what will connect with a particular client as opposed to another client. In his keynote address at the American Counseling Association (ACA) 2017 conference, Dr. Yalom drove this point home in his reflection on a previous case with a female client who had catatonia, the therapeutic bond, simply put, is quite powerful (Laurie Meyers, March 2017 article, Yalom urges ACA attendees to hold fast to self-care and the therapeutic alliance). In respecting this sacred relationship, I do not think that we can hide ourselves from this relationship and still be authentic, as we expect our clients to be. I am not stating that we have to share or overshare with our clients, but I think that the genuine-ness of our personality comes through in the way we interact with our clients, especially clients that we see often and over a long period of time. Dr. Yalom also addressed this as he noted that counselor vulnerability is something that he practices. The therapeutic relationship sets the tone for any further work to be done in the sessions. While, this is not an alternative tool, I believe that it is the most essential tool that exists in therapy.
Theoretical orientations usually provide suggestions on activities to engage in with clients. Since these activities are framed within these particular orientations, they are usually aimed at achieving results that under that approach would help the client move forward. Some activities may become so popular that they may be used outside of their originating approaches and be modified, an example is the empty chair technique. There are also activities that are generic and are just good practices and can help to build knowledge and skills, such as books and homework assignments. These are activities that can be used across clients and presenting issues. I have assigned books for reading to clients and various kinds of worksheets or activities to be done at home. Along this line, clients can be encouraged to visit workshops and conferences on the various issues that they may have. All of these activities can be discussed in the sessions and important themes can then be reinforced.
As counseling expands to be more multicultural, I think the activities and tools used should also reflect this change. For example, on the schedule this year for the NJCA conference is a 1.5 hour of yoga at 7:15 am. I was thrilled to see this, which is definitely a change from last year’s schedule. Many of the breakout sessions will discuss multicultural issues, minority groups, holistic treatments, and alternative tools that can be used to treat clients. I was especially impressed with the diverse lineup that was presented. As counselors, we have to be willing to consider alternative options to deal with the ever-changing populations we serve. For example, the internet provides a very good resource to obtain information on various issues. There are many therapists who provide various kinds of activities that can be used with clients in their treatments. I also use YouTube videos on various topics, Ted Talks, podcasts, and other online options. In addition, in working with younger clients and millennials who spend most of their time on social media, in some areas, we have to be willing to meet our clients where they are. This is especially true when working with younger clients who experience therapy in a different way than adults do. Another example is, when working on thoughts, behaviors, and consequences, I sometimes include things such as Newton’s law with older clients who can understand the principles. These maybe mathematics and physics principles but I think they are universal laws that govern our world. For example, Newton’s third law – for every action, there is an equal and opposite reaction. I remind clients that they need to monitor their behaviors and develop awareness on whether or not their behaviors are congruent with their words because behaviors have consequences, regardless of positive or negative. For every action you take, there will be a response to this, clients then must consider what reaction they hope to have to their behaviors. There are always consequences for what we say, for what we do, for how we carry ourselves, and for how we treat others and ourselves. This view on one’s life increases the internal locus of control so clients can begin to feel empowered and in control of their own lives.
There are many therapists who have expanded their services to utilize available resources such as the internet, search engine optimization (SEO), YouTube videos to provide services to a wider audiences. For example, Judy Belmont has a website that provides resources for both counselors and clients; Esther Perel has a YouTube channel that provides feedback to couples. There are also the options of workshops and conferences that clients and counselors may also utilize. If there are local events that clients can attend that can be beneficial to them, these activities should be utilized and processed within the sessions. Workshops and conferences can be very helpful with helping clients expand their environment and support systems. In addition, tools such as the Ted Talks and podcasts are ongoing services that clients can access for themselves on a variety of issues and can provide value to the clients after they’ve moved on from therapy.
In choosing alternative treatment options, clinicians have to be sure of the clinical values of the tools chosen. The clinical tools must add value to the clients. The uses of the tools must be able to either bring about change, elicit whatever emotion the clinician is hoping the client will connect to, or create some sort of realization for the client. The thought and emotion must connect to create change for the client. Hence, the importance of thoroughly processing the results of these tools in the therapeutic relationship.
As therapists, we know the importance of the connection between thoughts and emotions and behaviors and oftentimes, we have to help our clients stabilize this connection. I have realized that clients often devalue thoughts. I like to ask clients about how they talk to themselves and many times, they are their worst critics. I heard once – I don’t remember where from – that some of the things we tell ourselves, if someone ever spoke to us that way, we would want to cut ties with this person immediately. Yet, it is so interesting that we are then accepting of talking to ourselves in these maladaptive ways. I try to help my clients to see that thoughts have power. Our thoughts possess energy. It is then our choice in what kind of energy our thoughts have. If we engage in negative thoughts, then we send out negative energy and coupled with Newton’s third law, we will receive negative energy back and we will keep attracting back this negative energy in a vicious self-fulfilling prophecy because we then feel like we cannot achieve anything positive. I ask my clients to journal and write letters to help them reflect on how they see themselves and others. Oftentimes, once you get into a groove and write continuously, thoughts flow unfiltered and I find that clients are often surprised by some of the things they wrote. When we process the letters in our sessions, whatever tone the letter starts out in, is typically the tone it ends in. So, a letter filled with negative thoughts reflect that the client is still struggling with their relationship with their thoughts. I, then, work with them to help them gain control of their thoughts.
Thoughts are critical tools, like the therapeutic relationships, because they affect everything in our clients’ lives. Helping clients to regain control of their thoughts will help them regain control of their lives. Therapeutic work is essential in helping clients regain control of their lives. Also, other tools, such as yoga and meditation can help with mindfulness and awareness. In therapy, it is our job to use whatever tools we have available to aid our clients, as long as the tools can be therapeutic and add value to our clients’ lives.
Charmaine Perry is a counselor who works mostly with adults and couples in central New Jersey. Her passion is mental health and writing and finding ways to incorporate these two fields to advocate for mental health services for African and Caribbean Americans.