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FindingATherapist7TipsForTherapy

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Short guide for consumers looking for a therapist; also provides tips for clients who find themselves in a therapy that is not working

Short guide for consumers looking for a therapist; also provides tips for clients who find themselves in a therapy that is not working


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  • 1. Dr. Barry L. Duncan, Director_______________________________________________________________________ CDOI Training and Implementation of the Partners for Change Outcome Management System A GUIDE FOR SEEKING MENTAL HEALTH SERVICES If you decide to seek therapy, it should work for you and with you. For this to occur, however, you must be an informed consumer, and perhaps be a little skeptical of mental health services. First, rest assured that therapy works! In fact fifty years of research have unequivocally demonstrated that those in treatment are better off than 80 percent of the people in the no treatment comparison groups. So seeking a therapist to assist you in your efforts can be exactly what you need to inspire the changes you wish to make. But a key factor is finding a therapist that is a good fit—not all therapists are created equal nor are therapists approaches all a good enough match with your preferences or ideas or what is called your theory of change. Finding a Therapist The best way to start is to call prospective therapists and interview them by phone. It doesnt really matter what professional degree the person holds (social worker, counselor, psychologist, marital and family therapist) or whether he or she has a masters or a doctorate, unless of course you have a real preference or believe that such distinctions are important for you; it is much more critical that you find a person you can work with—who is good fit for you. Get the nuts and bolts questions regarding fees, insurance, and location out of the way with the receptionist or office manager, if there is one. Tell him or her that you are interviewing prospective therapists and would like to schedule a ten minute phone call with the therapist or counselor. An unwillingness to give you ten minutes to ensure a good fit should be all the information you need to cross this one off your list. Respect the therapists time and keep to the ten minutes. Ask these questions or others you think relevant. 1. What is your philosophy or orientation of therapy? 2. How do you think change happens? 3. What do you think of diagnoses? 4. How important do you consider collaboration and client participation? 5. How many sessions do you average per client? 6. Do you keep outcome data? Tell me about it. (If they dont monitor progress) Do you mind if I monitor my progress? How are you at taking feedback from clients about the direction of therapy? Listen for answers that reflect faith in client resources, strengths, and capabilities as the cornerstone of any change. Listen also for an emphasis on having a good relationship and the importance of your participation. Compare the answers with your own views of how change occurs. If the therapist identifies with a particular orientation, reflect about whether it fits your theory of change. If it is different but you still think it has some merit, try it out. Recall that change principally results from your input and participation-you are the star of the therapeutic drama. Research shows that:PO Box 6157, Jensen Beach., FL 34957; 772.204.2511; 561.239.3640; barrylduncan@comcast.net
  • 2. 21. Change depends on your resources and abilities. Effective therapy utilizes your strengths to createsolution possibilities.2. Change depends on your perceptions of the therapist and the relationship formed in therapy.Effective therapy is based on a strong alliance.3. Change depends upon addressing what you want, and fitting your views of change and inspiring thehope necessary for action. Effective therapy matches your theory of change. Seven Tips for TherapyThe way out is through the door. Why is it that no one will use this exit?Confucius1. If you dont like your therapist, then find another one.Don’t be shy. No therapist can be all things to all people. Trust your gut. If you get a bad feeling orvibe from your therapist, don’t waste your time trying to figure it out. Just go see someone else. Justslip out the back Jack, make a new plan Stan, no need to be coy Roy, just get yourself free!2. If you think that your therapist doesnt like you, understand you, or appreciateyour point of view, then find another therapist.It is essential that you believe that your therapist is on your side and that you don’t have to worry abouthis or her evaluation of you. If you are worried about it, then this likely is not the therapist for you.Discuss this problem with your therapist and carefully attend to his or her reaction. If he or shedoesn’t’ change, hit the road Jack! This is one of three key elements of the alliance. Problems hereusually result in no change.3. If you dont agree with the goals of the therapist, or do not think they are yourgoals, then find another therapist.If your therapist is telling you that you can’t get there from here, then you probably won’t. Stick toyour guns about your goals. Recall that your goals represent all your motivations and desires and willencourage you to work hard. Agreement on goals is the second aspect of a strong alliance, so if yourtherapist does not accept your preferred port of destination, abandon ship.4. If you do not agree with the opinions or suggestions of your therapist, or if youare asking for something and not getting it, and your feedback does not alter his orher approach, then find another therapist.If you want to give the therapist’s approach a shot, then do it. But if you don’t, tell your therapist thatyou disagree with the approach and give him/her a chance to adjust to your feedback. But leave if he orshe persists in an approach that does not seem relevant or does not fit for you. Agreement about theapproach represents the third piece of the alliance. Get off at the next stop before this train derails.5. If you think your therapist sees your problem or situation as hopeless orunchangeable, or that it will require years to change, then find another therapist.Nothing is permanent, especially problems, and besides who needs a pessimistic therapist? Hope iscritical to the change process. Without it, this plane is going down; parachute out before it crashes.
  • 3. 6. If you dont get something positive going within three to six sessions, talk to your therapist. If no progress persists, then find another therapist. Recall that change, if it is going to happen, usually happens relatively quickly. This doesn’t mean that you will be “cured” of all difficulties in 6 sessions, it only means that you will begin to notice some inroad to your concerns, and you will know that you are on the right track. Remember George Washington. Ironically, old George even requested the bloodletting to be done the third time—don’t make the same mistake when you have evidence (on the ORS) that you are not making any progress. Just hop on the bus, Gus. 7. If the therapist (or your doctor) recommends psychiatric medication and you have not asked for it, or have any doubt whatsoever, find another therapist (or doctor). If anyone tells you that you have a chemical imbalance, discuss what that really means. If you believe that medication is the right choice for you, then do it. Please keep in mind, that just like bloodletting in George Washington’s day, treatments today are just prevailing wisdoms of this day and time. They are driven by market pressures and economics. Drug companies spend far more money on advertising than on research and development, about $10,000 per physician per year. It is hard for any doctor to resist such a barrage of marketing—they just don’t have the time to research drug company claims about their products. Drugs are the prevailing wisdom of the day. If that fits for you, like it does for many, then go for it; if it doesn’t, please feel free to just say “no” to drugs. You don’t need to discuss much…just drop off keys Lee and get yourself free. The above excerpted from What’s Right With You by Barry DuncanPO Box 6157, Jensen Beach., FL 34957; 772.204.2511; 561.239.3640; barrylduncan@comcast.net
  • 4. 4About the Heart and Soul of Change ProjectThe Heart and Soul of Change Project (hereafter the Project) is a practice-driven, training and researchinitiative that focuses on what works in therapy, and more importantly, how to deliver it on the frontlines via client based outcome feedback, or what is called the Partners for Change OutcomeManagement System (PCOMS). The Project features an international community of providers of allstripes and flavors as well as researchers and professors, all dedicated to privileging consumers andimproving psychotherapy and substance abuse outcomes. Researchers at the Project conducted allthree RCTs that led to inclusion in SAMSHA’s National Registry of Evidence-based Programs andPractices. In addition to the RCTs addressing PCOMS and the benefits of consumer feedback,researchers and scholars at the Project have published 15 other recent studies and papers regardingimproving psychotherapy outcomes and the training of mental health and substance abuseprofessionals. The Project is distinguished by its commitment to ongoing research and dissemination tofront line practitioners.About the Director, Barry Duncan, Psy.D.Barry L. Duncan, Psy.D., is a therapist, trainer, and researcher with over 17,000 hours of clinicalexperience. Dr. Duncan has over one hundred publications, including fifteen books addressingsystematic client feedback, consumer rights and involvement, the power of relationship, and arisk/benefit analysis of psychotropic medications. His work regarding consumer rights and clientfeedback has been implemented across the US and in 20 countries including national implementationin couple and family centers in Norway. His latest books: the 2nd edition of the Heart and Soul ofChange (APA, 2010); and On Becoming a Better Therapist (APA, 2010). Because of his self helpbooks, he has appeared on "Oprah," "The View," and several other national TV programs.Barry co-developed the ORS/SRS family of measures and the Partners for Change OutcomeManagement System (PCOMS) to give clients the voice they deserve as well as provide clients,clinicians, administrators, and payers with feedback about the clients response to services, thusenabling more effective care tailored to client preferences. He is the developer of the clinical process ofusing the measures and PCOMS, first articulated in the first edition of Heroic Clients, Client Agencies(Duncan & Sparks, 2002). Barry implements PCOMS in small and large systems of care and conductsagency trainings, workshops, and keynote presentations on all of the topics listed above for bothprofessional and general audiences. Drawing upon his extensive clinical experience and passion for thework, Barrys trainings speak directly to the front line clinician. His presentations not only coverconsumer based outcome feedback or PCOMS—which improves outcomes more than anything sincethe beginning of psychotherapy—Barry also talks about what it means to be a therapist and how eachof us can re-remember and achieve our original aspirations to make a difference in the lives of thosewe serve. His trainings integrate the nuances of the work, our dependence on the resources of clients,and an appreciation of the hard work required for strong alliances across clients with the systematic useof outcome and alliance feedback. Video examples from a wide variety of clients demonstrate both theideas and practices of CDOI—and moreover show that Barry doesnt just talk the talk.