Therapy

When Clients Have to Manage Their Therapists

Curt and Katie chat about the work (or mental load) therapists often give to clients that is really ours. We talk about requiring our clients to do things that are not helpful to treatment like: manage our time, do excessive paperwork, negotiate through our money stuff, be guinea pigs, or teach us about their culture or other differences. We also look at the impact of these abdications of responsibility on the therapeutic relationship and the clinical work.   

It’s time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age.

In this episode we talk about:

• When we give more work to clients (that isn’t really good therapy)
• The mental load or emotional labor that therapists can unwittingly add for clients
• Time management and the impact of poor practices on clients
• Being late, managing the shape of the session, scheduling
• The difference between being authentic and being irresponsible
• The care you show when managing rescheduling and the impact on the relationship
• What can come up, especially related to attachment wounds
• The problem when you consistently forget to get back to your clients
• Paperwork as a burden on clients, especially when clinicians don’t read the paperwork
• The message you give when you don’t follow up on a client’s homework
• When outcome measures feel like paperwork that is solely for the benefit of the therapist, rather than something that feels relevant to the client
• Feedback Informed Treatment (FIT) poorly implemented
• Delayed billing, not providing superbills timely
• Allowing a balance to accrue
• The power dynamic and power imbalance when clients owe therapists a sizable amount
• The labor we’re giving to our clients when don’t have structure on payment (sliding scale fees and payment plans)
• How our own money stuff might come into these conversations
• Adding new theories or trying new interventions on clients without a strong clinical rationale
• The danger to the client’s trust in the process if we throw new interventions in each week
• The mental load of asking our clients to teach about their own experience or navigating therapist bias
• Identifying a lack of fit or when treatment is over (rather than forcing our clients to do so)
• Own our humanness and set ourselves up for success
• Why this work sometimes gets handed to clients (rigidity, therapy culture)