A word of warning to my friends: You might want to think twice before asking me to help move any heavy pieces of furniture.
We recently repainted our counseling office; and last Friday afternoon, I decided that a fresh coat of paint was all the inspiration I needed to rearrange my furniture. I wrapped up my therapy sessions and my insurance billing for the day and shuffled bookcases, leather chairs, and lamps around my 8×10 foot space. I recruited two of my co-workers to help with the piece de resistance: an oak-finished desk that looked and felt like it weighed over 200 pounds.
This is the part where my ego reared its ugly head. Not wanting to admit to my colleagues that I probably didn’t have enough upper body strength to lift the desk, I convinced myself (and them) that it would be much more efficient to scoot the desk across the carpet from one side of the room to the other.
You can probably guess what happened next. We had only made it a few inches before we heard the sickening sound of wood splintering and cracking. We looked under the desk and discovered a deep fracture that went all the way through the bottom left cabinet. We were eventually able to stabilize the desk and set it in its rightful place; but all I could think about for the next several days was how the desk would probably collapse during the middle of one of my therapy sessions, sending my unsuspecting clients (and me) into a full-fledged panic attack.
Resistance. Even after seven years as a child and family therapist, that word still puts a knot in my stomach every time I hear it. It’s not a term that was tossed around much in graduate school, when my classmates and I were fresh-faced, wide-eyed, and armed with dreams of saving the world. But it’s a reality that all of us who devote our careers and our lives to helping others will confront from time to time. Maybe it’s the addict who has been court-ordered to participate in therapy, the teenager whose parents are “forcing” him to talk with a counselor, or the child who is reluctant to process her past trauma. Knowing how to respond effectively to resistance can mean the difference between a positive treatment experience and the helping relationship being left more bruised and battered than the desk in my office.
Don’t be afraid to ask for feedback. There has been a push in recent years toward using outcome-based measures in therapy, particularly as government-funded programs such as Medicare and Medicaid and private insurance companies have become stricter about what treatment services they will and will not cover. I’ve had mixed results with using formal surveys during sessions but have found it helpful to spend the last 5 to 10 minutes of each session informally gathering feedback from clients. Did you feel heard and validated today? Did we cover everything that you wanted to talk about? Do you feel like we’re moving in the right direction? These simple questions often break down emotional walls in even the most resistant clients.
Know when to refer. Sometimes, for whatever reason, the therapeutic relationship just doesn’t “click.” Maybe the client is in a different phase of life than we are, and they question whether we can truly relate to them. Maybe they have been in treatment for months or even years and little progress has been made. Or maybe the issues they are seeking help for exceed the scope of our training and expertise. I firmly believe that, as mental health professionals, we should always be growing and challenging ourselves to become more skilled and better-rounded practitioners by taking on cases that fall outside our comfort zones. However, there are times when referring a client to another therapist is the most clinically appropriate – and most ethical – course of action.
Recognize that we’re all resistant. Therapy is hard. Change is hard, even for the most engaged and willing clients. I strive to make the counseling process as smooth as possible for the children and families I work with, but I also caution them at the beginning of treatment to expect some discomfort along the way. My role as a mental health professional is to challenge my clients to examine their attitudes and behaviors and to help them make changes when necessary. And for most of us, if we’re honest, the thought of making those kinds of changes is terrifying.
I’m not that much different than my clients. Whenever God nudges me to make changes in my career, in my relationships, or even in how I spend my time, I bare down, clench my fists, and dig in my heels. I know He has a plan for me and that His plan is better than anything I could ever imagine; but it’s hard giving up control over my future. I’m finding that the lessons He is teaching me today are the same ones He has been trying to teach me for years. Lessons in swallowing my pride, letting go of my fear, and trusting that He can redeem and restore even the most bruised, battered, and broken-down pieces of my life.
I am also learning that moving 200-pound furniture is probably not one of my spiritual gifts. And I think that lesson is going to stick for a while.