Types of Therapy
Brief or long term?
Both are viable forms of therapy, and will likely be determined by client preference, economics, and the ease or intractability of the problem at hand. Sometimes psycho-education, or brief intervention is all that is needed or required. Brief or Solutions-oriented therapy focuses on the here and now and de-emphasizes the past. Primary focus tends to be on what triggers the unwanted behavior(s) and the obstacles to change. These days Therapists are still calling it brief therapy even if it takes 5 to 15 sessions. Longer forms of therapy are better adapted for people with more complicated problems, developmental issues, and personality or character disorders.
What are the most important things a therapist can provide?
Privacy, confidentiality, and most importantly the client must feel safe in order to talk about difficult hurtful, sometimes shameful subjects. The therapist must suspend judgment and attempt to hear from the client's perspective what they have been through. Rapport is not something a therapist can provide alone but is the end product of the client and the therapist being a comfortable match. This too, is very important, and if a client feels unsafe or uncomfortable with his/her therapist, they should seek to find one they do feel comfortable with.
Individual, Marital/Couple/Relationship or Family Therapy?
Most clients appear to pursue change or personal growth on an individual basis. Clients having relationship issues are mixed in terms of how they would like to proceed. I often start with a 4 session evaluation in which the couple are seen in the first and fourth sessions, and individually in the 2 and 3rd sessions. This system of evaluation provides ample time to evaluate the best path forward, and the viability of couples counseling. Sometimes, individual therapy is better indicated, for instance in the case of violence, addictions, or client preference. All forms of therapy will generalize and effect the couple, even if only one attends.
The Therapists tool box:
Essentially it is talk therapy. We sit across from one another and engage in the process of communication; talking and listening. I have borrowed and continue to borrow what works for my clients. This means that interventions from the Psychodynamic/Systemic/Cognitive/Solution Oriented, NLP, hypnotherapy, addictions world of treatment are all used. It is all about what works for the client. If the client prefers to work in one modality or another that is fine, but often the issues the client brings up determines the interventions utilized. For instance, if a client is having nightmares or dreams it might be useful to try to determine their meaning. Some clients prefer to work on their unconscious processes while others would prefer not to work with their eyes closed. I think what I am trying to convey is that the process and the choices will change depending on what the therapist thinks might help and the client's own preferences. It means that the work that is forged is often unique to the individual and to the process being engaged.
