The Counseling Process, Factors That Impede a Successful Outcome and How to Avoid Them.

As a professional in the field of mental wellness care, I wanted to write about the counseling process to enlighten those who are in counseling or considering counseling in the future. I have found over the years that there are many variables that impede the healing process. But the biggest variable impeding successful results lies in a lack of knowledge related to the process of therapy.

My goal in writing this article is to clarify the process and hopefully give those of you who are in therapy or considering therapy a better chance of being more successful in achieving a successful outcome.

Before I go into what therapy is, let me first describe to you what therapy is not.

• Therapy is not a doctor’s visit where you just call up the doctor to schedule an appointment when a problem arises.
• Therapy is not a quick fix. We will not slap on a bandage and send you on your way.
• Therapy is not limited to individuals with a clinically diagnosable disorder. Therapy is also for individuals who are symptom-free and looking for a better way of living their lives.

Therapy is a process! There are stages to resolving problems and treating symptoms.

The counseling process can be divided into four stages: Exploration, Discovery, Planning & Treatment, and Termination. However, the length of time spent on each stage is an individual experience.

Stage one – Exploration:

The first stage of counseling is not just about gathering information from the client to help them resolve their problems. The exploration stage is about fostering the counselor-client relationship. This is the most important stage of the counseling process. Research supports the importance of the relationship showing that the presence of an open, trusting and empathic, counselor-client relationship, along with mutually agreed upon goals, is the single most important factor in a successful counseling outcome.

Studies also show that only when the client believes there is hope for change and that the counselor truly understands and supports them are they ready to engage in the difficult task of deeper exploration and behavioral change. Building rapport could take several sessions but a client could decide in the first session if the connection will work or not.

Obviously, if the connection doesn’t work the process stops. If the connection works we then move on to the second stage, Discovery.

Stage 2 – Discovery:

I call this the discovery stage because in this stage we are going deeper, peeling back the onion to uncover more details that could possibly be contributing to the problem.

If a client is forthcoming during this stage there is a better chance that the problems and contributing factors can be identified relatively quickly. This is something to keep in mind especially if you are considering counseling for your child. Children are often guarded in therapy so the process could take a bit longer.

This stage is also where the counselor and client come to an understanding of the diagnosis of the problem that takes into account the client’s history, life circumstances and strengths and weaknesses.

The diagnosis is often based on behavioral observation, client reports symptoms, data gathered from others connected to the client and standardized test that focus on academics, career, or personality variables.

Once the information is gathered the next stage is to set goals for change.

Stage 3 – Setting Goals for Change

In this stage, the counselor and client work together to determine how to achieve the goals stated during the first two stages. While there are many tools, skills, and resources to use in achieving any stated goal, the counselor and the client have to consider the client’s abilities.

Working through this stage as with the first and second is an individual experience. The length of time to achieve a goal is based on the client’s motivation, ability, and dedication.

Once a client has resolved their problem and achieved their stated goal they can decide if they want to enter the last stage, termination or stay in therapy/counseling to resolve other issues or to maintain follow-up mental wellness care.

Stage 4 – Termination:

This is one stage that is often overlooked by clients. Termination is an opportunity for the client and counselor to discuss and review the process to ensure the client is satisfied with the outcome and has reached their desired level of functioning.

Following are some additional things that impede the therapeutic process.

Late Cancellations & No-Shows:

Therapy is a relationship between the counselor and the therapist. Like all relationships when one person in the relationship is not holding up their end of responsibilities the relationship suffers.

Just as clients expect their counselors to be trustworthy, empathic and available; counselors expect their clients to be considerate, and invested in their mental wellness care. Late cancellations and no-shows show a lack of consideration and respect for your counselor. Most counselors require a twenty-four-hour notice which is ample time to cancel an appointment.

Granted there will be times when you’ll need to cancel late. The issue of late cancellations and no-shows become a problem when it is habit forming.

Inconsistent follow-up sessions:

Your therapist will discuss with you the expected follow-up frequency; that is, once a week, bi-weekly, once a month. Whichever follow-up plan you agree on should be followed as closely as possible. Your follow-up coincides with your treatment plan and is intended to measure progress. If you are inconsistent with your follow-ups it will make tracking progress more difficult.

The dog ate my homework!

In my early years as a therapist, I remember my clinical director describing me as the type of therapist that comes with their sleeves rolled up, carrying a boatload of tools and resources for my client only to find that the client is only ready to take one tool from the pile and sometimes not even that.

Sometimes clients are not ready to do “homework” but what you need to know is therapy sessions are only 45 minutes long. This means for that until your next session you are on your own to follow through to work on the goals you and your therapist have set.

For some clients, this is not a problem. The bottom line, be upfront and honest. If you can’t do the work, talk with your therapist to find an alternative way to achieve your goal. Otherwise, you’ll come across as not being invested in your own mental wellness care.

Recap

Below are some tips to help foster a successful therapeutic experience.

• Start by creating a list of questions that you might have for your therapist and don’t be afraid to ask them. Your therapist is there to help you.
• Take along a pad and a pen to every appointment and use them! Take notes. Often in session, your therapist will give you little insights that may not have anything to do with your plan but can be helpful to you.
• Be proactive on creating your treatment plan. The more input you give about what you’re able to do the easier it will be to follow through with your plan.
• If you have an issue with anything your therapist is asking you to do, speak up. Remember you are a co-creator in this process.
• Show-up and be an active member in your life’s plan. It’s simple. If you are not following up with your mental wellness care nothing will get accomplished. When you stop, progress stops.
• Keep lines of communication open. Talk to your therapist about any problem you have with the process.
• Don’t expect a quick fix. Problems manifest overtime and it will take time to work through the process of not only resolving the problem(s) but to also learn new behaviors and ways of viewing things.
• See it through to the end. Often when clients are starting to feel better and they are close to reaching their goal(s) they will stop coming to therapy. As stated earlier by review the process to ensure the client is satisfied with the outcome and has reached their desired level of functioning.

Also there are times when a client is not happy with the counseling process and instead of speaking to their therapist regarding their concerns, they will just stop coming.

I hope this article has been enlightening for you and it helps to put into perspective what to expect whether you are in or considering counseling.

 If you are looking for a therapist who will be equally, if not more, invested in helping you to manage your mental wellness care, let’s talk! Call today for a compatibility assessment, (401) 944-0426.