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From: Ellen-Marie Silverman
Date: 02 Oct 2008
Time: 13:43:21 -0500
Remote Name: 64.12.117.67
A very useful question . . . Engaging the client as a collaborator in the therapy process to the maximum extent possible helps. From the very beginning, with that orientation in mind, discuss and negotiate the terms of treatment, which includes the criteria for termination, i.e., goals to be met and general requirements, such as attendance and payment of fees. Keep in mind and share with the client/caregivers that the conditions for a mutually agreeable conclusion are subject to change as new information becomes available, which then, too, become open to discussion and subject, as need be, to negotiation. >>>> As is known, skills and mind-sets introduced and practiced within treatment sessions and monitored situations elsewhere are not as strong, even at the conclusion of formal treatment, as older, competing habits of behaving and thinking, so there will be inevitable lapses. Discussions with clients prior to the conclusion of regularly scheduled sessions about what to expect when these sessions end need to include statements to the effect that lapses will occur, that reverting to older stronger behaviors and mind-sets will undoubtedly happen because the older behaviors and perceptions currently are stronger, and to recognize that all is part of learning, nothing more. When this happens what is needed is to resume applying the new behaviors and related mind-sets that lead to desired outcomes. There is no need for self-recrimination, although problem-solving as to why the lapse occured can be helpful but not necessary. What is necessary is to resume doing what is known to be helpful. That action, of itself, strengthens the desired behaviors and weakens the unwanted ones. >>> So much can be said in response to this basic question. I hope this has been helpful. Thank you for asking it. Ellen-Marie Silverman