As usual, things are going well. I have been fortunate enough to be able to sit in on a number of sessions with different therapists. It has been such a learning experience for me, witnessing how various therapists facilitate their sessions. The sessions I have watched have been formulated around Cognitive Behavior Therapy, Interpersonal Therapy, Cognitive Behavioral Analysis System of Psychotherapy, and Acceptance and Commitment Therapy, just to name a few of the models. It has been great because I am starting to understand the language used more depending on the theory, and have been gaining ideas of responses and techniques used in different situations. I really want to write more about how I have been conceptualizing the client stories, but I need to be careful of confidentiality.
Sometimes it is odd being in the room with clients who have been in therapy for a while, because they often feel that they have to include me in the session. Being foreign, they are curious what all I am doing here, how I am liking Scotland, and what all I have done and seen so far. That is fine (and natural, I suppose), but I wonder what influence that has. I'm not really in a "therapist" position, so it's not exactly a client-therapist relationship, but I feel like it should be maintained as such? My direct supervisor is on holiday now, but the therapists I have asked do not seemed to concerned about the clients including me in the sessions - everyone here is so friendly, I think it is just expected they are going to take interest in me.
Something else I have noticed is my personal reactions to sessions. I sat in on a few back to back last week, and I was absolutely exhausted afterwards. They were all very different cases. For example, the first person was extremely gregarious, and I think the therapist said VERY little during the sessions. However, the next person was referred due to wanting to work on communication difficulties. It is not a medical issue or anything, but rather an active choice to allow time to pass before responding. Thus, there was SO much time between everything that was said. We sat in silence most of the session, and it was so uncomfortable. Each time after a session, the therapist and I sit and talk about our reactions, and it often involves what we felt during it. This is often a reflection on what people in the "real world" feel as well, so it can be useful to understand.
My supervisor has been away on holiday this week, so I have been helping out the other therapists more - scoring their neuropsychological assessments and inventories, case notes, and accompanying them to their sessions. I have still been working on the research for the Dissociation Project as well as the Women's Trauma Group.
I have also started compiling a paper detailing the differences between the NHS and the USA's privatized system. My responses are that there are merits and drawbacks to both systems. However, through the NHS you're guaranteed to get some sort of treatment, regardless of what issues you are dealing with. The NHS is constrained by budget difficulties, so some of the newer or experimental medical treatments might not be available through the NHS yet. However, you will get what help they can provide using approved treatments. In the USA if you can afford it or your insurance will cover it, you can get the newer and experimental treatments. But the problem is, not everyone has that. I think in the USA you have more options too of your healthcare providers (as long as they are in your insurance scheme). Another major drawback I think to the NHS is there is often a long waiting list for issues that are not deemed accute. For example, the target waiting list time now for psychological therapies is 18 weeks. I was shocked when I heard this. But many of the people on the list are not considered here to need immediate attention, and patients who need to be seen sooner can be pushed towards the top. I think the idea in the States is, if you want to start therapy, you should be able to start right away before your motivation to diminishes. Mainly, I think there are aspects of each system that have their merits, and that really we should be looking at our differences and try to learn what we can from each other to strengthen our systems. The Obama Care plan is vastly different from the NHS, but ultimately I think we are moving towards a universal health care policy that will one day resemble the NHS. It would be a good idea to look to countries such as the UK, Australia, the Netherlands and Canada to help us tackle the growing pains we will face when moving towards this type of system. Hopefully I'll be able to work on it more in the next two weeks, before I leave Scotland to travel until the end of August. A month from today, I'll be back in the States. I can't believe it - and I don't think I want to!
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