I had another really good day at my internship! But I have so much writing to do and no time to do it! I've been sitting in multiple sessions every day this week, and I really feel like in each one I am learning more.
An aside - I have realized I have some issues with terminology when referring to people who use psychological services. In the NHS, the term "patient" is used, which I'm not particularly comfortable with. It's very sterile word, I think. In therapy, we all bring our stories to the room - and some stories are less tidy than others. It's not a sterile environment, it's often emotional, deep, messy and raw. But for the sake of trying to frame everything in the way people do here and assimilate to the language used, I've been trying to use that. The term "client," which is used at home, isn't really used here at all, except maybe by folks in private practice, which I really have not had too much exposure to. Some divisions of the mental health services, such as the Intensive Home Treatment Team use "service users." I don't really like that either. I previously had an internship where people were called "consumers," which I also feel is really impersonal. So I've been trying to say just "person," and that is a little bit awkward too...so sorry if my reflections on narrative seem disjointed...words are failing me.
I think last week I may have mentioned the one session I sat on with a person who was very sociable and loquacious. We had another appointment with her today, and like last time, it seemed like the therapist rarely got any words in. While she really has no one to talk to or confide in in her life, it seems like absolutely everything is spilled all at once during the hour. Because of that, the session ends up with us listening and the therapist briefly reacting in between verbalizations from the person, before the dialogue returns to a monologue. The person has said she always feels better after sharing everything, just getting it all out in the open. While this is perfectly fine and sometimes people need to vent, she is really eager to start learning new techniques (this is a CBT therapist's case), to address her negative automatic thoughts and hopefully challenge some of her core beliefs. However, it has been a few sessions like this now and it is not as productive use of time as it could be. We actually went a whole 30 minutes over in the session today (I have doubts whether that would happen in private practice)! I suggested to the therapist afterwards that maybe seeing if the person would be interested in journaling as a way to get her thoughts out in the open. Maybe have her journal throughout the week, and each night read the entry from the day before, to increase the processing of events, emotions, and her reactions. Maybe then, the sessions can become a little bit more focused, and the time spent with the therapist can be more focused on pulling apart specific thoughts, feelings, and reactions rather than just 90 minutes of narrative of everything that has happened over the week. The therapist really actually liked this idea, and that made me happy. I second guess myself a lot, and I often feel like I don't share my ideas out of fear they will be rejected or criticized. I am just a student after all, so I know that I cannot give "professional opinions." So I was pleased when my idea was taken well. It really is such a little thing, but it made me feel more confident anyway.
After this session, I really noticed how worn out I was from the fast-pace of the time spent with this person. It's been a great experience for me getting to sit on multiple sessions back to back because I notice my own reactions as well. There is so much to think about when in a session, including body posture, physical reactions, when it is ok to laugh with the client and when it can be damaging or facilitating a negative coping pattern, etc. etc. Even though I'm not facilitating the therapy myself, I try to think about what I would say and what I would ask. I'm learning the phrase "I wonder..." is my friend.
I wonder what tomorrow will bring!
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