Do I have a plan?

As a therapist, I'm often asked 'do you have a plan?'

Do I know where the course of therapy will take us? The answer is simple, yes I do but it is entirely based on a few things:

• What the client tells me - the more honest and open a client is the more I have to work with, now understandably, some clients are coy and have reservations about divulging painful experiences after only meeting someone for a few hours, that is why before I even consider exploring main issues we have to create a bond and build rapport.
• The main issues that I deal with are sensitive and complex, for example, suicidal thoughts. To do this there must be a lot of care taken to ensure that I don't cause any more distress. This means a little gentle exploration to ensure that I have all the trauma identified and there are no surprises down the line.
• I ask the client to identify their goals and ambitions, thereby working to what the client wishes to achieve. Sometimes this can be a specific goal or in some cases that can be just wanting to feel better. Either is fine, but if the client wants to feel better then that gives me slightly more freedom to explore the issue.
• Then therapy begins and I use a wide range of techniques to help identify and resolve issues.
• The revelation is a bit when the client balances their resolution with their problems; this is a very positive experience that places things in perspective and gets life back on track.

Now, as you may have noticed there is no specific plan such as session 3 will achieve this. Some therapists do plan and that is good for them, however, I have never had a strict plan as due to the fact that a client may walk through my door with any issue, including one that has just happened. I, therefore, need my planning to be flexible and not suffocating, i.e. yes I know your dad has died a week ago but I would like to work on your phobia - imagine if anyone said that. Completely inappropriate not only bypassing the client and their feelings but also ignoring the grief that is clearly presenting.

Another feature of my planning is that it has to be unique and tailored to the individual meaning that it can be accessed by the client and subsequently makes it relevant to them. This means that if the client has a visual learning style then we can use more images and examples so they are processed effectively. Any concept needs to be presented well to allow processing to occur. This is crucial when we wish to reach that revelation point.

I hope this provides a small insight into the world of therapy preparation and give you an insight how I and perhaps other therapists operate.