What we think makes an effective counselor may evolve over time, but in the end it is the willingness to evolve itself that offers the most reward and sustainability throughout our careers. As counselors, we know that our growth is equally as important as the growth of our clients. And although we receive countless contributions along the way from teachers, mentors and peers, the gifts we receive from our clients offer us the most reward and the best opportunity to progress as counselors.
Marcie, a young adult, started coming to therapy after developing debilitating anxiety that interfered with her ability to manage a new career as a dance instructor. Although she had worked hard and been on stage her entire life, she had begun to doubt herself after other dancers told her she did not deserve the coveted position. In addition to reviewing other sources of self-doubt during our counseling sessions, Marcie identified and practiced a set of beliefs that produced a very different emotional response for her. After several conversations, Marcie’s anxiety disappeared almost entirely as it became clear to her that she was indeed the best candidate for the job based on her experience. She repeatedly told herself, “I deserve to be here … no apologies.” Courage and support are powerful allies when it comes to growth.
My hope in creating The Hope Chest column for CT Online is to pass on valuable tokens that I have collected in my career as a counselor. I will present various case studies and highlight what I have found essential in my own evolution as a counselor. I hope to offer strategies that other counselors can easily integrate, while also sharing new ideas to help promote effective change for clients. We evolve by staying open to our own process and by tolerating the discomfort involved with self-doubt and risk. It is within this discomfort that we grow as counselors, craft our own therapeutic style and stand strongly in the belief that we have a right to be here. No apologies.
As counselors, we want our clients to feel safe, understood and loved for who they are, regardless of their mistakes, habits and blemishes. It is from that place we may even reveal some of our own humanness. We strive to understand each unique experience, and we support our clients’ progress by pointing out inherent strengths and resiliencies session after session. The relationships with our clients provide the rich soil that promotes growth, but once a strong foundation has been created, then what? What can we look for consistently when assessing whether treatment is effective?
Successful treatment lies in our ability to help clients identify and work toward their goals, while also learning the importance of awareness or intention as they move toward creating new habits. Effectiveness is also measured by our client’s ability to maintain flexibility and to tolerate painful feelings while moving toward beliefs and practices that create positive emotion. These therapeutic tasks, remembered through the acronym GIFT, can happen simultaneously and may indicate that treatment has been effective as well as when it may be nearing its end.
When I first met Jenny in her 60s, she was timid and small. She leaned heavily toward one side of the love seat in my office, as if something else was taking up all the space beside her. My sofa had never seemed large until that moment. In those first sessions, I listened to how Jenny’s experiences of growing up with an absent father and a mother who was severely mentally ill had affected her, how she had survived chronic abuse starting when she was still in utero and her mother had tried to terminate her pregnancy. Jenny provided most of the caretaking for her three younger siblings when she was still a young girl herself, and she endured years of psychological abuse.
Jenny described a childhood in which she had subsisted by vacillating between perfectionism and invisibility but never truly succeeding at either. She was never good enough to avoid an incident of harsh criticism, and she could never completely disappear. Her mother would always find her eventually. Although Jenny had long ago escaped her chaotic childhood she had lived her life grappling with the belief that she was deeply flawed, while also feeling continually disconnected from those around her.
Throughout treatment, Jenny’s goals became clearer, endlessly polished by her statement, “I want to live a life for me.” She said this a little more boldly each time. She also began to detach from the side of my couch as we discussed what it would be like to live a life for her, how she would feel when she reached her goals and what steps she would take to get there. She gradually grew into a solid presence as she talked about all the things she enjoyed, including daily walks, reading and taking the necessary steps to feed her love of learning by enrolling in classes at a nearby school. She scheduled additional trips throughout the year to see her adult children and was particularly excited about her gardening, saying she always felt happier with her fingers raking the dirt.
Jenny moved in a different direction while still believing she would be punished if she made her needs a priority. Although uncomfortable, she continued to take the necessary steps to change her reality, and she built emotional tolerance along the way. I talked repeatedly about how she deserved to have her needs met and her dreams realized, and I encouraged her to continue visualizing a life of self-love both in therapy and outside of it. As counselors, we may find ourselves repeating the same reassurances over and over, but it is through this repetition that we help to carve the new streambed that gives the water a different direction to flow over time.
As is the case with many of our clients, there were moments when Jenny would slip back into old habits, becoming activated and inflexible. For example, during our time together, one of Jenny’s good friends experienced a car accident that left her severely disabled. With great compassion for her friend, Jenny discussed how this incident had left her shaken, doubting her ability to change her course in life. It is at such tenuous moments that we remind our clients of their intention, the bigger picture and the importance of sticking to the path regardless of where they top out in the end. With Jenny, it involved reminding her that the purpose she had created for herself involved living a life for herself NOW — regardless of how much time she had left.
It is through these activating events that our clients may become rigid as they recoil from fresh pain. They may feel overwhelmed, helpless and alone. By bringing our clients back to their goals and intention, we have an opportunity to offer them a corrective experience. Without judgment, we help them regain both footing and perspective. We encourage our clients to cultivate flexibility by reminding them that challenges are an opportunity to integrate new beliefs and habits, to work through raw material and to return to the path regardless of the various twists and turns. We accept them through all of it by matching their pace rather than imposing our own.
Although many clients will report that their relationships outside of therapy have grown stronger, sometimes clients experience an increase in relationship discord instead. In Jenny’s case, growing relationship struggles were a sure sign that she was making progress — her husband struggled to catch up to the changes she was actively making. Although Jenny’s husband eventually started accepting her new independence and greater presence, this is not the case for some of our clients, and relationships end. The weeding process is an essential part of active growth. Change can be hard for our clients and for those around them.
Within the safety of the therapeutic relationship, our clients find the freedom to explore their goals, the changes they want to make and what it is that makes life worth living. If we have tended the soil properly, providing both nutrient and light, at some point we begin to sense expansion breaking through the surface. Our client’s ability to transcend doubt and fear depends on the environment we have provided for them to promote such growth.
When considering therapeutic effectiveness, we need to ask ourselves (and our clients) the following questions:
• Have we helped them create a clearer vision of what they want?
• Are they able to practice awareness and intention, focusing on the bigger picture through all of the inevitable distractions?
• Do they have the flexibility needed to stay the course regardless of unforeseen challenges?
• Can they tolerate the discomfort involved with exploring new terrain and the uneasiness involved with doing things differently?
Lasting change happens through the support of caring others. It is here that we can safely resist the urge to flee and where we learn to tolerate anxiety, staying present long enough to be acknowledged and to allow ourselves to feel loved.
I know therapy is beginning to wind down when I feel my own grief begin to emerge. I feel deeply for my clients, and I am sad when they leave. I do not hide this sadness but rather consider it another opportunity for my client (and perhaps me) to experience the richness of real connection and the unfiltered emotion that goes along with it. Upon one of our final visits, I noticed the dirt underneath Jenny’s fingernails and how she sat directly on the couch — fear was no longer taking up all the space beside her. We reflected on our time together, shared gratitude and discussed the connection we would always share.
Through our presence, we teach our clients that they deserve to have their needs met simply because they exist on this earth. When our clients tell us they want to change something, we point out that they will only bind themselves if they want greater happiness but do not actually believe they deserve it. We start with the deserving, tending soil and watching for signs that growth is happening throughout our weekly conversations. That is the true gift of therapy.
Kim Johancen-Walt is a licensed professional counselor with almost 20 years of experience. Her clinical experience includes working as a therapist for La Plata County Human Services, where she helped develop a treatment model for adolescents in Durango, Colorado. She has presented her clinical work at mental health conferences nationally, including the annual conferences for the International Society for the Study of Self-Injury. Additional clinical experience includes a position as assistant training director and senior counselor in the Counseling Department at Fort Lewis College, where Kim helped train and supervise graduate-level interns in addition to working with college students. She currently operates a full-time private practice in Durango. Contact her at firstname.lastname@example.org.