The first stage in any therapeutic process is to assess need. I describe myself
as a counsellor and therapist.
The counselling is to address short term but immediate problems which are making
life unmanageable. Once these Presenting difficulties are taken care of, then therapy
can begin to deal with healing, and underlying problems. My experience is that what
is at first presented, very often is not the core problem.
To ensure that the client gets the best treatment, and the therapist the best chance
of helping, there needs to be a two part assessment.
The first (and ultimately the most important) is the therapeutic alliance. Client
and therapist need to talk and establish if a working relationship can be achieved.
If there is not an element of mutual trust there can be no good outcome.
Trust takes time but if either client or therapist are uncomfortable from the start,
it is unlikely that any meaningful work can take place. I place a great deal of
importance on empathy. To know that the person you are revealing very intimate details
about your life to, understands to some degree and is supportive.
The second part is to discuss the issues, both the presenting and underlying. Client
history is important at this stage.
If client and therapist are clear about where they are going, there will be a greatly
enhanced chance of success . A degree of education on the part of the therapist
to explain their theoretical approach will be needed. It is not good that a client
leave's more confused than when they started.
The therapist should be able to give a reasonable estimate of the timescale for treatment.
Patients will have heard of therapy going on for years not be the norm.
If then the client and therapist are in accord, work can begin.