Let’s bring out into the open something that might be a bit uncomfortable and awkward, but that we all know is going on: beginning the instant that you contact a therapist, that person is assessing you. It’s this fact, that I think often stops people from going to therapy to begin with. There are fine lines between assessment, assumption, and judgement and you don’t know this person yet! It’s normal to feel a bit vulnerable and the idea of being assessed carries a negative connotation that can be uncomfortable. But remember, we are all to some degree assessing one another all the time. As humans, this keeps us safe and able to relate to one another. A therapist’s assessment actually might be safest of all: from a therapeutic perspective, assessment should be objective, non-judgmental and function to lead the therapist to determine which interventions will be most likely to help.

Sometimes people welcome a therapist’s assessment and want to know right away, am I going to be ok, can you help me? But from your perspective, at any time you may be thinking, what does this therapist really think of me? Like any relationship, therapy does require taking a leap of faith. You may feel safer however, knowing that most therapists come from a strengths-based approach. This means that they are most interested in assessing your strengths, to help you build on these strengths and employ them towards solving any problems or working through any issues that are bringing you to therapy.

Trusting this process helps, but at the same time it is essential to reflect on your experience and make your own assessment of how it works- or doesn’t work- for you. Sharing your own honest assessment of this with your therapist, especially when it’s difficult to do so! actually presents a huge opportunity for growth – what you are there for.

Not who you are, but where you are at

Is growth what you are there for? What are your goals? It’s ok if you don’t know yet. A skilled therapist will be less interested in who you are and more interested in where you are at, from one moment to the next. To a large extent, where you are at will determine the make-up of the client-therapist relationship. It’s the therapist’s assessment of this ever-changing relationship that should weigh heavily in determining which interventions they employ. Largely the client-therapist relationship determines how quickly and effectively one works towards meaningful change.

How can we create a highly productive and helpful client-therapist relationship? What type of relationship do you have with your therapist or what type of relationship would you like to build with a therapist? A competent therapist can usually facilitate this, but learning about and reflecting on client-therapist relationships can provide you with insight that may help you set and progress towards your goals more quickly. I’ll give you the inside scoop.

More than guess work 

Solution-focused brief therapy (SFBT) is an evidence-based therapeutic intervention that is widely considered to be an essential component of a therapist’s toolbox of basic skills. It was developed by Insoo Kim Berg, possibly the most influential psychotherapist of our time and her husband Steve De Shazer. The therapist’s intent in SFBT is to help a client to identify and work towards their own goals, that when reached will improve their life. The therapist hopes to assist the client to uncover, enhance, and employ their already present strengths to reach these goals. The quality of the client-therapist relationship is a key component in establishing and determining progress in these regards and one that both client and therapist can actively influence.

In order to build an understanding that can help one influence this relationship in a helpful way, let’s examine these relationships further. The client-therapist relationship, like any relationship, is dynamic, unique, and constantly changing. While categorizing relationships can be tricky, sometimes not possible, and should be done with great care, it can be useful to understand 3 common categories of client-therapist relationships posited by SFBT: visitor, complainant, or consumer.

1. Visitor: In this type of client-therapist relationship, the client is able to identify a problem or problems, but they do not yet see a possibility of change. Here, no progress is made toward setting goals. Commonly, but not always one may be coming to therapy only because someone else wants them to. They may have been given an ultimatum or they may be trying to please someone else. Perhaps they are coming of their own volition, but are feeling hopeless and/or helpless. There may be any number of factors contributing to this type of relationship, but what we know for sure is that this person is struggling and usually suffering. Without the right intervention(s), they run the risk of using therapy to perfect some neurosis instead of getting help. Essential point: they are stuck.

2. Complainant: In this type of relationship, the client is coming from a perspective where they see something(s) as painful or troubling and can describe it (or them) very well. They are in the beginning stages of seeing that they themselves need to take concrete steps towards change, but they are not yet committed to doing so. This person is in a place where they need encouragement to keep thinking it through to find their way to their next step.

3. Consumer: In this type of client-therapist relationship, the client is ready and able to set goals. They see that a solution to their problem(s), regardless of the source(s), requires them to take action and they are ready to do so. This type of client-therapist relationship facilitates change. Building and maintaining a consumer relationship is thus central to therapy working well. After all, nothing changes if nothing changes!

What next?

What can you do to help build a relationship with your therapist that is that of a consumer? Perhaps start by asking them! If you are not already building this type of relationship, no need to worry. In fact, in my experience as a therapist most client-therapist relationships do not start out as that of consumer. Furthermore, we all enter relationships of complainant and visitor now and then.

A skilled therapist understands that there are reasons that client-therapist relationships develop as they do. A professor of mine in graduate school said something that enlightened me and helped me move past judgment: there are always reasons for reasons. If you are struggling with self-judgement, it should be helpful to discuss this with your therapist. A good therapist will help you address your reasons and to understand any patterns of thinking and feeling that are getting in your way.

An illustration:

For example, if you feel the urge to spend your session venting about your spouse, but this feels like spinning your wheels- talk about it! Your therapist can help you understand your thoughts and feelings and work through them in order to become empowered towards the change that is right for you. Visitor or complainant client-therapist relationships may be an essential step in your process. You can’t fast forward to setting and taking steps towards your goals. You may not yet know what goals are right for you!

Ultimately, your therapist may end up helping you to learn and implement good communication skills to broach a difficult topic with your spouse. It may mean that they help you to develop skills to cope with a reality about the relationship that is currently too painful for you to face. Perhaps it will look like helping you to develop a deeper understanding of your own reactions or triggers in response to your spouse, and to work on resolving something painful and difficult that you bring to the table in the relationship. It may look like all of the above, all of which stem from consumer relationships, or like something else altogether! There is no right or wrong, there is only knowing and trusting yourself or not being there yet. The best therapeutic relationships help you to learn to know and trust yourself.

Describing the problem in detail (complainant relationship) can help you and your therapist gain clarity about the situation and then lead you to figure out what next steps are right for you (consumer relationship).

Try to let go of any idea that we should already know ourselves and that growth in this area means we are not good enough, not smart enough, not emotionally intelligent enough. Who we are and what we are capable of is not fixed and finite, but infinite and unknowable! What we do know is that the opposite of growth is stagnancy.

If it’s hard to let go of self-judgement or shame or if you feel stagnant or stuck (visitor relationship) talk with your therapist about this. Talking about being in a visitor or complainant client-therapist relationship is in itself building a consumer relationship.

But every therapist may not have considered naming their firstborn child Insoo!

While widely considered basic therapeutic skills and interventions, your therapist may not be trained in SFBT, and/or they may not be thinking of therapeutic relationships in these terms. Every therapist has their own unique style and practice. It is hard to say whether any one way is right or wrong, but what is important is your own reflection on what’s right for you.

While it’s normal and natural to wonder what your therapist thinks of you, trained in SFBT or not they are probably more concerned with assessing the type of therapeutic relationship that is forming, than with an assessment of you. After all, the type of relationship that you are building with your therapist forms the safe base from which your own process of growth stems. Your insight and reflection on what this base looks like, can help you figure out what to do next.

No right or wrong answers

Do some people come to therapy with a bunch of things going on around them that should change? Most definitely! Can a therapist do anything about those things? In most cases, no. Even in the most complex, problem-saturated situations, the person- regardless of where they are when they start the process of therapy, has an infinite and unknowable potential to impact meaningful change in their life. Insoo Kim Berg believed that people can create their own miracles– and she proved it! through research.

A skilled therapist thinks that you are courageous. They believe, even when you don’t, that you have the strengths within you to set and reach goals that will improve your life, regardless of circumstances! and lead to your fulfillment. They believe you are inherently valuable and genuinely want to know you in order to help you to know and trust yourself. If the relationship doesn’t feel right, and this isn’t resolved through an honest discussion with your therapist, it may make sense to look for someone new.

It’s easy to say that things would be so much better if our therapist had a magic wand. But would they really? The therapeutic relationship works best when the outcome is that you develop your own magic wand – wouldn’t you rather have that instead?

Bottom Line:

It’s normal to wonder what your therapist thinks of you. Many people are leery and/or want to know right away, am I going to be ok? but what’s more important is the type of relationship that you form with your therapist. It’s the quality of this relationship that will determine the outcome of your work together. A good therapist will meet you where you are at and work with you to facilitate the formation of a productive relationship.

It may be helpful though, for you to reflect on the 3 most common types of therapeutic relationships: visitor, complainant, or consumer; in order that you actively influence the building of the most productive client-therapist relationship- that of consumer.

Helpful mantras:

-I will be open with my therapist.

-My goal is to be comfortable being uncomfortable in order to grow.

-Nothing changes if nothing changes.

 

Alisa Reed, LCSW-R