Wednesday, December 16, 2015

New Beginnings

Center for Conscious Living has begun its second iteration. We are now located in Oregon, seeing clients in Bend and Redmond. It has taken longer than expected to get licensed in Oregon, and while it seemed excessive, I do not at all begrudge the many hours spent reviewing ethics!

It is always good to review, and reviewing the Ethical Standards for Psychologists has given me time to review how I practice and how I want to perceive my clients. These standards cover the very basics such as, never, ever enter into personal relationships with clients, maintain high standards for privacy and confidentiality, and, most important of all, FIRST DO NO HARM, a principle that is taught to every treating professional.

The question I ask myself and ask of every other professional I know, is how do I best avoid accidental harm? The first thing that comes to mind is how I am chosen by my clients. While it is for you, the consumer, to shop for me, the professional, and you certainly know more about your preferences than I; my job in our first conversation is to be as real as possible; to introduce myself and what I do to you as honestly as I can, so that you can make a rational choice as to whether I am the right professional for you. While I truly believe I am good at my profession, that does not mean I am good for each person who phones me for an appointment.

I strongly believe that you, each of you, have within you the power to heal, but not every caller wants to seek this inner healer. Consumers are free to choose between professionals who offer support and medication management and those whose goals are more comprehensive. Is depression a disease or a mood that, however intractable it feels, can be changed through hard work and new learning? Is chronic pain a fixed entity in your life or a meaningful symptom indicating that your pain mechanisms are somehow overworking? It is my first job to help you decide whether what I offer matches what you seek.

Suppose you indeed choose to make an intake appointment. What should you expect at that time in the theme of "First Do No Harm"? My strategy at an intake, which I always schedule for a double session, is equally for me to learn about you and for you to learn about me. This means more than just taking your history, however long or short it may be; it means getting your impression of what works and does not work for you and what is most distressing to you right now.

To me, doing an intake also means more than making a diagnosis. You are NOT a DSM symbol; you are an individual. In psychology, diagnoses are more for insurance billing than they are for treatment. Your insurance needs a code to tell them what is going on. I need a conversation. Your problem is more than a conglomeration of symptoms that match a diagnosis; it is information as to what is going on with you and what you'd like to change.

The intake appointment is also for you to learn about me. It is standard for clinicians to take several sessions to get a complete picture of who you are and what you need. This is as it should be, since you are not one-dimensional. However, if that is all that happens for the first three to five sessions, then how will you know if the clinician you are seeing can help you, other than by taking his word or the word of the referring professional? To me, each early session must be equal parts you telling things to me and me teaching things to you. In this way, you get early samples of my style of psychotherapy and, indeed, ought to begin to feel change taking place.

For some people, a session or two to get off a wrong path onto a right one is all they need, but I expect that for most, a session or two will demonstrate whether there is a match between therapist and client. Is a trusting and effective therapeutic relationship developing? Is the therapist following an effective strategy that reflects what you have revealed and helps you to move toward a solution? Are you invited to be an active member of your treatment team both by discussing who you are, what you want to change, and how you learn, and by then participating actively in the change process via homework assignments and self-care strategies?

"First, do no harm". To me this means helping each client to choose the best provider and make the most of each hour of professional time. It also means helping each client to complete a course of therapy efficiently and to be an active participant in the process, such that the treatment strategy developed collaboratively is a fit for you as the client.

Welcome to the Center for Conscious Living, Oregon. Please feel free to phone (916-936-2325) and explore the potential for me to help you make the changes you wish to see in your life for this upcoming new year.

No comments:

Post a Comment