SAQ, Part 2: How To Be A "Real-World Authority"

Last week you may remember I wrote about the questions I thought that Beginning Counselors should be asking (SAQ) instead of the questions that are most frequently asked (FAQ.) While I don’t blame you – I certainly didn’t know I needed to ask these questions, I want you to thrive as a Beginning Counselor, not just survive.

Read last week’s SAQ, “What kind of a counselor do I want to be?” here.

This week’s “should-ask” question is “What do I need to do now to become a real-world authority on the needs of my clients?”

What do I mean by Real World Authority”? Well, fresh out of school, we know theory and academia inside and out. We don’t often know, though, what else is going on outside of this. In other words, we don’t know what is going on in the real world.

Our clients will turn to other people and resources outside of our services before coming to us. Sometimes, they will want to use those resources in conjunction with our services as well. If you don’t know what resources they are using, you are putting yourself and your clients at a major disadvantage.

If you don’t know what your clients are reading, who they’re listening to, and what else they’ve already tried to do to help their problem, then you don’t know:

• What assumptions they’ve taken in about the way things are…some of which may be completely contrary to your methods of counseling or even established scientific facts.
• What level of knowledge they already have about the subject at hand; they may be more advanced than you are expecting, or perhaps their knowledge is more basic than you've realized.
• How you can develop the skills and techniques you offer them in contrast to those other resources that they are using, giving them a different value for their time and effort than what they’ve already experienced.
• Whether you need to warn them about certain choices they are making. (Did you know that taking St. John’s Wort – a common ‘natural’ remedy for mild to moderate depression – in conjunction with other medications, such as birth control, can render them ineffective? That’s certainly valuable to be able to share that information with someone who doesn’t want to get pregnant!)

Every counselor needs to have a strong working knowledge of what resources are available to their clients to solve their problems in addition to their services as a counselor. Pop quiz: would you know what to say in response to any of the following questions?

• What books should I be reading in between sessions?
• What do you think of Tony Robbins?
• Is there an app to help me with my anxiety?
• I’ve heard that peppermint extract is good for stress relief. Is that true?
• Is there anything out there that can help families of sexual assault survivors?
• What things might be helpful for a couple who has just experienced a pregnancy loss?

If you don’t know what quality resources are out there to enhance your therapy work, then you risk:

• Having both you and your client work harder than would be necessary if they took advantage of some of the other things that are out there for them.
• Losing valuable talking points that can come from introducing another’s ideas into the therapeutic conversation.
• Overlooking helpful homework assignments.
• Providing care in a way you can’t on your own. (Therapeutic tools, alternative methods of healing, and so forth.)

It takes TIME to develop these knowledge bases, however. Which is why the perfect time to start for you is NOW. Here’s how you can start making that happen, today.

First, choose a general area to start researching. If you know who you want to work with specifically, you have a bit of a head start, because you can narrow down your research to that major area or topic. But if you’re not sure which group you want to work with, don’t despair.  You can still do your research, your topic will just be a bit broader.

Then, ask yourself two questions:

1. How will they look for help?
2. What will they not know to look for?

Discovering the answers to these questions and compiling a shortlist of recommended resources will be how you can become a real-world authority for your clients. As a result, you'll be a more informed  - and more effective counselor. 

I realize though, that this is easier said than done. Which is why I'm providing a little extra help. I've created a free 2-page worksheet for you that you can use to help you on your way to being a Real World Authority. Click here to instantly download.

Was this second SAQ helpful to you? Do you have any questions about becoming a Real World Authority? Post in the comment section below!

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7 Ways To Practice Confidence With Your First Clients - Even When You Don't Feel It Yourself

The first time that you meet with a client is a heady mix of thrill and terror. It will probably seem both like it came too quickly and you've been waiting way too long for it. 

And one of the biggest things on your mind during those first few meetings? 

"How can I inspire trust in my clients so that they can open up and get the help they need?" 

One of the most effective ways of inspiring trust is displaying confidence in your own ability to help your clients. When you trust yourself, your clients will trust you. But how can you display confidence in your abilities when you're struggling to feel it yourself? 

Though I dislike the connotation of the maxim, "fake it till you make it," I have to admit the principle applies here! The more you practice self-confidence, the more you will feel it - and conversely, the less you practice self-confidence the more likely you are to get stuck in a cycle of feeling like a failure. You practice self-confidence by identifying the anxieties in your mind that are attacking your faith in yourself, and creating a new framework of understanding to operate from going forward. 

7 Ways To Practice Confidence With Your First Clients - Even When You Don't Feel It Yourself

1. Instead of worrying over what you don't know, take stock of what you DO know. What do you do well? What did your professors praise you for in class exercises? Try to come up with at least 5 things that you can pull out in situations in which confidence is hard to to find.
2. Check their expectations - which are probably not what YOU think they think. We can pretty easily work ourselves up wondering if this client is thinking we're messing things up, or that we're no good at what we do. But really, how likely is it that that condemning US is what's most on their mind right now? Practice telling yourself that they have other things to worry about then our abilities, such as the reasons they are coming in to get help from a counselor. 
3. Get a yay-sayer in your life. Everybody needs someone encouraging around them on a regular basis! For many of you that will be your clinical supervisor, but if not, connect with a fellow counseling student or layperson friend who can tell you that the small things you are agonizing over really aren't that big of a deal.
4. Pre-settle the "experience" question. A lot of us in the student stage get ensnared by the experience question, i.e. "How can you know what I'm going through? Do you have (fill in the blank) kids/husband/wife/traumatic experience/death of a loved one. You're never going to "win" by a direct yes or no answer to this question, because there will always be some experience you have not shared. Plan on how to deal with it using a version of these two responses: 1) Getting at the real question: "Why does it matter to you if I've been through that? Your experience is what matters." And 2) Getting clear on the fundamentals: "I may or may not have been through _______ but I've felt pain before, and pain is pain no matter where it comes from." 
5. Don't be afraid to say that you don't know. You might think the worst possible thing you can say for inspiring trust is "I don't know." But you can't possibly know everything! It's all in the attitude. If you calmly and evenly say, "You know what? I don't know the answer to that right now, but it's important to me and I will look into it before our next session" it will both inspire trust and provide excellent client care.
6. Remember the "get-to-know-you" gap. When you first meet a new client, it honestly takes a minimum of 1 1/2 sessions to start to get a handle on the person...at least it does for me! Before then, we may have some idea, but we don't have enough information to move forward. So don't pressure yourself to know everything right away. No one does!
7. LISTEN. Sometimes, you don't have to have the answers to inspire trust. Sometimes, you just have to be willing to listen. 

When you struggle with self-confidence in beginning counselor training, what do you do or say to yourself to remind yourself of what you have to offer? 

5 Ways To Broaden Your Training Experience (Even If You’re In A Single-Focus Internship)

Thrilled with your current position as an intern at a domestic violence shelter, a hospital ER, or a faith-based counseling center, but wishing you had the chance to explore more of the variety that is out there in the counseling field?

Here’s your guide to getting the most out of the time you have in training – no matter what your internship focus is!

1. Multitask. Whatever you’re doing for hours now, think

about how you can get the most possible experience for your time there. Can you spin your work with preschool play therapy into some parent coaching sessions? Can you develop and use different sets of skills with the same group of clients, like trying cognitive-behavioral & EMDR-based methods on your trauma clients?

2. Observe. Other interns in different specialties. Your supervisor. Any other counselor that will allow you to watch them in practice. 

3. Read. Case studies, journal research articles, autobiographies, memoirs, counselor-authored practice books. Here’s some possibilities to get you started:

Journeys To Professional Excellence: Lessons From Leading Counselor Educators And Practitioners 
Ariadne's Thread: Case Studies in the Therapeutic Relationship 
On Being A Therapist 
Inside the Session: What Really Happens in Psychotherapy 

4. Volunteer. Any kind of social services agency will work!

5. Man (or Woman) a Hotline. Sexual assault recovery, crisis pregnancy, suicide prevention, LGBT, domestic violence – there is a hotline for almost any specialty you might want to explore further. While you would likely be a volunteer in this position, it’s still worth your time to pursue if it’s of significant interest to you. 

Right now, you may be feeling stuck, or out of options. But you have more flexibility than you realize. This is literally the only time in your life when you are new to the field of counseling, AND you have the assistance of a trained supervisor to help you with any and all of your counseling-related questions.

And that’s the key that’s going to make the suggestions above work for you. Any of these suggestions on their own might do you some good. But if you consciously filter these new experiences that you’re having through that lens of new counselor experience you will have insights you’ve never gained before and some you’ll never have again. If you take notes back from these experiences to discuss with your supervisor, or practice with a fellow intern, you’ll find your intern experience to be both diverse and more rewarding than you ever thought it could be! 

How do you suggest finding diversity in a more narrow internship experience? Comment and share below!

The Medication Deliberation

Have you ever had a client say to you, "I'm just not comfortable with medication?" Do you, yourself, ever struggle with whether or not to refer out to a psychiatrist, or if you decide to refer, when it's appropriate?

People - and counselors - have a lot of competing ideas about medication for mental illness.

Is it a panacea? (A sweeping solution, with the implication that some aspects of the patient's needs will slip through the cracks.)

Is it a band-aid, that will slow the damage to a wounded heart but not heal?

Is it a last resort, which should only be used when everything else has been exhausted?

Is it part of the intake process, something that should be dealt with at the beginning of therapy? 

To be honest, there is no one answer that will satisfy all therapists, and all clients. Some therapists, usually categorized as holistic therapists, do not believe in the use of medication, instead integrating alternative therapies like aromatherapy into their practice.

And whatever the therapist believes, the client may be resistant to medication, perhaps saying something like this:

• It's a sign of weakness.
• I don't want to "numb out."
• I want to trust God, not drugs (or) my church doesn't believe in medication.
• I don't want chemicals in my body.
• I believe my body can correct itself.
• I want to try the natural approach. 

Whatever you believe (or your client believes) there are two major options for how to approach this.

Continue to focus on non-medication alternatives. There are several resources that medical doctors recommend for situations like depression, such as increasing exercise. You might also recommend books like Trudy Scott's The Antianxiety Food Solution. 

If you choose to recommend medication, I find that you get the best results with your clients when you follow the following guidelines:

• Do your best to coordinate care with the client's prescribing professional. Ask the client for a release form from the doctor's office to speak with the doctor or the staff nurse about their medication and possible side effects. Most doctors do not have the time to fully explain every possible side effect, and will not see them on a weekly basis. Therefore, your doing research on the medication they are taking for possible side effects can help them greatly. If you see a side effect popping up, you may be able to recognize and intervene more quickly than they can recognize it themselves. 
• Reinforce medication instructions. Medication non-compliance is one of the BIGGEST challenges facing medical professionals today. A lot of that comes from misunderstandings of the risks of incorrectly taking prescription medications and lack of accountability. For example, many people tend to stop taking anti-depressant or bipolar medication when they start feeling better. But abruptly stopping some medications can drastically increase risk of suicidality and it must be addressed both before and during the implementation of a new medication.
• Emphasize the client's ability to choose what they do what they feel is right with their medication, but to do it SAFELY. Remind them regularly that you will listen if they truly want to cease medications, even if you do not agree, so that they will share with you if they stop medications and you can help them do it safely. Otherwise, they may hide it from you in order to avoid your 'disapproval' and follow an unsafe medication regimen on their own.
• Remind them of the importance of discussing non-prescription supplements with their doctors. "Natural" remedies, including St. John's Wort, can STILL interact with certain medications and cause unsafe side effects. 
• Don't neglect the emotional impact of societal perspectives on medications for mental health. Whether the client's immediate society is their church, their regional area, or their family, it matters what others think about them. They may worry about judgment from others, about keeping 'secrets', about being shunned or blacklisted. They may worry that others will simply think they gave up or sold out. And they may have transferred that judgment to themselves. 
• Consistently help them see the "big picture."  You can tell them that: "You don't have to be on medication forever, necessarily. Many people believe it is no different than taking a blood pressure medication. You have tried all the other alternatives. You may have to to dull side effects like sleeplessness, apathy, etc., so that you can implement what I am working with you on in talk therapy." Of course, if you don't believe in these things, don't go against your conscience, but if you approve of these statements they may be what the clients need to hear. 

What has been your experience with helping clients who have been prescribed psychiatric medication? What is one tip you think other counselors should know when working with clients considering psychiatric drugs? 

Post your comment below!

Goals of Sexual Trauma Therapy: When Are You "Done?"

Because nothing you can do in therapy can erase the trauma, it can be hard to know when you have helped your client to the point where they are ready to move forward on their own. This video will share with you several major milestones that tell you that your sexual trauma client is moving to a place of healing.

To Tell The Story Or Not To Tell The Story?

When I first started working with clients who had been through sexual abuse and assault, I could see the pain in their eyes when they recounted what they had been through. 

Click here to watch the video in YouTube.

In therapy for sexual assault, the beginning counselor can wonder whether or not to encourage the client to tell their story, causing the client distress. But is it important enough that the therapist should encourage the client to talk about it even when they don't want to? What should the therapist be careful about when they ask the client about the situations they've overcome in their past? This short video helps the therapist know what precautions to take when recalling an assault with a client and ultimately how important it is to the client's recovery. 

*Note: The advice in this video is intended only for licensed therapists trained in working with clients who have experienced sexual abuse or assault. Nothing in this video should be considered a substitute for professional counseling, training, or supervision.*

The Power of Language in Sexual Trauma Therapy: Words That Oppress, Words That Heal [Video Post]

The childhood rhyme was wrong. Words can often hurt you.

Click to watch in YouTube.

How much do your words matter in sexual trauma therapy? If you are a counselor, your word choice can radically change the emotions of your client - for better or for worse. Old-fashioned words like "rape" can throw back a client to feeling like it matters what she's wearing and where she was when an assault happened. Naming a client as a survivor, on the other hand, can uplift and empower a client who is feeling powerless. 

Next week, come back for the third installment of our special therapist competency series: To Tell The Story or Not To Tell The Story? The Question of Uncovering The Abuse Story in Sexual Trauma Therapy.

What do you think of the special focus series on sexual trauma? Are there any specialties you'd like to see covered in the future? Let me know!

Support Sexual Assault Survivors!

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Profit from each purchase goes to support counseling, research and advocacy. Show your clients you believe in their stories while while contributing to survivor healing!  

Your Sexual Trauma Client: The Reality Of Their Experience.

Click to watch in YouTube

April is Sexual Assault Awareness Month. Did you know that every 2 minutes, someone is sexually assaulted? That one in 6 women have experienced an attempted or completed rape? That means a great majority of the clients we see in our offices will be survivors of sexual assault or abuse. It is our duty to educate ourselves as to the reality of their experiences. This month, we will be focusing on increasing our therapist competency in the area of sexual trauma recovery. 

This video starts out the month by explaining the reality of what the sexual assault and abuse survivor experiences when they are considering reporting sexual misconduct to law enforcement, seeking medical help, or pursuing legal action against a perpetrator.

You think you know what the reality is? You have no idea. Watch the video to find out. 

Next week, we will discuss Words That Oppress, Words That Heal: The Power of Language in Sexual Trauma Therapy.


Support Sexual Assault Survivors!

Survivor Advocacy by SurvivorIsAVerb

Profit from each purchase goes to support counseling, research and advocacy. Show your clients you believe in their stories while while contributing to survivor healing!