Psychologists arguably have one of the most human-focused of jobs. It’s a role that requires social intelligence, creativity and empathy—three human elements that cannot be hardwired into a computer program. Because every client is unique, and many issues confronted by the psychologist are nuanced and weighted differently, every approach must be individualised. A psychologist must be extremely resourceful to find ways around challenges raised by each client. Tailoring treatment to the client’s needs is paramount to the success of any therapy program. It’s why psychology could never be fully automated. For example;
Building rapport
1. Rapport is an essential component in treatment success and depends upon the client’s level of comfort in talking about their lives on a deeper level to someone they don't know. In some situations, a sense of connection and trust will be established easily, while for others, it may take a long time to share openly.
Respecting different needs
1. Despite years of evidence-based research, an approach that works for everyone is yet to be found. People respond differently to different strategies. What works well for one person will not necessarily work for another. For example, when dealing with the treatment of anxiety, some people love a component of meditation, some get better at it with practice, and some are completely averse to it. Others may respond to techniques that move away from too much internalising and don’t focus on the body or physical sensations.
2. A therapy session will evolve with minute-to-minute shaping through empathising, normalising, reframing, and highlighting issues in response to the client and their goals. An ongoing balance will also be maintained between the therapist directing the conversation and it being led by the client.
3. A diversity of values, beliefs and cultural expectations need to be recognised and respected. Psychologists consider the impact of ethnicity and culture on a client’s behaviour and treatment, and avoid projecting their own values and expectations onto clients who may not share them.
4. The need for understanding and volume of information about an issue will vary with each individual. One client may like lots of reading. Others may not be open to completing exercises outside of the consultation or find it increases their anxiety. Some people can't read or have significant language barriers. Age levels and intellectual abilities need to be taken into account. The level of symptomatology will also determine how much information can be taken on-board and this may vary over the course of therapy.
5. Different mind-sets and emotional states require a flexible approach. People are sensitive to different matters depending on their values and past experience. For instance, perceived failures and significant losses need to be traversed gently. This requires the psychologist to be constantly assessing and responding to verbal and non-verbal cues to adjust to a client’s needs.
6. The duration of the program will also differ. Some people like short- term, solution-focused therapy. For others, therapy will mould into a longer term relationship where they feel supported, even intermittently, for life's challenges often unknown in advance.
Understanding multiple approaches
1. A therapy program is tailored to each individual and may consist of a combination of approaches, for example (in no significant order): cognitive behavioural therapy, acceptance and commitment therapy, mindfulness, psychodynamic approaches, schema therapy, attachment informed therapy, narrative therapy, humour where appropriate and common sense.
2. Ideally, a psychologist will work with a range of techniques and allow for interaction in planning and designing therapy sessions. A general plan of treatment will be redesigned to maintain relevance and to incorporate improvements. It will also reflect the client’s evolving needs, response to treatment and deepening understanding of the factors interacting to maintain their issues.
3. The impact of a therapy program is assessed at every moment in each session. A psychologist will be aware of the shifts in the therapeutic relationship; as a client engages and disengages in the process. While a client should still be challenged, it’s important that a sense of teamwork is maintained. The psychologist walks alongside the client rather than taking another path.
4. A psychologist ensures their treatment remains evidence-based while at the same time acknowledging the body and mind’s capacity for healing and finding a way forward. At times, the client holds a significant key that is drawn out through therapy rather than being handed from professional to client.
Being self aware
1. Compassion and empathy often spring forth naturally when we hear stories of suffering. Experienced clinicians choose their words carefully without overstepping, becoming overly familiar, or assuming they understand the client’s total experience. A place for silent contemplation can also be appreciated.
2. Limited self-disclosure may be appropriate to normalise some of the client’s concerns. Sharing needs to be carefully balanced to maintain professionalism and a clear focus on the client’s goals.
3. Psychologists are individuals too. The therapeutic relationship is influenced by the psychologist’s personality and character traits. Not every practitioner will be suitable for every client. Therapy is a relationship and the client has a right to choose the individual that feels right for them to achieve their goals.
Psychologists rely on the very essence of being human. Psychological treatment is commonly conducted within a context of conversation. The ability to connect with the client on an emotional level requires trust, understanding and rapport. The course of therapy, while planned, often has an element of unpredictability. As psychologists, our individuality and flexibility during our exchanges with clients are often our greatest assets.
Wendy Roncolato & Prue Foster
