Thursday, February 25, 2010

Treatment plans

After a dissatisfying session this week, particularly because I am wondering where we are headed in therapy, I'm left wondering about treatment plans and goals. I've read a lot about how therapy is supposed to work - you go in and talk about what is bothering you and decide on a plan for working out the issues. Most that I've read indicate there should be goals with a treatment plan and a timeframe.

I don't have that at all and at times I feel like we are aimlessly wondering along. Despite what my T says about nothing being pointless and we'll go where things take us. So that leads me to ask - do any of you have well defined issues, goals and treatment plans?

Perhaps my lack of these is due to the "type" of therapist I have. I'm not even sure about that - I think psychodynamic.


  1. From a therapist point of view I suggest that each time a client comes to see me they ask the question, "Am I getting what I want out of this". Whilst they don't ask it each time it does get asked semi regularly. Indeed I will often bring up the question myself with, "What do you get out of coming here".

    This can be answered at two levels. there can be specific behavioural goals such as dealing with the husband differently and so forth.

    There is also the possiblity of 'deeper' psychological change and that happens through the relationship with the therapist. This is where it gets less clear and harder to answer should one be wanting to achieve this. Get the Free Child out there and listen to what she has to say about what she is getting from the therapeutic relationship and then you might have your answer..

  2. Tony -
    Thanks for the reply. I thought of replying back via email, but not sure if you have a posted email. Some quick thoughts - perhaps my free child is thinking that it isn't working with this therapist (despite the fact that I do like her) and that's causing some internal consternation. This has given me food for thought though - perhaps I should set some short term goal, but realize that this relationship is a long term plan. Given that though, I still think, at times, that the therapist can contribute to a session when the patient comes up short on ideas.

    My impression about you (please tell me if I'm completely mistaken) is that you don't force periods of silence on your clients just to prove a point that it is all about them.


  3. I don't know what type of therapist I have. I do know that she uses a variety of techniques. Right now we are working on some well defined issues. But I have to say that it took a while for my therapist to figure out that was the best approach for me.

    Together we have been figuring out the issues within the larger issue of child abuse(does that make any sense?). My problem is that if I go into a session without any direction I can avoid the hard stuff.

    If my therapist has a timeline I'm not aware of it. As for goals, when I first started therapy, the first session was figuring out what my goals were and we revisit this every three months or so. She does this because she says goals aren't set in stone.

  4. ooops - here is some of the answer to my previous comment. Sorry for doing them out of order.

    I know that each person is different - although issues with CSA tend to be similar. What sort of goals do you have with your therapist? Personal question again - obviously you don't have to answer :))

    I have a session today - I'm not looking forward to it. I had to change the time of the appt, and in that phone interaction, T knows that I am not happy with last week.

  5. I never thought I had any goals, and every session seemed disconnected to the last. But last week I talked to my T and he talked about "maintenance" issues, and more focused issues. Kind of like having a personal trainer and working the basic exercises each time, but if something else needs to be addressed we can work on that as well. A treatment plan sounds nice, but I don't know if my therapy can work that way.