What If I Feel My Therapy Isn't Working?

Do you go to therapy wondering what you're going to talk about? Do you feel like you're spinning your wheels and getting nowhere? Feeling discouraged that you're constantly taking one step forward but 3 steps back in therapy?

Therapy requires time, patience and work, but you probably don't want to feel like you will be in therapy forever. If you're feeling discouraged, it's real easy to call your therapist, cancel the appointment and never reschedule. But is it really the best decision for you? Could be....maybe not.

Therapy is a complicated art. There are many factors which contribute to the success or failure of therapy, the main factor is the rapport between the therapist and yourself. Other factors include: your commitment to therapy and yourself, the therapist's competence and confidence in their own skills, the issues you bring to the table and the length of time you've been dealing with the problems, just to name a few.

Dropping out may prevent you from facing the problems that brought you to therapy in the first place. So what do you do?

First, talk to your therapist as soon as you start to feel discouraged. Let your therapist know how you're feeling, what you are seeing is happening with the therapy, and what your expectations are. Opening this channel of communication helps the therapist understand what you are wanting and an open discussion of your needs and expectations can be laid out on the table.

After having such a discussion, you and your therapist can lay out a new treatment plan addressing your concerns, which may include additional resources in addition to therapy such as support groups, medical evaluations, etc. After processing all your options, you may agree transferring to another therapist may be needed. If this is the case, your therapist should be able to provide you with appropriate referrals so you can continue your journey.

Can I Be Friends with my Therapist?

Many people seek counseling due to some sort of crisis within their lives. They seek out someone neutral, objective, like a counselor, because their family and friends provide advice based on emotions and the connection with the person.

Once in counseling, you may start to have feelings for your therapist. This is very common. You start to feel like you really could like being friends with them. You feel like the therapist understands you and really listens to you. They may laugh with you n sessions, they allow you to cry when you need to. They accept you for where you're at. As a result, you may want to see your therapist over lunch, at a coffee shop, etc.

The California Association of Marriage & Family Therapists (CAMFT) establishes the Code of Ethics. They state, therapists should not engage "in a close personal relationship with a patient" as it may skew the therapy. Is this person now your friend or your therapist? How do they maintain that professionalism? Are you now paying your therapist or a good friend to help you? It can all become confusing and counterproductive.

Another issue is your relationship wasn't based on the makings of a friendship. Counseling is a business transaction with personal impacts. How much do you know about your therapist, really? Friendships are struck based on commonalities, such as interests, likes/dislikes, and personal experiences. How much of these things do you know about your therapist? Probably not as much as you think. Therapists don't disclose too much about themselves during your sessions. They can be likable people, but it doesn't mean you know that much of their lives outside the office.

CAMFT recommends a 2-year waiting rule to be extended to all types of relationships with clients, including friendships. There are several reasons for this. First, you may decide to return shortly after ending the therapy, which is common. Second, there is a belief that if a client and therapist want to engage in a relationship (friendship or otherwise) outside the therapy, 2-years to determine if a friendship could really sustain beyond the parameters of therapy.

If you have additional thoughts about becoming friends with your therapist, I recommend to discuss this directly with your therapist. It would be a good process for you in figuring out what characteristics you need for friendships as well as keeping the therapist in their role and allowing them to do their job...to provide you with a safe, valuable service.

Disclosing to the Counselor -- How much is too much?

Counseling is an interesting phenomenon. You pay a complete stranger to open up to them, become vulnerable and place some level of expectation they will be able to help you through your problems and come up with better solutions. This can feel weird, overwhelming, even downright scary. But, how much should you disclose?

Your counselor can only help you if you're upfront and honest with them. This may not mean you have to unlock every skeleton in your closet, but if you're holding back, they may not be able to help you move forward. For example, if you are actively engaging in the use of alcohol or marijuana and you emphatically deny this to your therapist, they may attribute your symptomology to more severe mental disorders. They cannot assess, and thus intervene, appropriately.

Communicating with your counselor can also be beneficial if you find you are having difficulties with the direction your therapy is going. Sometimes, I find clients may experience difficulty bringing up problems to the counselor when it has to do with the counselor; however, counselors are people too. We make mistakes and misinterpret client signals, which could inadvertently derail your therapy.

If you find yourself uncomfortable with your counseling experience, I recommend you bring it up with your counselor. Let them know how you're feeling and what your concerns are. Again, the counselor can't read your mind and will want to know how they can best help you.

Wanting More From Your Counselor

Counseling is a very interesting process. You come in spilling your guts to another person who is practically a stranger. You tell them things you've never told anyone else. You may have broken down in tears when you're upset, or maybe have turned to them when you're feeling like you're at your lowest point. And all this time, they've never judged you or shamed you...just provided the support and guidance you needed to get through these rough times.

Suddenly, you may find you are having feelings towards this person. You may want to become friends with them or even closer...maybe even have feelings of love. So what's the problem?

If your counselor is true to your therapy, they cannot reciprocate your feelings. It's understandable you would have such strong feelings for your counselor. You have put your trust in them and become vulnerable during some difficult times. For your counselor to share your feelings could have detrimental effects. They will not be able to maintain the objectivity, which you sought out in the first place. Counseling is a professional relationship which can sometimes feel very personal. However, it isn't personal. Do you pay your friends and family to talk to you? Probably not.

Your counselor is trained to deal with these issues. They can help you process your feelings in a positive way. However, if your feelings begin to overtake the therapy, your counselor may recommend (as a last resort) to transfer your therapy to another counselor, who can continue the work. Although this can feel like rejection, the counselor is really doing what is in your best interest. They want to see you succeed in life, and will not be able to help you achieve this if they are personally involved in your life.

The Importance of Communication

Communication is so important for a relationship to endure. Couples who have difficulty with listening and responding in an open manner have a higher likelihood to have arguments, tension and misunderstandings. In order to minimize such rollercoasters, here are some tips to help you understand the importance of communication:

Keeping it all in

Have you ever felt so misunderstood by your partner, you decide not to speak your mind. I mean, what's the point? They aren't listening anyway and it'll just end up in an argument, right? So, let's look at what happens if you continually make this choice over and again:

You give in over and over. You stay quiet time and again. You keep bending over backwards in hopes that'll keep the peace. Soon, you start to feel angry all the time. You begin to nit-pick at your partner's faults. Those faults have always been there, but now they are really beginning to get under your skin. Suddenly, arguments over simple issues, like cleaning dishes and taking out the trash, become as large as World War III. Now, your conversations are continually strained. Tension has become a way of life in your home. You wake up one morning and decide you can't live in this relationship anymore. So what really happened?

You made a choice. The choice to stay quiet. The choice to not speak your mind. You began to bend over backwards so much you're on the verge of breaking. It appears you're angry with your partner, but really you're angry with yourself. You've kept quiet and you're angry to allow yourself to let this go for so long.

Ask yourself this question....was your choice really worth it?

What are you willing to do?

Are you in a relationship and feel like you've done "everything" to make it work? Are you still feeling frustrated? So what's going wrong?

Consider this...are you really doing everything to make the relationship work? What is the problem? What needs to be done to fix it? Are you really doing it? Here's some examples:

Conflicts with parenting styles: Are you going to parenting classes? They really help. Consistency is key and these classes give you the tools.
Feeling disconnected: Are you trying to connect? Or are you coming home every night and zoning out in front of the TV or going to separate rooms and spending the rest of the night apart.
Money problems: Do you just argue? Or have you set a budget? Gone to a financial planner? Seen a tax advisor? Accessing resources will help you deal with a business issue without the emotion.
Constant arguing over nothing: Are you taking the time to hear your partner? Or are you ready to defend yourself with every word coming out of their mouth? What we say is only 10% of what we mean. The other 90% is what we don't say. If you're trying to get the last word in edgewise, you're not hearing your partner.
Going to couples' counseling: Are you doing the work outside of the sessions? Or are you waiting until the next meeting to deal with the week's problems? Are you listening to the counselor and following up on their recommendations and suggestions? Or are you following your own plan? f you're not following the recommendations of your counselor, then think about this....are your own beliefs of how to solve the problem really working?

These are just examples to skim the surface. So ask yourself....are you really doing everything possible to get the relationship you want? Or are you expecting it to happen? Think about it....and be honest with yourself and your relationship.

Listen to your Heart?!?!?!

Have you ever had the experience of your head telling you one thing, but your heart is telling you the exact opposite? What is that all about? Why does it prevent us from taking steps to improve our relationships? The secret is uncovered!

So our partner says something that angers us. Logically, we know they didn't mean it. Emotionally, we can't let it go. In many situations, our feelings/emotions are triggered by an instantaneous thought process...like a knee-jerk reaction. What we don't realize is this irrational thought reflects something about ourselves we believe to be true. Examples may include, "I'm not good enough" or "I'm bad." We've internalized these types of thoughts and react whenever anything challenging these messages. The irony is most people aren't in tune with these thoughts, but we're in touch with our feelings: a heavy heart, a stomach in knots, or a painful chest.

So what do we do? We react to ease the painful feelings we're having; however, we're reacting to irrational feelings as a result of an irrational belief about ourselves. If we're able to take a step back when our partner triggers us, we can determine the root of our feelings and make better decisions as to how to react to the situation. Most of the time, you may realize the gut reaction may not always be the best reaction.

Getting the Most Out of Counseling

If you've never been to counseling before, you may wonder what to expect out of the process. Counseling requires hard work, not in the way of using physical exertion, but more of working towards your goals. Wait! That means you need to have goals! So, you're going to counseling. What do you want to get out of it? What would you like to accomplish from your time with your therapist? How will you know when you're finished with your therapist? If you give yourself an opportunity to think about these questions and discuss them with your counselor, you'll be able to determine an appropriate path towards accomplishing your goals.

Now your goals are set and you have worked out a plan with your counselor. Now the work begins. Your counselor cannot do the work for you. This is your life and your responsibility to change it. Your counselor can provide you with tools to help you change your life, but if you aren't actively using these tools, you won't get very far and begin to get frustrated with your counselor and the therapy process.

Look at it this way. Your counseling sessions are only 45-50 minutes a week. This means you have an additional 6 days, 23 hours and 10 minutes before your next session. This provides you with ample opportunity to take what you've learned in your counseling and apply it in your everyday life. It's real easy to take the stance of "Out of sight, out of mind." However, your life isn't either. Your life is always in sight and staring you in the face. You now have the opportunity to take control and do something with it. You're paying good money to see this therapist. You owe it to yourself (and your wallet) to put the work into it.

If your feeling challenged by the work or the process is bringing up uncomfortable feelings, inform your counselor! It helps your counselor to know how you're reacting to the therapy. If you feel like you're hitting a wall each time you make the attempt to do the work and don't inform your counselor, that wall will feel bigger and higher trying to do it on your own. The counselor can help you process and work through what you're experiencing.

Counseling definitely follows the adage, "You get out of it what you put into it." Put your "all" into it and you'll have a better chance for therapeutic success!

I Have My First Appointment - What to Expect

So you've made the decision to get some counseling. Good for you! Counseling is an extremely beneficial means to obtaining support, guidance and a safe outlet to explore and overcome struggles, which may be plaguing you. Now you might be asking, "What will happen when I get there?"

You may need to attend your first appointment a bit early to complete intake paperwork. Like visiting a new doctor for the first time, there is paperwork which needs to be filled out. With the age of technology, some therapists have their intake paperwork online for you to download and complete. Your therapist will provide you with instructions as to what will be required from you.

Upon getting to the office, you might see a wall panel with your therapist's name and a light switch next to their name. Go ahead and flip that wall switch. The light indicates to the therapist of a client in the waiting room. At this point, have a seat and wait. If you need to complete the intake paperwork, now is the time to fill it out. Your therapist will leave out a clipboard for you with all the paperwork for you to review and complete.

At this time, your therapist will come out to the waiting room and take you back to their office. Their office may look like a living room, with couches and chairs. Ultimately, it should feel comfortable. Have a seat!

The therapist will ask you why you're seeking therapy, how they can be of help to you, and let you know of any policies, which will help you understand the process of therapy. Ultimately, it's a "get to know you" session. Some therapists may need to know specific information and ask specific questions. Others may give you the floor to discuss your needs, concerns and expectations.

However your therapist directs the session, allow yourself an opportunity to notice how you're feeling about the environment and the therapist. This is your time to see if the therapist is the right "fit" for you. If you don't feel comfortable, let the therapist know. They are trained to process your feelings with you and together, you may determine the "fit" isn't right. There's nothing wrong with this. Finding the right "fit" is the most important dynamic of the counseling relationship. Give yourself the opportunity to find your "fit." You'll know when it's right for you.

Finding the Right Counselor for You.

You realize you need some help. You are struggling and recognize you can’t solve your problems alone anymore. Where do you start? Where do you look? How do you know your choice is the right choice for you? Here are some steps to take to help you work towards the help you’re seeking:

1. Begin by looking up counseling directories. The benefit of accessing such directories is the ability to check out multiple therapists in your area. There are many on the web, many of which verify the counselor has a valid license to practice. Some examples are PsychologyToday.com, Find-A-Therapist.com and MarriageFriendlyTherapists.com.

2. Look for a therapist who works with your problems. Therapists have license to work in many disciplines and with many populations. However, no one can be an expert in all fields. Some therapists focus on working with children and adolescents. Others work with trauma. Still others focus on couples work. Read the therapists’ profiles and see which one seems to “speak” to you. Narrow down the field to 2 or 3 so you can make the best selection for you.

3. Making contact. You’ve found a therapist who seems to be a good “fit.” Now’s the time to contact them. Most on-line directories have a feature where you can contact the therapist via email. If you email the therapist, you may have to wait for a response. Keep your emails brief, as some therapists prefer not to engage with a client via email, to protect your confidentiality and request you call them. Therapists want to see if there is a connection, which is difficult to determine over email.

The other option is to call the therapist. Leave a message if they don’t respond. If you call on a weekday, most therapists will return your call within a few hours. If you call on a weekend, they may not return your call until they return to the office.

4. Asking the right questions. Now you have them on the phone, what do you say? Let them know what prompted you to call them. The therapist may be calling you in between clients, so do not take it personally if they cannot spend a long time on the phone with you. However, the right therapist will take the time to answer your questions and feel comfortable and open with discussing their fee. But what are the right questions? Ask the therapist:

•If they have experience in working with your problem.
•What their education and training is in relation to your issues.
•What their fee is.
•How long their sessions are.
•What their availability is.
•Where their office is located.

5. How is the therapist responding to you? Pay attention to the therapist’s responses to your questions and information. Do they seem genuinely interested in you and your pain? Listen to your own feelings. Does this therapist feel like they would be the right person for you? If not, you can continue your search. If you are feeling a connection with the therapist, make an appointment.

6. Attending the first appointment. Make sure you attend on time and prepared. Some therapists already have their intake forms on the internet, for you to complete prior to your first appointment. Others require you to arrive to your first appointment early to complete the paperwork. To get the most of your appointment time, follow the therapist’s request. If you come unprepared, you may have to use a portion of your time to complete the paperwork.

You may leave your first appointment feeling like you made the right choice. Congratulations if this is the case! If you find after a couple appointments like you’re not making a connection with your therapist, let them know. It’s okay, really. Therapists are trained to deal with such issues and are willing to talk to you about it. If you still find you aren’t connecting, let your therapist know you would like referrals or your intent to search elsewhere. You ultimately have to feel comfortable with your therapist. If this connection isn’t occurring, you aren’t getting the most for your money.

How Can Therapy Help Me?

Have you considered going to therapy, but have yet to pick up the phone? What's stopping you? Are you worried what others might think? Are you wondering if therapy is really for you? Maybe you're trying to decide if spending the money is worth it.

When I scour the web, I read posts from many people looking for therapist referrals. They ask for "good therapists," or "therapists who use Cognitive-Behavioral therapy." If you check out message boards like, Craigslist.org, it's no wonder trying to figure out if there are benefits to therapy. There's so much pessimism about therapy that many people steer away from it.

However, there's good news! Researchers at The Institute for the Study of Therapeutic Change (ISTC) and Partners for Change have proven that there is value in therapy. However, the value isn't in the therapist's techniques or what school of thought the therapist works from. The value is inherently in the professional relationship between yourself and the therapist. In fact, the ISTC shows that about 60% of the success of therapy relies on this relationship. If you trust and like your therapist, there is a higher likelihood that you will have a greater level of success in therapy. The other 40% is based on therapist techniques and the therapist's confidence in those techniques.

With this in mind, how do you know if the therapist you're looking for is the "right one" for you? Well, there's no exact science here. There are plenty of outlets to find therapists, including online directories like PsychologyToday.com or state-specific directories like TherapistFinder.com. Read through the bios. Find a couple that "speak" to you.

When you call the therapist, you will probably only get a few minutes to chat with them to discuss the general issues you want to work on, how much it'll cost and set an appointment. If you get a bad "vibe" from the therapist, do not feel obligated to set an appointment. Move on to the next one.

Therapists work differently, so what to expect upon your first visit can vary. You can read more about what you can expect from me here. The therapist should feel comfortable responding to your questions about the therapy process and any expectations you have.

Hopefully this will help you take the leap to making changes in your life. Therapy is a journey and you have the opportunity to make it work for you!

My Clientele

Okay, I'm not going to talk about my cases here, but I did want to address the type of clients I work with. Many times, I get calls from potential clients stating, "I see you work with couples, but will you work with my issues even though I'm not a couple?"

I do a lot of marketing towards couples because it's an area that I'm very passionate about. My graduate program got me excited about working with couples after taking a 16-week course on couples counseling. From that point, I was hooked! I attend a lot of seminars on couples counseling to keep my skills fresh and I, in turn, provide better skills for my clients.

On the other hand, I like working with individual clients as well. It's exciting to have an individual client contact me. Hearing the motivation in your voice to want to work on whatever issue it is that is plaguing you really impacts me. Working in an one-on-one environment allows us to really delve into the presenting issues without distraction, which can happen in couples counseling.

I want to note that I maintain my practice for those 18 years of age and older. While I am qualified to work with minors, it isn't my forté and I don't feel that I can provide the services needed. However, I do have a close network of therapists who I confidently make referrals to and will provide potential clients appropriate referrals if we find that I am not the right "fit" for you.

If you have further questions about the clientele I provide therapy to, please leave me a comment and I'll respond as quick as I can.

Counselor, Social Worker, Psychologist...What's the Difference?

People have told me that they never know whether to call me "Dr. Blackley," Ms. Blackley or Jodi. Let me clarify how to distinguish the different degrees in the mental health field.

A social worker will have a Master's degree in Social Work and have a License in Clinical Social Work. Unless they sought out a Doctoral degree beyond their Master's, you would not call them a "Doctor."

A therapist will have a Master's degree in Counseling or Clinical Psychology and have a License in Marriage and Family Therapy. Unless they sought out a Doctoral degree beyond their Master's, you would not call them a "Doctor." For this reason, addressing me as Jodi is more than appropriate. If this feels too informal for you, Ms. Blackley is fine as well.

A psychologist has earned a Doctorate of Psychology (Psy.D.) or a Doctorate of Philosophy in Psychology (Ph.D.). You may call a psychologist a "Doctor" as they have earned the appropriate degree.

A psychiatrist is a doctor of medicine (M.D.). Like a general practitioner or a cardiologist, a psychiatrist has also gone through medical school, residency and has earned the appropriate degrees to be called a "Doctor."

Hopefully this will help clarify when to call a mental health practitioner a "Doctor" or not. As for me, please feel free to call me Jodi.

If you have questions about this or any other blog, Please feel to leave comments. I'll be happy to respond.

The Value of Therapy

I have been wanting to start a blog to help people understand what therapy is about and to help clarify what counseling is all about. There's so much confusion and miscommunication around counseling.

First, I'm a Marriage and Family Therapist. What does this mean to you? It means that I have a license with the California Board of Behavioral Sciences that demonstrates the completion of a Master's degree in Counseling, a 3,000-hour internship and 2 state board exams. My license allows me to work with individuals, families, children and couples. I must continue updating my education through workshops and classes to ensure that I am striving towards being the best therapist I can be. I cannot prescribe medications. This is limited to those with an M.D., like a psychiatrist or a general practitioner.

I cannot work with all problems. You wouldn't want to take your Volvo to a Toyota mechanic, right? When you call me to make an appointment, I want to know that I can provide the quality of care you deserve. For this reason, I will ask you about the problems that are causing you to call me. You deserve to have a therapist who is a good "fit." My questions aren't meant to be intrusive, but they are to help me determine if I'm the right therapist for you. If we decide that we won't be able to work together, I have many alternate, qualified therapists that I refer to and will provide you with the appropriate referrals so you can get the help you're seeking.

I will continue with this blog and help demystify counseling for you to make the process feel more comfortable. If you have specific questions or would like me to address specific issues regarding the counseling field, please leave comments for me and I'll be happy to answer them!