Sometimes I am useless

I like to think that I could help anyone improve their life, however occasionally I see a client who I don’t think I will be of any use to…

I was reviewing some statistics recently. I provide paid and unpaid work for a charity providing counselling services in Glasgow, as well as seeing private clients. The charity uses questionnaires before, during and at completion of therapy to assess clinical outcomes for the clients who use the service, this is mainly for the charity’s funding but it also provides a way of seeing our outcomes with clients. I looked at a graph with all the results from the clients I’d seen over the past 18 months and I was really surprised (in a good way) that of around 30 clients nearly all of them had improved in a clinically significant way. There were only three clients who hadn’t improved, they had stayed the same. Thankfully no one had gotten worse as a result of coming to therapy with me. The ones who’d not improved had stayed for less than 5 sessions or in one case had been really erratic in their attendance before leaving. The 90% who’d stayed for between 5-30 sessions had shown moderate to high improvement. In a way, despite being delighted at seeing this, it wasn’t something that surprised me. The questionnaires that I’ve asked clients to fill out only confirm what’s already apparent to me.

Sometimes though, I am of no use to a client. I always see a client for the first time with the expectation that I will be able to help them. I stay with it, even if it’s awkward or difficult and sometimes a client leaves after a few sessions. I don’t really have any way of knowing why, although I wonder about this. For the first time the other day I met with a client for whom I knew in the first session that I would be of no use to.

There were several things about this client that led me to this conclusion. Firstly they had real difficulty with comprehension during completion of the initial assessment questionnaire – these questions are not difficult to understand but the client really struggled with some of them, I had to keep rephrasing, they kept asking me to be more specific. They may have had issues with reading as they asked me to fill out the form for them. The second thing was their memory; they had been for counselling a few years previously for around 14 months, but they weren’t able to say why they’d attended, remembered who they’d seen or what benefits they’d gotten. Then they said they was already attending counselling with someone else. All they would say about that was that it was very specific and they attended fortnightly. They didn’t want to tell me what it was for or which organisation was providing it. Generally you shouldn’t see two different therapists at the same time, they may work differently, they may be working unknowingly at odds with each other, it can be confusing or it can complicate things. Given that the client’s other therapy was very specific this on its own is not a reason to not offer someone a service. If it was an addiction service they may be very focussed on drinking behaviours and drink diaries, it’s possible to also see another therapist to talk about more general mental health issues or relationship issues. However, coupled with the difficulty with memory and comprehension I felt I would be of little use to them. This is the first time I felt so sure a client would gain very little, if anything, from therapy.

So that’s an example of when I felt as if I’d be no use to a client. This is quite different than feeling useless and I have on occasion felt useless as a therapist. I’m pretty sure on those occasions the client is left with the impression I was useless. This has usually happened because I’ve not given the client what they want – rescue. Some clients come to therapy wanting you to rescue them or fix them or provide them with the solution to all their problems. I can’t do this. I am not a benevolent wizard with a magic wand, although I can understand why seeing me for the first time might give you that impression (no, I don’t wear robes but I do have a stubbly greying beard). It comes out of a feeling of awkwardness, usually during a silence. I am left feeling useless in response to a client. I have only really been able to work through this with a client when they are not paying for therapy, when they are paying they tend to leave after a few sessions rather than work with me to overcome this feeling that I am useless.

Usually – in this working through of things – they slowly change and find they don’t need answers or solutions because the issues they had have gone or don’t bother them any more. I think this is down to a change of perspective.

Phrases I hear from clients when we review how things are going are usually along the lines of “it’s like a weight has lifted”, “I think about things in a different way.”, “It seems so obvious now why.”, In some cases circumstances haven’t changed for that person but the situation is no longer a disaster they can’t cope with. I am useless sometimes but 90% of the time I’m really effective. That’s good enough for me.

If you are looking for a therapist get in touch here, or book a session here. If you want to find a therapist and you don’t want to see me I’d be happy to recommend someone who doesn’t look like they might be a wizard.

benefits of therapy, imposter syndrome, magic wand, solutions, usefulness, uselessness

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