Therapeutic process

Locke (17th century)

 Let's use an example:
You are having breakfast with your
family. Your daughter knocks over a cup
of tea onto your shirt. You have no
control over what just happened.
What happens next will be
determined by how you react.
 One possible reaction: You curse
 
You harshly scold your daughter for knocking the cup over. She breaks down in tears.
After scolding her, you turn to your spouse and criticize her for placing the cup too close
to the edge of the table. A short verbal battle follows. You storm upstairs and change
your shirt. Back downstairs, you find your daughter has been crying not finishing
breakfast and not getting ready for school. She misses the bus.
 
Your spouse must leave immediately for work. You rush to the car and drive your
daughter to school. Because you are late, you drive 40 miles an hour in a 30 mph speed
limit. After a 15-minute delay and throwing NRs 2000 traffic fine away, you arrive at
school.
 
Your daughter runs into the school building without saying “goodbye”. After arriving at
the office 20 minutes late, you find you forgot your briefcase. Your day has started
terrible. As it continues, it seems to get worse and worse. You look forward to coming
home.
 
When you arrive home, you find coolness in your relationships with your spouse and
daughter. Why? …

Why did you have a bad day?

A) Did the coffee cause it?
 The other possible reaction:
Here is what could have and should have happened.
 
Tea pours over you. Your daughter is scared and about to cry. You
gently say, "Its Okay dear, you just need to be more careful next
time". Grabbing a towel you rush upstairs. After grabbing a new
shirt and your briefcase, you come back down in time to look
through the window and see your child getting on the bus. She
turns and waves. You arrive 5 minutes early and cheerfully greet
the staff. Your boss comments on how good the day you are
having.
 
Notice the difference?

Two different scenarios. Both started the same. Both ended

different.
 Assessment

This phase typically involves the completion of forms that convey your
physical and mental health history, current challenges, personal
goals for therapy, and establishing the foundation for a healthy
working relationship.  To the extent that psychological testing is needed or
recommended, such testing would normally occur during this phase.
Stabilization

Stabilization involves identifying immediate areas of health or

well-being concern where intervention and symptom relief are
vital.  Stabilization can involve different things for different people.  Typically,
stabilization focuses on self-care issues (nutrition, sleep, exercise, work/life
balance, relationships, etc.).  The therapy relationship continues developing
through hope, warmth, compassion, acceptance, and mutual respect.
 Symptom Relief

This phase varies to a great extent, based on the unique challenges of the
individual and their particular mental health diagnosis.  For example, those
recovering from trauma might experience a relief from flashbacks,
hypervigilance, nightmares, and other related symptoms.  An individual
healing from excessive levels of stress and anxiety may experience a
greater sense of peace, an enhanced ability to engage with
their lives without chronic stress or improved sleep and nutrition habits. 

Skills, Tools, Cognitions, Behaviors

This phase is all about addressing your beliefs and filters (those which serve
you and those that do not serve you).  We also identify tools and skills
you would like to strengthen and those you would like to
replace.  We focus on developing an understanding of how your
unique experiences and coping skills contribute to your actions and
behaviors.  We engage in learning new skills and healthy coping strategies.
 Self-Acceptance & Appreciation
I like to think of this phase as the summary phase where we get to celebrate
your progress and continue applying your new tools for self-
management and personal well-being.  Typically in this phase, you are
building a strong relationship to your physical, emotional, mental, and spiritual
self.  You are developing deeper trust of self and self-confidence.  You are
learning to appreciate who you are in relationship to yourself and to others.

Transformative Change (Self-Mastery)

Embracing transformative change and the art of self-mastery takes time.  In this
phase, you are adjusting to new feelings, self-confidence,
and self-esteem, and becoming well-practiced in your new
skills.  You have  experienced letting go of old skills and
patterns that no longer serve you and you respond actively
to life with its many opportunities.  I call it the "thriving" phase.