Changing The Conversation

For some, there’s a negative stigma surrounding the word ‘therapy’ that can serve as a major deterrent from seeking help. Many may feel disappointed in themselves or judged by loved ones. Some even grapple with feelings of guilt or worthlessness after recognizing the need for therapy. As a clinician, do you seem to find yourself looking for effective ways to normalize getting help for your clients? 

The negative feelings a person may have regarding therapy can stem from any number of past or current experiences. Consequently, there is no one recommendation that will help you remove the stigma for each patient – but a varied approach could help address and normalize these issues. 

Ask Your Clients About Therapy Sessions

It is natural to focus on the immediate matter at hand during therapy sessions, whatever the reason may be. However, it is also important to ask clients about their thoughts on why they are seeking help and how they went about it. Some may share their feelings about being in therapy or how others have reacted to the information. This may be important to understand their immediate attitude and how you can help break the stigma surrounding seeking care.

Break the “Crazy” Myth

Research from Bradley University points out that the stigma surrounding therapy is directly correlated with society’s view of mental health. It confirms that these stereotypes reduce the likelihood of people seeking help and also hinder the healing process. Those who seek help often struggle with personal feelings or external bullying that paints a picture of the “crazy” person needing treatment. An open mind is essential to getting better, and sometimes professionals have to help their clients get to that point. Anyone can benefit from therapy – no matter what their background is.

Teach Coping Mechanisms

Professional behavioral health services can help people overcome some of the most devastating trials in their lives, one of the many reasons why it’s so valuable. However, if your client does not know how to cope with the adverse reactions to therapy from others, they may begin to see therapy as part of the problem. Prepare them for potential negative reactions from family and friends and equip them with the coping mechanisms necessary to tackle this. Then, return to the issue at hand.

Consider Group Therapy

Research done by Bradley University believes that clients may feel less awkward about therapy once they realize how many other people from all walks of life rely on it. Occasional group therapy sessions may help make this possible. If you do not personally host group therapy sessions, you may recommend local community outreach programs instead.

Be Mindful of Word Usage

Sometimes, how clients feel about therapy comes from subconscious reactions to specific words. For instance, if someone already thinks they are ‘crazy’ for seeking help, terms like ‘patient’ and ‘suffer from’ may not help break this mindset. Research  confirms that these terms and others like them often have negative connotations that may also dehumanize the individual. It also recommends reconsidering the phrasing of diagnoses. For instance, it is better to say “someone who has schizophrenia” instead of labeling an individual as “a schizophrenic.”

Encourage Daily Sessions

The more often someone engages in a particular activity, the more desensitized to it they become. Your client may not have the means or time to meet with you several times per week. However, there are other things they can make personal time for each day. The regular addressing of mental health may help to desensitize the negative feelings that accompany therapy sessions. These are some tasks to consider assigning for personal me-time sessions such as journaling daily, keeping a gratitude journal, and doing daily meditations.

Take Varied Approaches

As mentioned earlier, the reasons behind the stigma people internalize may differ. Take time to understand the problem and the client before deciding how you will address the issue. In some cases, you may find it is better not to address the issue at all or not in the beginning. There are many instances of clients starting sessions enthusiastically and only running into negative perceptions from others after the fact. In some cases, they may never experience this negativity at all. Being the first to bring up the potential stigma to prepare patients before it happens may do more harm than good.

Regardless of how you think your client should treat therapy, they will have their boundaries in place. Strike a balance between guiding them in the right direction and respecting their existing boundaries. 

The Bottom Line

One of the biggest mistakes behavioral health professionals make is to wait until the beginning of sessions to advocate for clients. The work begins outside of the office. It starts with family, friends, and even other colleagues. Educating the general public can help reduce the likelihood of negative reactions for others. There are more people in therapy than ever before. Millennials have been credited with spearheading this development. This trend signals that the stigma is lifting, making it easier for you to normalize therapy. Having a stable platform to depend on for strong referrals can further help build trust in behavioral health services as part of a standard, holistic treatment. Start your free trial on TPN.Health to access more trusted referrals today.

Lessons From My Mentors

Written by Brandy Price Klingman, LCSWBACS

In my career thus far, I’ve been blessed to have some great mentors, supervisors, and colleagues. These leaders have helped shape me into who I am today through their generosity and knowledge of wisdom. In the spirit of sharing the wealth, here are my favorite tips for new or developing therapists that I have learned from many mentors and supervisors (P.S. I’m naming these great masters to honor them.)

1. Strangers on a Train

An early tip from a great mentor came from my internship’s first supervisor, Butch Robicheaux, LCSW, BACS. I was excited to be interning at this site and had prepared a beautiful binder full of handouts for my clients, covering every topic from coping skills to grief and loss. 

I asked him, “What should I do before going into my first individual session?” He looked at my color-coded binder and was kind enough to say, “That’s very nice, but you won’t need that. You will have a conversation in this session. You will speak to this person with sincere curiosity and compassion like a stranger on a train. You don’t need to have anything wise to say because the connection is good enough to start the relationship. You won’t connect with a handout from that binder.” 

I often reflect on this “strangers on a train” guidance and smile because I’ve now made my career off of this simple piece of advice. The importance of a connection that comes from the simplest of conversations filled with compassion and curiosity can change the session’s dynamics from ‘therapist driven’ to the ‘client here and now.’ It’s helpful because there are so many problems a client could bring into a session that are out of anyone’s control, and I could never create enough handouts for all those stressors. But, I can always go back to the idea of a conversation with a stranger on a train.

2. Crisis Is Contagious, So Prepare Yourself

One of my first jobs required me to provide psychotherapy to groups of 10-12 people in a partial hospitalization program. I loved this work. I enjoyed and feared these groups. Often these settings had many personalities and a shared struggle of emotion regulation. The job was simple in my mind – find the problem with all the clients, and fix it. 

But the issue was complicated because there was always a crisis. Luckily, I’m good at crisis management, and during this time, I considered myself a professional firefighter (always looking for small fires to put out, as I was feeling better and better about my skill set). However, I was exhausted at the end of the day, week, or month, and I knew I would quickly be spent by the end of my career. This must be what they taught us in school about burning out. I understood at this point. 

When I discussed this with my clinical supervisor Karen Travis, LCSW, BACS, CGP (even more letters behind her name), I told her how well I was managing these crises, and she asked me how I felt. I described myself as tired, overwhelmed, and anxious. She then told me, “Crisis is contagious girl, and you are catching it.” She discussed the importance of understanding the client’s crisis separate from the therapist’s. She reviewed the importance of not meeting their situation with my crisis of “managing,” “fixing,” or “resolving.” She taught me how to help them explore their concern and process their feelings around it. 

Karen also told me the importance of allowing them to sit in the crisis until they were ready to move on. I will forever hear her voice when I think of rescuing my clients in crisis. I now even reposition myself the same way she did when I notice this happening in a session (very relaxed, arms casual on the chair, shoulders back and low, and voice soft, calm and confident). I’m grateful for this lesson as a professional and as a person. It turns out to be great advice for parenting, too!

 3. Permission to Feel in the Session

In school, I had a professor, Sherry Smelley, LCSW, who taught a Grief and Dying Class. The class was particularly difficult for me to remain in my cerebral safety zone due to all of the presenters’ vulnerability in sharing their experiences of grief or loss. At one point, I remember a speaker sharing something so sad, the entire class (including me) became tearful. When I asked my professor, “How are we supposed to hear these kinds of stories and not feel too much?” She smiled and said, “Well, honey, you are supposed to feel…you are human. It’s what you do with these feelings that’s important. You’re permitted and even encouraged to feel in these sessions.” She said this with a soft, buttery voice and a southern accent that reminded me of my grandmother. 

Permission to feel is vital in our daily work. It is our job in individual therapy to serve our clients in the ways they need, and one of those is by checking in with our feelings, thoughts, and judgments as a barometer of the room and the world concerning them. Our emotions are important and helpful in figuring out ways to serve our patients best to achieve their goals. 

This advice is incredibly useful these days due to the overwhelming stressors of current times. I encourage my staff to be mindful of their stress, grief, worry, fear, anger, etc. as they walk into a session. This personal awareness improves their ability to connect to the client in the here and now. 

As I write this, I am mindful of so many things my early mentors and supervisors have taught me – I could go on and on. For now, I will stop here, flooded with gratitude for so many great lessons from the masters who took the time to reach out to me. #blessed

About the Author

Brandy Klingman, LCSW-BACS

Brandy Klingman, LCSW-BACS, is a skilled psychotherapist with a small private practice, as well as an owner and operator for mental health and addiction clinics. Her mission is to improve behavioral health standards of care and decrease barriers to accessibility for all. She does this through direct patient care, professional supervision, academic/university affiliations, professional consultations, public speaking, business development, and legislative advocacy. She is a coveted speaker in professional workshops, academic settings, and trainings.