Decisions, Decisions

When seeking a therapist, related questions in this process are “What am I seeking to get out of counselling, and who do I want to help me?” A common response to these questions is ‘I want a counsellor who helps with relationships, anxiety, anger management, etc.”

There is another aspect— therapeutic fit— the importance of finding a counsellor with whom you feel heard and respected, and with whom your goals are understood and that there is agreement about how to move ahead.

In assessing therapeutic fit, a key question is whether you wish your thoughts, feelings, behaviours and experiences to be challenged by the counsellor and if so, how much?

The Challenge Continuum

One way of conceptualizing challenge is to look at challenge as a continuum, keeping in mind that therapists may vary their position on the continuum depending on several factors that I will touch on below.

These are not fixed categories and there may be overlap between even seemingly opposite categories; the deciding factor should be the needs of the individual client. The following are general observations.

Low-Challenge Counsellors

Typically, a low-challenge therapist would not, or rarely, offer their opinion or make suggestions. Rather, they would likely listen, reflect back their understanding of what you have said and offer little resistance to what you are saying. Their tone is accepting and positive. 

Who Benefits? – While there are always exceptions, in general:

• Counselling clients who have a history of being excessively criticized, put down by others, emotionally abused, judged or shamed.
• Counselling clients who have never been adequately listened to or have no one currently in their lives that listens; Another variation on this: people who want the counsellor to bear witness to their experience – the client is not attending counselling for advice.
• Counselling clients who benefit more from “letting it out” as either a form of tension release or as part of a process of ‘talking it out’ which then helps the person to come to their own conclusions.
• Counselling clients who have a history of trust violations which would make feedback unwelcome, particularly in the early part of a course of counselling, until therapeutic trust has been established.
• Counselling clients new to counselling who are nervous about the process and want time to adjust.
• Counselling clients who need to see rapport established with their counsellor first, before being open to challenge.
• Counselling clients who have done a lot of work in therapy and accomplished many of their counselling goals. The counsellor at this point is supporting and helping to consolidate these changes.

Who Does Not Benefit – Again there will be exceptions, but in general:

• Counselling clients seeking more feedback or direction from the therapist.
• Counselling clients who are seeking a structured counselling approach.
• Counselling clients who are triggered by the idea of a ‘blank slate’ therapist and are seeking engagement from their counsellor.
• Counselling clients who are seeking a direct therapist who will cut to the chase; such folks often become frustrated or irritated by indirectness.
• Counselling clients who are looking to ‘fast-track’ their therapy and consider pleasantries a waste of time.

High-Challenge Counsellors

Here we might see a situation where the therapist calls the client out on things like:

• Illogical thoughts
• Stuckness/lack of action steps taken
• Behaviours that have had negative consequences/could lead to negative consequences
• Repeat patterns
• Lack of initiative/investment in counselling

The counsellor may deliver this message in the form of specific feedback, questioning, or by assigning challenging homework. Such therapists are often not afraid to use common, direct language that is decidedly non-academic, in order to make a point. This should never include such things as mistreating a client by verbally abusing them, name calling them, swearing at them, threatening them, labelling them or the therapist lording their power over the client.

Who Benefits? Understanding again that exceptions will always apply:

• Counselling clients with a direct, ‘no-nonsense’ personality themselves.
• Counselling clients who are specifically seeking challenge.
• Counselling clients who do not offend easily, providing the counsellor is actually not trying to be offensive.
• Counselling clients who value their friends but find their support “too supportive”…when friends are perceived to “take my side no matter what…I want an objective opinion.”

Who Does not Benefit (although exceptions will apply here, depending on the person):

• Counselling clients who are tentative or unsure about counselling.
• Counselling clients who self-describe as shy/non-confrontational.
• Counselling clients who have a history of trauma and may require a non-directive counselling style that values the client’s autonomy.
• Counselling clients who are very sensitive to feedback of any kind, no matter how well-intentioned; Counselling clients who are not looking for feedback.

Medium-Challenge Counsellors

Here the counsellor attempts to strike a balance between a supportive counselling approach and providing feedback and challenge; generally the latter will occur when rapport and trust have been developed in the counselling relationship, which usually happens after an extended period of time working together. When there is insufficient trust in the therapeutic relationship, any challenge introduced in the therapy may be perceived as “high challenge.”

Self-Assessment

How does both counselling client and counsellor decide where they fall in the challenge continuum? The reasons are actually quite similar and may include:

• Personality
• Both client’s and counsellor’s previous experiences as a counselling client. Through such experiences clients will understand what works best for them in counselling, and counsellors, who have had previous counselling, will develop empathy for being on ‘the therapy couch’ and what may or may not be helpful in counselling.
• The length of the counselling relationship – has sufficient trust developed?
• Client’s and Counsellor’s Assessment – Counsellor: based on how they have assessed the client’s situation and needs and what interventions the counsellor thinks might be the most compatible; Client: what the client, based on their self-knowledge, believes would work best for them

If you’re still unsure about what you need, arrange a consultation, if available, and ask the counsellor to describe their therapy style.  Consultations are often a good move regardless. Listen to your guts after speaking with the counsellor: does their style jive with yours? This is just another element of the all-important counselling fit.