“Always remember you are braver than you believe, stronger than you seem, smarter than you think and twice as beautiful as you’ve ever imagined.” – Dr. Seuss
When we start seeing clients during our earning-hours phase, whether we are 5 or 1500 hours in, we encounter a mix of emotions and challenges. It can feel exhilarating to finally be doing therapy or counseling clients, and at the same time feel overwhelming as we enter into their darkness and difficulties. We may feel in over our heads or in a groove. We can begin to wonder, “What is our responsibility to them as a clinician and what is theirs as the client? Where does their self agency begin and my therapist role end?” Or you may feel frustrated that you are not quite doing therapy or counseling because much of your work is case management with a lot of administrative paperwork and quotas to meet. You are tired of that and wish you could focus more on the actual work of seeing clients.
Finding our way as a therapist encompasses so much. It is contingent upon the opportunities we get, or don’t get, professionally. It’s based on where we work and the clients we interact with, as well as colleagues and supervisors. Everything affects who we become as clinicians. And it is not only the skills and knowledge we gain but also our own personal issues we bring to sessions—who we are as people.
We are Susceptible to Stress at this Time
All of this leads to our susceptibility of getting tangled up in a web of challenges, confusion and plain old stress.
“What do we ask next?
Is he or she seeking advice from me, or is their real need to be heard and understood?
How do I help him or her stay sober?
What technique should I employ right now?
Will they feel like I care more if I allow them to carry on past the time the session should end?
How else can I help, beyond sitting and being with them in their struggles?”
We may long to find the perfect antidote for every ill a client presents with. It can be a helpless feeling to face clients’ serious struggles without something to do or implement.
These and an endless number of questions and doubts percolate as we meet with one client after another. Each person presents with unique needs and problems which challenge our ability to get, and stay, grounded as therapists. We may pour our energy, heart, soul and mind into our clients only to be left with an inability to manage our own personal and family relationships. We get drained mentally and emotionally, and anyone else’s needs or moods may feel more than we can handle. We get tapped out and wonder how to keep moving forward.
All of this is because:
- Becoming a therapist or counselor is grueling. It’s difficult to hear and take in many client’s woes and problems. We question ourselves and our abilities–are we enough? Plus, there are multiple layers of work and growth occurring within you at any given time with each client, and it’s important to take care of yourself personally and professionally. We have limits to what we can do and how much we can feasibly take on. What that means for each person may be unique, but there are general guidelines and routines that can be implemented.
- Better boundaries are usually needed. As we move forward in this line of work, we must continually assess where we are at internally with how a) overwhelmed we feel, b) how compelled we feel to rescue our clients or go above and beyond the call of duty as their therapist or counselor (e.g. codependency), c) tapped out we feel in our interactions with our own family and friends, d) well our self-care routines are supporting and nourishing us (are they effective, or not enough?).
- Even with the best supervision and internship site, there is not enough guidance or training available to address the numerous needs we have as training therapists/counselors. One or two hours a week with a supervisor who has his or her own caseload, and other supervisees, has a limited capacity to support you in the ways you need, in order to grow and learn in optimal ways. Many questions and conundrums go unaddressed or unanswered, which over time impacts your effectiveness.
- Our own issues affect our work as we adjust to becoming a counselor or therapist. Whether we have been in therapy or not, certain challenges will rear their head in our lives as we become therapists and counselors, which are actually blessings in disguise. These are opportunities to grow, but unless we can recognize them (and we cannot usually without the help of a good supervisor, or our own therapist or consultant) they will remain unconscious and continue to affect us, simply because we are blind to many of our own issues. And when we begin as a therapist, our issues will surface in some unique ways that probably hadn’t before. Interactions with clients bring certain issues to the fore. Our childhood, or family of origin issues come out as we’re finding our grounding as therapists. Our core issues that stem from our early development play into how we experience our clients and what countertransference surfaces. Also, many of us who come into this field do so because we were “caregivers” or had the role of helper in our families. We may also be the one who was the peacekeeper or scapegoat in the family. There is a vast array of experiences we have had within our families, so it’s important to explore this and understand where we are coming from and what issues we need to grapple with ourselves as we continue to see clients and gain hours.
- We may be in unhealthy relationships ourselves and stuck in unhealthy patterns, which is taxing and draining on our overall well-being. Whether it is in our work or family life, or perhaps a friendship or intimate partner, staying in toxic relationships can drain us and wreak havoc on our well-being. Let’s face it, as therapists and counselors we are human first and foremost. Unfortunately, we are not immune to being a part of toxic relationship dynamics. Exploring this with a therapist yourself can do wonders for helping you assess if this is the case and how you can best handle those situations, which often involves implementing some better boundaries and coping skills.
What You Can Do
Early on in this work, one of the best tactics you can implement is making an effort to not be attached to outcomes in our clients. This may be counter to what you hear from site supervisors or clinical directors, because for administrative purposes they have a need to show progress. It’s not that you altogether give up the desire for your clients to overcome their issues or grow in certain ways, it’s that by internally making a shift from needing to see an outcome, you will let go of internal pressure and be more in tune with the process of therapy, better able to be in the moment emotionally. Often early on, we want to implement a technique or intervention that will alter something right away. When really following your clients’ process and where they need to go in session is primary, as well as remaining curious and accepting–and most of all trying to put yourself in their shoes.
Also, refraining from praising or blaming yourself when a client improves, stays sober or relapses can help you not to take your work home, so to say–and may reduce stress.
If you are fully present for each session, giving them your all in terms of active listening, non-judgment and geniune curiosity and properly handling any legal or ethical issues, then you farther ahead than most. Just trying not to worry about your clients, but caring about them, and having faith that you will improve in time, can do wonders for your overall well being. And, seeking additional advice and consultation on challenging cases will broaden and deepen your understanding of clinical issues, and allow you to rest better knowing you have a handle on the most difficult cases.
No Magical Elixers
The last thing I want to be is presumptuous and communicate that I have an elixir for all the problems every pre-licensed clinician faces. What I can offer are tried and true approaches that work in the therapy/counseling business, and what has helped me and countless others successfully navigate the licensure process. It’s truly about getting help to navigate the business aspects and becoming a better clinician. Whether you are a mental health counselor, marriage and family therapist intern, social worker associate, professional clinical counselor, or registered psychologist associate, it is possible to put your best foot forward to ensure you do well and live the licensed life. There are many obstacles to navigate through, and as someone who has overcome many and helped others too, I developed services to help pre-licensed clinicians get through pre-licensure successfully.
What I Can Do For You
My coaching services can help you with the various aspects of finding an internship and landing the ideal job (whether it’s a traditional type or not), or help you succeed in starting and growing a private practice as an intern.
My consultation services can help you better understand your cases, or particularly challenging ones. With advanced training in psychodynamic theory/therapy, as well as training in DBT, EMDR, CBT, Solution-Oriented, attachment and family systems, I can help you overcome challenges and areas where you get stuck. So, you can grow as a therapist and advance your skills.
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Happy New Year and Let’s Make 2018 the Best Year Yet!
Tyra Butler, LMFT, Early Career Clinician Coach
Part of this post was inspired from a conversation with my colleague Jennifer Nash-Naiyer Jennifernashnaiyertherapy.com. She is a licensed clinician in private practice.