Thursday, February 21, 2008

What should we expect from our therapist?

I posted this question on yesterday:

I'm wondering if you could describe to me what a typical session with your therapist looks like.

We are using a PhD that specializes in family issues and eating disorders (is associated with a local in-patient eating disorder center). He is a good mix of both and he fully supports us in using family-based therapy. I've felt like he was a good choice because there are no Maudsley therapist around us. Our first months of visits have been fantastic. He gave a lot of new ideas. N likes him and answers his questions honestly (although the therapist has never seen our son when the anorexia was pushing through). We attend the sessions together (usually our son and one of the parents).

Lately, though, I've wondered if progress with the therapist has stalled. Most things that come up are just repeats of previous conversations. The therapist even told me once that he had pretty much given me "everything he had" and we would just be working on tweaking things and adjusting things as our son needed it. I was learning so much and so fast when our son was first diagnosed. Maybe it feels stagnant to me because the learning curve has dropped off and now things with my son are more like a broken record.

We typically visit every-other week for about 50 minutes. The therapist usually asks my son how he is doing (going through the typical school, friends, how do you feel about yourself? ocd, anxiety, stress, and any other previous issues). Then he'll ask me to characterize how things are going. We'll talk about this generally for a while. The therapist will give suggestions for any new (or not working) issues a long the way. Then the therapist will ask me if there are any specific things that he should address. I'll make a suggestion (like last night it was managing stress). Then the therapist will give my son some new ideas (or repeat old ones) on how to deal with that issue (stress last night). We all contribute, but I try to stay out of it mostly. I can tell that my son "sugar-coats" everything so sometimes I'll throw in my thoughts. I also try to help my son apply what the therapist is talking about. I think the therapist usually deals with older adolescents and adults. But he has a 12 year-old son, so he is usually pretty good about applying ideas to an 11-year old mind. But sometimes, I think, it helps me to put things in a context that I know my son will understand.

Should more be happening?


Anonymous said...

My son sees a therapist for fallout from strep issues, and has been for a year now. I guess every therapist's style is different, (and we've seen quite a few now). The structure you're talking about doesn't seem that unusual.

Usually what happens with us is checking in on anything that's developed since the last visit, reinforcing coping skills, looking to the time before the next visit.

I guess the key thing is whether your son thinks it's helping. I always ask mine after the visit if he thinks it was helpful. There were some therapists he didn't think helped at all, others who helped "a lot".

Good luck to you and your family. This is a tough thing to deal with.

Wendy said...

Thanks for sharing. I need to ask my son if he feels like the therapist is helping. I'm interested to see what he says.