During therapy

I don’t feel very involved in the process

In this section we are examining key processes that will be helpful to consider if you don’t feel very involved in the process of therapy and suggest ways in which you might be able to feel more involved. 

Collaboration

The therapist used a rigid approach with me, rather than listening to what I needed. I might as well have read a self-help book.

At its heart, collaboration refers to the experience of a respectful, mutual and cooperative relationship, between the client and therapist. In practical terms it refers to the ways in which they are both (literally) ‘working together’. Without this important process therapy may become one-sided, vague, impersonal and may lead to imbalances of power

An obvious way in which collaboration occurs is the degree to which client and therapist agree on what the client wants to get out of therapy (i.e. the goals of therapy), and what needs to happen in therapy to reach those goals (i.e. the tasks of therapy). These two aspects form part of what has been termed the Therapeutic Alliance. From this point of view, it is not simply enough to like and have confidence in your therapist – for effective therapy to take place there also needs to be an agreement on the goals and tasks of therapy. 

What gets in the way of collaboration?
A number of factors can lead to clients not being, or feeling, very involved in therapy across all stages of therapy. These can include 

  • Limited availability of effective therapies in a particular area,
  • Poor information on what to expect from therapy I think that at the beginning my therapist should have laid out a framework or a plan so I would know what to expect
  • Distant relationship with the therapist
  • Being too close to the therapist
  • Unprofessional therapist behaviour
  • Excessive fear or terror in the client
  • Unequal balance of power …there was a power inequality really. I didn’t really feel like I could say anything
  • Client finding it difficult to work collaboratively
  • Therapist devaluing the client
  • Therapist blaming the client when things go wrong
  • Therapist being rigid
  • Therapist’s emotional reactions inhibit the client
  • Therapist unnecessarily prolongs therapy
  • Client not involved in planning ending of therapy

What can I do to get more involved in the process?
The first step is to try to negotiate or renegotiate the goals of therapy with your therapist. This will be easier if there is a positive emotional bond between you and your therapist. However, it will be more difficult if you don’t feel you have a positive relationship with your therapist or are not getting on with them. Nevertheless, in all cases we would encourage you to raise the issue with your therapist. If you are able to do this, you can then work towards negotiating and agreeing the goals of therapy, the therapy methods and, ideally, the nature of the relationship between you. 

This of course assumes that it is possible to develop a relationship with your therapist, and that you feel comfortable and safe enough to raise these issues. 

If you do not have 1) a positive relationship with your therapist, 2) agreed tasks and 3) agreed goals, you are less likely to derive as much benefit from therapy, so it may be useful to consider seeking another therapy or therapist.