When clients don’t turn up (it’s not you! Probably…)

Waiting

There’s only one thing harder than when clients turn up and you have to ‘do’ the therapy you’re training to be better at, and that’s when clients down turn up.

They say pride goes before a fall; at Christmas, I was congratulating myself that I hadn’t yet had any ‘did not attends’ (DNAs). In the first week of january, all my clients except one DNAed. Lesson learnt.

I actually learnt two lessons there. One of my potential clients was coming from somewhere where they had access to a support worker and the appointment had been made through the support worker. It was the support worker who cancelled, using they words ‘they refuse to come’. My first reaction was to be cross – the word ‘refuse’ set me on edge. And then I sat down and thought about it, and it occurred to me that in many ways, MOST DNAs are essentially where a client ‘refuses’ to come. Sure, there will be ‘genuine’ reasons why people don’t come (or let you know, but that’s a different post), but for some people, some of the time, they have just decided that they aren’t coming that week – they can’t face leaving the house, or an hour of therapy. If that’s not a ‘refusal’, I don’t know what is.

My second lesson learnt was ‘clients will DNA and you can’t know in advance when that will happen. Go prepared’, and now, I make sure I have a book, or something to read, so that if my early client DNAs, I have something to occupy me until me late client arrives (or DNAs, in which case, I get to go home early).

Also, that clients will, invariably, not turn up. Either because they forgot, or something has come up, or because they’ve decided that they’re sorted and don’t want to ‘waste your time’ any longer, or, as happened the week of new year, a combination of all of those.

IT’S NOT YOU. Probably.  I thought it was me. This link suggests that 20-57% of clients don’t turn up after the first appointment. That figure for me is currently 10%, and that around 40% of clients only attend twice. So far for me that’s about 20%, so I think I’m above the odds here. It’s worth bearing in mind these figures. They help you feel better!

What to do if a client doesn’t turn up?

The first time this happened I was all ‘I DON’T KNOW WHAT TO DO!’ (the joys of starting and running my own placement – no advisor on hand and no format in advance). Luckily, I was mid-text-based conversation with a couple of trainee friends, and one of them advised that her procedure was to give the client 10-15 minutes and then call them in the session time, which is what I now do on all occasions. It’s getting less scary each time, I’m happy to report.

How do you deal with DNAs?

Related articles

• Expressive Arts and Brief Therapy
• Psychotherapy and Counselling in January – Part II

• Thinking About Attending Psychotherapy? (madeleinemaya.wordpress.com)

Keeping up the impetus

motivation

I don’t know about you, but there are times between training weekends when it can be REALLY hard to be motivated. I feel like I have every book in the world (not true…) and too many things to do at once – I am paralysed by indecision.

It can be really hard to pick up a book when there are so many other books to read, that I’ve decided to take different tacks.

Firstly, there’s facebook. There are several groups of interest on there, with varying degrees of lively and interesting conversation. There’s my facebook student group, there’s the counselling and psychotherapy student lounge, and person-centred psychotherapy and focusing to name but three. I’ve had some incredibly interesting and theoretical conversations on there – it’s not *just* a time-wasting exercise – all you sceptics out there…

There are also journals. much easier – each paper is generally less than a chapter and there is a definite sense of having achieved something. Google scholar is a good place to start. If you have an institutional membership, try clicking ‘more’ and then locateit (or other universities might have different names) if there’s no link. Quite often a university will have the access to the paper under that link -it’s just not immediately apparent.

There’s also online events, which is an amazing resource. It’s free for students to register, and then you get access to all their videos, which include interviews and presentations from some of the biggest names in today’s person-centred world.

Finally for me, for now, there’s twitter. I did a search for person-centred, and then went out from there. I’m on there – why not add me?

If you have any other resources that you use, please add them in the comments!

Focusing-oriented therapy for beginners

Holding the sun

I love the person-centred approach (PCA). I like that it lets you stay with your clients and does not expect you to direct them – indeed, requires that you do NOT direct them.

The PCA has several branches to its family including expressive arts therapy, existentialism and focusing-oriented therapy (FOT) (very americanised spelling, but that seems to be the way it’s ben kept, even in UK). I was never really bothered about FOT; I’m quite a ‘head’ person. I ‘think’ about things and can find it difficult to connect that to an emotion, or a feeling. Conversely, I can experience a body feeling but not have an emotion-word for it, so I thought that focusing would be hard for me to do and something I couldn’t relate to. Then I experienced a demonstration and it was like nothing I’d ever experienced, and I began to wonder if this might be something that would work for me as a therapist, and as the client I have to be.

So I booked an introductory 12-hour course with New Focus Therapy and merrily went down for the course.

It took some time for me to get in to, and I wasn’t always sure I’d like it. It can be process-directive (so you might ask your client to stay with a feeling, to talk to it, to acknowledge it etc, where in traditional PCA you wouldn’t), but I realised more and more over the weekend that as a PCA (trainee) therapist, I just choose DIFFERENT things to focus on.

Watching my fellow trainees (a group of us went together) experiencing being on both ends of this, and then having my own experience was incredible. Suffice to say, i am sold on this method and plan to learn as much about it as I can, in order to integrate it into my therapy. I think it would have very practical applications, for issues as diverse as dissociation, self-injury, sexuality ( coming to terms with) and more.

But my main point about this is: don’t wait until you’re qualified to look at things that interest you. If you have the resources (time-wise, emotionally, financially), GO to things. Some courses will say ‘only when you’re seeing clients’, but that’s not set in stone- I go to a CPD group in London once every few months that shares one of my areas of interest. The paperwork says that you must be seeing clients, but they were happy for me to come when I asked.

New year’s resolution. Or ‘ways to stay on top of coursework’

Calvin and Hobbes discussing new year’s resolutions

My new year’s resolution is to be more organised with my classwork. It’s not the writing of the assignments that’s the problem, but the organising of the papers and then… references (most students’ nemeses).

On my course, the tutors are kind enough to put up some of the reading materials that they deem ‘essential’ (all within correct copyright usage of course!). This is lovely, but I have to keep going back to our moodle site to check which were for which assignment, and that gets long-winded.

I’ve been using a program – Mendeley (available free for mac and PC), to organise my papers. Essentially, you put all your papers in one folder and tell Mendeley to look at it. Then when you open it it lists all the papers there! Magic! Or at least, it is (often) if you’ve downloaded the newer electronic versions, as all their fields tend to be in the right places (title, authors etc). If it’s a scanned copy, that doesn’t happen and so you have to spend some time fixing those things.

It occurred to me as I was writing my last assignment that I just need to ‘tag’ each paper with the module code and then when I was writing my essay I could look for the module tag and voila! It’s only taken me a year to think of it…

The other magic thing it does, ALSO that I didn’t realise until this essay, is that if you spend the time fixing the info that comes in with the paper it references for you (handy hint- if you make sure the title is correct and then tell it to do a google search on title, it often comes back with the correct/nearly correct info, which you can ‘agree’ to or correct as needed) if you download the free word plugin.

When writing your essay on something like ‘the necessary and sufficient conditions’, you might like to cite Rogers’ 1959 paper. If you install the handy mendeley plug in for word, you just click an icon, type in ‘Rogers 1959’ (or some of the title if you prefer) and it puts the citation in for you. You then scroll to the place you want your reference list and ask it to ‘insert bibliography’. Thereafter, every time you cite something, it automatically adds it to your references, in alphabetical order.

You can tell it which referencing system you’re using, so ‘Harvard, Middlesex university’ type, and it will put them in in the correct format for your institution.

The last thing you can do is (at least on iOS) download the free mobile phone version of Mendeley and link it to your computer account and it lists all the papers. If you want to read one, you can download it to your phone. As you can see from the image below, I have the top article on my phone (the book icon) and if I wanted to read another, I’d just press the down arrow to get it.

For Android users, you can use Referey, which is still free, but you get slightly less functionality.

Now, if only it would write my assignments for me, I’d be delighted 🙂