What Does It Take to Truly Help Clients

What does it take to truly help our clients? Do we need to have helped ourselves? Do we need to be continuously helping ourselves? Or does it even matter?  Do we need to have a certain amount of knowledge? If so, what amount and what type of knowledge specifically, given how broad of a field we are in? Do we focus more on their emotions, more on their behaviors, or more on their thoughts? When do we focus on their beliefs? Or is it about focusing more on their past, or on their relationships, or on what solution they are seeking to what problem?

These questions may sound overwhelming to some unless they are properly contextualized. Let us give it a try:

There are over 500 forms of psychotherapy. Not 50, not 5, rather, over 500, though most of us may have heard about only a few dozens of them, which are likely to be the most common ones. Several studies conducted across major academic settings have proven that almost all of these forms of psychotherapy have their own merit, and that there is no absolutism that any one of them is better than the other.  Let us qualify this last statement before moving along:

If your main focus with the patient and client is on addressing Cognitive errors, then CBT may be your best choice. If your main focus is on helping someone live better with his or her emotions, then you may opt for DBT. And if you want to help someone, by focusing on his or her ability to grow, on his or her strengths, then you opt for Humanistic Therapy, which in turn has a number of subtypes. If your head is already spinning, please note, we have only mentioned 3 forms of psychotherapy, two of which are among the best known by everyone, including non-clinicians. 

Now, let us go back to some of our initial questions: When do we focus on someone’s thoughts? When do we focus on their behaviors, or their emotions, or their beliefs, or their trauma, or their past?  Well, one reflexive response might be, “well, we are to be collaborative, and we will help determine the treatment plan in collaboration with the client.” And that is correct, and very few clients come to us and say, “I need to work on my beliefs.” Those who do, belong to the minority, and even then, you often discover that same sentence was part of their own defense. So the question remains, and let us try to get to the answer:

1. None of the 500+ forms of psychotherapy can ever be a panacea for any of our patients
2. No single clinician will become an expert in all 500+ forms of psychotherapy, and we would encourage against even trying
3. Our clients do come to us, hoping for positive outcomes
4. We know that as long as we use exclusively the same tools we currently have, the outcomes they are hoping to get from working with us will be either elusive or limited at best
5. As the intelligent clinicians that we are, we start thinking, “There must be another way,” and you ask, “if there were another way, what would it be?”

And the question is almost always more important than the answer, though we are going to provide a brief introduction to the answer:

As long as we continue to address our clients’ needs at the level of psychology, we will continue to address such needs from the perspective of their manifestations and symptom formation, and we will never get to address them at the root of their cause. This means, once again, the results will continue to remain elusive at worst, and limited at best.

What to do: Be in the lookout for our next article on where to find the root cause to address our clients’ needs. Meanwhile, consider joining at least one of our certificate courses, for free, if you are a member; and if you are yet to be a member, do respond to this question: What are you waiting for?

Until soon,

Karen and Mardoche

Karen Dubin-McKnight, PhD, LCSW, is a Columbia-trained Social Worker with wide clinical, teaching, and supervision experience. She also has a background in management, mentorship, and leadership that spans almost 20 years. Her added passion is in advocacy, coaching, public relations, and mediation. Her goal is to ensure that social workers and women feel empowered and have a voice “at the table.” She has previously held Executive level positions, and two other directorships in different organizations. She is currently Adjunct Faculty at Columbia University School of Social Work and Adelphi University School of Social Work. She also maintains a private practice, working with individuals who have experienced loss and trauma, and also provides clinical and management supervision.

Mardoche Sidor, MD is a Harvard-trained Quadruple Board Certified Psychiatrist, Assistant Professor of Psychiatry at Columbia University, School of Physicians and Surgeons. He is trained in and taught all the major psychotherapeutic modalities, including and not limiting to CBT, DBT, Family Systems,  and Psychodynamic Psychotherapy. He is also the author of 3 books including Journey to Empowerment; Discovering Your Worth; and The Power of Faith. Dr. Sidor has worked both as a primary care physician and as Medical director in three different settings, including as Chief Medical Officer of Center for Alternative Sentencing and Employment Services (CASES). He is the Founder and CEO of the SWEET Institute.