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The 3-Point Therapist

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An ambitious trainee therapist, determined to make her mark in the therapy world, seeks supervision and guidance. In her meetings with the 3-Point Therapist she gains much more than she had bargained for. The 3-Point Therapist is the charming story of one trainee's journey in search of professional success and recognition. What she learns is unexpected and changes her predicted path. The characters and situations in this book are purely fictional but the principles, the learning and the practice points are drawn from the author's thirty years' experience working with families in different paediatric and mental health settings. The books style is light, readable and at times humorous - but the messages are strong with far-reaching effect. The trainee and her professional practice are profoundly changed for ever.

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CHAPTER ONE: First Visit to the 3-Point Therapist

ePub

The trainee, flustered and a little late, arrived at the door of the therapist.

She knocked and reflected that she had learnt as much theory as she could, read all available books and papers, and attended supervisions and tutorials as offered. She was not sure what else she had to learn. However, she was truly ambitious and wanted to progress up the ladder in her chosen career.

She felt overwhelmed by information but was anxious to acquire more knowledge and wanted some help in writing some more papers. She had many ideas. She also hoped to be told how to be more confident and authoritative with the families with whom she met.

She wanted to develop her ability to think about and analyse the theories in greater depth, giving her greater understanding and expertise in therapies and the different techniques.

As soon as possible, the trainee wanted to move on in her career; she loved to teach and hoped to pass on all that she knew. She also hoped that she would come to feel more expert and to be widely respected in her chosen field. She wanted to do research and publish more papers. She planned that she would gainfeelings of expertise and confidence from the 3-Point Therapist. She had heard that the therapist gave consultations to trainees and qualified therapists alike. She had heard that the therapist gave advice on preparation of talks and consultations, and on gaining recognition and respect for one's knowledge and expertise.

 

CHAPTER TWO: Work of Which You Are Proud

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The trainee was slightly bemused but very curious, and returned one week later.

The door opened promptly and she sat in the same comfortable chair.

The therapist greeted her, and then said nothing. The trainee began.

I am seeing a very difficult case, the Abbott family, I don't know where to begin.”

“Tell me about the family and the work of which you are proud,” the therapist invited.

“Both parents attend my sessions together with their teenage daughter. It's the daughter who is the problem, she is very difficult and the parents are at their wits’ end. I have tried everything and I think I have done some good work. The mother is so anxious, my supervisor thinks she needs some medicine to calm her down. I'm not sure what to do now”

“Tell me about your work of which you are proud,” the therapist repeated.

Well, a couple of weeks ago I decided to try some circular questioning, to try to get to the root of the mother's anxiety, to try to find out what she is really worried about. It went very well, the reflecting team complimented me on my technique. After a while the mother put her headin her hands and just sobbed. I think we began to get to something, though the problem seems just as stuck as ever and I am not sure what to do now. I've tried some anxiety management, but it doesn't seem to work with this mother at all. She just seems to want to talk on and on and I have to intervene frequently and be quite assertive in order to do any work at all”

 

CHAPTER THREE: Starting to Focus

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The trainee was beginning to get used to the therapist's odd ways now. However, when she arrived exactly one week later, she was feeling some frustration that this was her third week approaching this door but she still had not learnt anything new – the therapist had not begun to teach her what she had come to find out.

The therapist opened the door as usual punctually at the appointed hour. She showed the trainee into the same neat and orderly room.

The trainee began quickly, offering some drafts of papers on which she was working at that time. She took a deep breath. “ The 3 Points you mentioned,” she began, “I'd like to work on my papers and discuss the 3 Points today, if that's all right with you?” She was somewhat nervous and tentative, and there was a questioning inflection at the end of the sentence. “I'm taking a lot of time out from work to come here; I really appreciate it, but I need to start to focus”

“Focus?” queried the therapist softly. “You want to be starting to focus?

“Let's begin, tell me about your last meeting with the Abbott family about whom you told me last week.”

 

CHAPTER FOUR: Congratulations on Beginning

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Exactly one week later, the trainee was again in her comfortable chair across the neat room from the 3-Point Therapist, who said nothing and seemed to be waiting for her to speak.

After a while, the therapist said quietly, as though to help, “You know why you are here, just begin slowly when you are ready and tell me what happened.”

“It was really difficult,” began the trainee, “I felt so useless.”

“Tell me what happened and tell me what you did.”

“Well, I did as you said. At a quarter to the hour I stopped what I was doing, I had booked the therapy room from that time and I went in to prepare it for my meeting with the family. I've never really noticed before but it was a bit messy – old drawings on the table, a plastic water cup, and the room was crowded with a mass of chairs all higgledy-piggledy. So I tidied it up, prepared four chairs arranged and spaced neatly, locked the door, and went outside into the fresh air for a couple of minutes. I returned to the room a few minutes before the appointment, sat quietly and went over your questions in my mind. I imagined the family there in the room with me.”

 

CHAPTER FIVE: I Listened

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The trainee was again in the therapist's room exactly one week later.

“Tell me what you understood you had done that was helpful in your last meeting with the Abbot family.”

The trainee looked intense and rather pained before she replied.

I have thought a lot about this. I realized that what I did was to concentrate very hard as I knew that I had to write up the session for this meeting with you and maybe for a paper in the future”

She noticed the therapist wince slightly and almost imperceptibly, but the trainee still offered a sheaf of papers, which the therapist declined with a raised hand.

“Because of concentrating so hard in the meeting with the Abbotts, I barely spoke. When I thought about this afterwards I concluded that this had therefore enabled the family to have space to talk and discuss what was important and useful for them. This was apparently more helpful than if I had been offering suggestions and trying to ‘do therapy, as I had done in the past. It helped me to realize how intrusive and unhelpful it can be at times to interrupt the family's thinking with my own flow of suggestions and my need to do therapy or to use techniques.”“Yes, this can often be more helpful to the families. What else do you think you did that was helpful?”

 

CHAPTER SIX: We Have a Choice

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“Have I learnt the 3 Points yet?” queried the trainee as she stood up, getting ready to leave the therapist's room at the end of their fifth meeting.

She really felt that she was learning something different and valuable but she was feeling a bit anxious about how long all this was taking.

“You are beginning with Point 1, we still have Points 2 and 3 to learn,” the therapist replied, also standing up to show the trainee out.

The trainee nodded. “Right, OK, Points 2 and 3 still to learn,” she repeated, again nodding in agreement. She was intrigued and interested and felt that she wanted to learn all she could from this different and rather special therapist.

One other thing, one other thing I was thinking a bit about from last week” the trainee chipped in, just as she was about to leave the room.

“Yes?” the 3-Point Therapist invited.

Well, I have often wondered whether or not it is a good strategy to be a little bit late for appointments with families, to come in deliberately just a little late. This way the families would realize that you were busy and important, that they were lucky to be seeing such an important person. Particularly as a trainee, that might give you an added bit of authority and in that way they would value you more.”It felt strange to be on time for the Abbott family last week and I wondered if they would get the idea that I was not too busy or something. I wouldn't want them to think that.”

 

CHAPTER SEVEN: Tell Me Your Story

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“Our discussion last week,” the trainee began, having arrived precisely on time and settled into her comfortable chair, “our discussion, alongside my work with the Abbott family, reminded me of an experience in my very first month of clinical training”

“Tell me your story,” encouraged the 3-Point Therapist.

“Well, it made me think again about culture and difference in all the families we see. I thought about Point 1 on preparation and the importance of listening so carefully – listening so that we hear the difference and uniqueness in each family's story, and we can focus with them on what is important for them”

The therapist seemed to nod almost imperceptibly. She looked and listened hard as the trainee continued.

“A little while ago I was on placement in a residential children's home and was told to do some family work’ with a young boy who had just been reunited with his mother, whom he had not seen for many years.

“I invited his mother to bring to the meeting her current long-term partner, but he did not attend the first couple of sessions. I phoned her a number of times to emphasize the importance of the whole family attending. I had been told repeatedly that I must insist that the ‘whole family attend.You don't understand our culture,’ the mother told me firmly after my third call to her on the subject. ‘My present partner does not have to be involved with my son, he is not his father, it's not like that in our culture, he will not be attending the meetings’

 

CHAPTER EIGHT: I'll Tell You a Story

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“Just sit for a few moments and I'll tell you a story,” the therapist began as the trainee was settling herself into her usual chair exactly one week later.

“Your story last week reminded me about families’ individuality and individual circumstances.

“Quite a long time ago, when I was just beginning this work, when I was a trainee like you are now, I met with a family who were experiencing some difficulties.

“The mother was a sole parent, was depressed, and her small son's behaviour was beyond her control. The psychological input at the clinic worked to a certain extent, though the family were poor attenders and it was felt that the mother was not committed to the programme and was really struggling to cope.

“The team felt that they should be referred to the social services department for assessment of risk to the child.

“The social services department found that the mother did not have the fares to attend the programme every week and had difficulty managing her young son on the three buses when she was able to come to the clinic.

 

CHAPTER NINE: Only if They'll Meet with You

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The trainee returned the next week, obviously bursting to talk.

“Sit down and tell me what's been happening,” the therapist soothed as soon as she opened the door.

“Well, this week I saw a new family who I knew had attended many different agencies and were generally thought to be a pretty difficult case, a really difficult family” she blurted immediately, and looked at the therapist anxiously.

“Right, the family came with a bit of a reputation and you may have felt a bit apprehensive?”

“A bit! I felt terrified. I wondered how I was expected to do anything to help, when all these other agencies presumably had not been able to.”

“Yes, I can see that that was probably a little daunting. Tell me what happened.”

Well, what happened was that I received a phone call from the mother in response to my letter of appointment. She said that the family did not want family therapy, that they had had it a number of times before and had found it did not help; in fact, it made things worse as it was so upsetting.

 

CHAPTER TEN: Simply Respect

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Exactly one week later, the trainee began telling the therapist some more about the Abbott family, of whom she had spoken in previous weeks.

“And when Ed told me that Ann …“ The therapist interrupted with a swift raising of her hand and a puzzled, even annoyed, expression on her face.

“Ed and Ann, remind me who they are, what is their relevance to this work today?”

The trainee huffed a little in frustration. It seemed to her that the therapist's listening was a little awry. Surely she remembered the names of the parents from their discussion the other week, it was not so long ago.

“Annie Abbott's parents,” she replied quickly, with desperate attempts to keep annoyance from slipping into her voice.

“You remember from a few weeks ago? I told you about that difficult family with the really anxious mother and I didn't know really what to do and …

The therapist interrupted brusquely and continued to make her point. “They are not your family, they are not your friends and they are certainly not children. Please refer to them only as Mr and Mrs Abbott,” she said firmly.

 

CHAPTER ELEVEN: Just Think the Right Language

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Exactly one week later, the trainee began.

“Since we spoke last week, I have been doing as you said. With all the families I have made a point of addressing the adults by their second name … and I was totally shocked, I was so surprised”

“What surprised you? Tell me.”

Well, no one commented; it was as if this was natural and what they expected. They all continued addressing me by my first name, as previously. A few call me by my second name and they carried on with that, of course”

“Yes, so no surprises. No one seemed surprised or commented. Why do you think that was?”

“Well, I thought a lot about that and I kind of concluded that they were not surprised as there was nothing surprising and they did not comment as there was nothing on which to comment.”

The therapist smiled. “It just seemed right and correct?”

“Yes, completely. And the other thing was that I felt different, I don't know if the families did in any way, but I felt different, more formal, and sort of more professional and adult – yes, more adult and responsible, more appropriate and more respectful.”“Hmm, I wonder if the families felt any different at all?”

 

CHAPTER TWELVE: In an Unexpected Way

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The trainee was beginning to understand, but was also feeling quite confused.

The 3-Point Therapist seemed to be teaching her something quite different – not what she had come to learn and not what she was expecting, but something was working and in an unexpected way.

She arrived the following week and settled into the therapist's room.

“Last week in my training placement I saw a new family, a really diff … a family with many difficulties.” She corrected quickly, hoping that the therapist had not noticed her near lapse into unacceptable language. “ The Barkers.

The two parents came with a very troubled child with extremely challenging behaviour. I had felt anxious and not sufficiently prepared, as the child's difficulty was in an area of which I had little knowledge and certainly no experience nor expertise.

“I remembered your instruction to listen well and make close notes on a new family with a particularly challenging problem. And I also remembered that I should simply ask the family about themselves, their situation, their solutions. I knew that I had to be prepared to listen very hard and very carefully indeed.To be honest, I was beginning to see how this way of talking and being with families actually related to doing therapy and, indeed, I think I was beginning to realize that this was, in fact, therapy itself. This, not techniques, not strategies, but curious and purposeful interest and listening.

 

CHAPTER THIRTEEN: Funny That/Funny This

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When she met again with the 3-Point Therapist exactly one week later, the trainee was pleased but confused.

I thought a lot more about the Barker family and the meeting of which I told you last week. It seemed that all I really did was ask them a couple of questions and gain information about them and what they had already done”

“And?” queried the therapist simply.

Well, what happened then was that they told me that their real problem was that they had never agreed between them on how to manage their son's behaviour, though they seemed to me to have tried everything. There was nothing that I could add and again I felt pretty useless and helpless.

“How do you think the parents were feeling?”

They told me that they had been feeling completely useless and helpless. Funny that, I seemed to have been feeling the same as them.”

“Yes, funny that, but maybe useful information, do you think?”

Yes, maybe” replied the trainee slowly and thoughtfully.

“So what do you think happened in the session?”

 

CHAPTER FOURTEEN: Catch Them Unawares

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The next week the trainee arrived and told the therapist that she had received a phone call from the local doctor of the Barker family, of whom she had spoken the previous week. The family had returned home and phoned their doctor to ask if they could have a therapist locally to meet with regularly as they had found the meeting with the trainee a few days earlier so helpful.

The trainee looked really pleased, but very surprised.

The 3-Point Therapist smiled broadly, confirming that the trainee had done very well.

“And now we will move on, but we will continue with this difficult part of Point 3,” began the therapist. “Most importantly of all, be sure to catch the families unawares.”

The trainee could not disguise her surprise, almost shock, at what the therapist had just said. She had, over the preceding weeks, welcomed and become used to the therapist's style of always supporting and respecting families, planning for each meeting. The work, she had learnt, focused on facilitating the families’ stories and histories, always using their strengths and expertise.

 

CHAPTER FIFTEEN: My Cat ...

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They settled into their chairs exactly one week later.

Suddenly and a little unexpectedly, the therapist began, “You have seen my cat, the small black cat who is often sitting outside when you come to the door?”

Yes, she's so sweet and friendly, I think you called her Millie?

“That's right. She was a stray, just decided to move in one day and has been here since. She is a very sweet cat, but she did arrive with a couple of very bad habits. I'll tell you a bit about one of them.”

Yes, fine,” the trainee replied briskly, feeling a bit unclear, but was sure that the story would be of interest.

“When Millie arrived here, she had a bit of a bad habit, the habit of scratching on the furniture. She scratched on a few pieces of furniture. This didn't matter too much, but the furniture she chose included a favourite chair of mine which had belonged to my grandmother. So I thought I must find a way of discouraging her as the chair was becoming a bit of a mess.”

“All cats do that, don't they?

“Yes, I think that they probably do. I really don't know, Millie is the first cat with whom I have become closely acquainted. Maybe some, most, or all other catsdo the same, I really wouldn't know. But back to Millie and her scratching …”

 

CHAPTER SIXTEEN: . . . And the Balls

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“So now, then, you can go on and teach Millie more and more things using the same method” the trainee offered eagerly, returning to the story of the cat as soon as she had sat down into her comfortable chair exactly one week later.

“You could teach her almost anything”

“What exactly did you have in mind?” enquired the therapist, seeming a little perplexed. “Could you give me an example or two?”

I think I can give several.” The trainee became enthusiastic, thinking ahead to transferring this conversation and this technique to her therapy sessions.

“In a similar way, you could teach her some tricks, teach her to …

The 3-Point Therapist stood up and went over to the mantelpiece just a few paces away. She picked up five or six small coloured juggling balls. She threw one gently to the trainee who caught it deftly and stood up as she saw another ball coming her way.

“Can you juggle with two balls?” the therapist asked, as she herself easily tossed two balls rhythmically into the air.

“Yes, I think so .” The trainee was again feeling a little perplexed, but had learnt to go with the flow and see what happened.”Yes, I am sure I can, it's not too difficult” and with some ease and more than a little concentration she juggled the two balls above her head for a few moments.

 

CHAPTER SEVENTEEN: Practice Writes Theory

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“But are you telling me”, the trainee quizzed on arriving exactly one week later, “that theory, all the theory I have been learning is of no real relevance? That if I remember the 3 Points, I will be all right? I do not really need all that theory?”

The therapist started, and answered quickly and clearly, “No, no, that is not the case at all. Let's be clear, theory is essential to your daily practice, as it is to mine and to every good therapist.”

Or are you saying that practice is essentially straightforward?” the trainee continued to question eagerly, “that it can be reduced simply to a formula of 3 Points and then it can be carried out with ease?”

The trainee posed these queries without conviction. She knew that the 3-Point Therapist was not saying that clinical practice was either easy or straightforward. However, she was in challenging mood and wanted to push this serene woman to be specific, to rattle her a little maybe.

“So,” the trainee went on, “theory is essential to our daily practice but what I have learnt, the 3 Points I have learnt here with you and which I apply in my work, they have nothing to do with theory. Do they? How does theory connect to the 3 Points?”The therapist straightened herself and, as calmly as always, began “Seeing someone in therapy is an extremely complex and highly sophisticated process. That is why it is most helpful to clear the mind as much as possible before meetings in order to focus on the families and on the information they are bringing.

 

CHAPTER EIGHTEEN: Mad with My Client

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The trainee arrived in the therapist's room exactly one week later.

The therapist thought she looked upset, with something on her mind, and waited for her to speak.

After a moment or two the trainee's gaze rose from her lap, into which she had been staring fixedly since the moment she had sat down in her usual chair. She did not look over at the therapist, but instead her eyes drifted blankly over towards the open window at the far side of the room.

I was so mad with her,” she began suddenly and without warning, shaking her head slowly and still gazing vacantly across the room. “ I was so angry with her that I could hardly speak.”

“Tell me more,” encouraged the therapist. “Who was this with whom you were mad? What do you think was happening to make you so mad?”

“But mad with my client, I should never feel mad with my client, should I?” the trainee wondered, for the first time looking across at the therapist, hoping for help and more than a little reassurance.

“Tell me more, tell me about feeling mad with your client.”

 

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