The answer is zero.
Why do I say that? Because the unwritten rule in therapy is that you don’t have to accomplish anything. There is no guarantee that you’ll get “there.” In fact, neither one of you knows where “there” is.
I know. I did that for years. True confession.
It begins with the legal contract that you sign. If you buy a car, there’s a guarantee that you’re going to get — a car! You paid for a car and that’s what you’ll get.
But therapy doesn’t work that way. It’s going to be a process of discovery, to discover what you want. So it can’t go into the contract. Even when you know exactly what you want, like when you come in with your spouse for marriage counseling and you know the problem is poor communication, where does it say that you will get good communication out of the deal?
It doesn’t.
Not only that, neither the contract nor your therapist will even say that you’re going to be taught good communication skills.
Now, I ask you: Why not?
Why can’t what, exactly, you will learn in counseling, be discussed openly as a topic of discussion?
Therapists out there, don’t get mad. I know what you’ll say. You’ll say because this is not psycho-education. When you’re dealing with feelings – which are generally irrational – you have to deal with them and put aside the education.
Wait a minute. Why can’t that be in the contract, too? That you’re going to deal with feelings? That you’re going to help people have healthy thoughts and positive emotions, at will? What is wrong with a nice, clear goal like that in therapy?
Okay, I know. You’re going to say because sometimes the situation requires going over the pain, the negative thoughts, the bad feelings. Well, sure, of course. Sometimes. But how much? How many hours must be spent in session with the client languishing in hopeless pain and no way out of the hole? Surely, that can’t actually be “therapeutic” can it?
Why can’t the contract say that only a certain amount of time is healthy to spend in victim-hood, even when – or especially when – you’re overcoming trauma and abuse? Let’s take an example. To overcome trauma (and abuse falls into the category of trauma) research shows that Exposure Therapy works. It’s a form of total immersion into trauma memories under very specific therapy guidelines. Only highly trained therapists can do it. So here is a case that it is clearly therapeutic to revisit trauma. However, standard research tells us that with that exception, revisiting traumatic memories will re-traumatize people.
Now, let’s take a different path. Suppose the therapist is very goal-oriented. They follow a solution-focused therapy model. That’s a great step forward. But how accountable are you, the client, to your therapist for doing the exercises and using the tools that you’re given? –
Not at all.
As my contract used to (proudly) say, you, the client, are in the driver’s seat. You direct exactly what we will talk about and you will decide what you will do. That’s nice and very empowering – except when you use it to get off the hook. Where’s the line to be drawn? Clients should feel empowered; that’s a good goal. But should they feel empowered not to do their homework? Isn’t that like a medical doctor leaving it up to the patient whether or not they will take life-saving medicine?
Since the client is in the driver’s seat, there’s no leverage for the therapist. Which is really unfortunate in the case of marriage counseling because one of the parties in the marriage has no leverage either – which was the problem to begin with. So they go to marriage counseling for the sole purpose of making things right. And they can’t.
In fact, the disgruntled client who doesn’t enjoy being told what to do can easily stop coming. Now what? What gets fixed, here?
Compare this to a system in which the client isn’t even taken on unless they commit to doing all the work. Wow. There’s a breath of fresh air.
Okay, it is true that a person can agree to do the work and then stop.
So we add another feature. We make sure they’ll do the work by making the program a high ticket one. Now, they’re committed. Either that or they don’t get started. Which is fine, too. Nothing like weeding out those who aren’t serious.
In fact, these two steps are the ones that four-year colleges take to ensure that their students are committed. Only when their parents are making the payments, the commitment is weaker than when they would be, themselves.
Let’s get back to the homework problem. What if they just don’t know how to implement it? Ah, we have that one taken care of, too. It’s called intensive, hands-on help. Imagine if you could contact your therapist by email every day. Imagine one better: The therapist reaches out to you whenever she thinks you might need assistance and checks in on how you’re doing with the homework.
When you combine that level of intensity with accountability, it is unmatched anywhere in the therapy arena. Even intensive weekends don’t measure up because it is not possible to learn all you need to learn – and have it stick – in a weekend. Better an intensive short-term, hands-on, accountable program to solve the problem.
If you want to learn more about how a program like that will is more likely to save your marriage, book a call with me. https://drdeb.com/book