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Therapist Integrity: How to Hold Space and Hope for Therapy Clients

December 20, 2016 Ili Rivera Walter, PhD, LMFT
Therapist-Intergrity-How-to-hold-space-and-hope-for-therapy-clients

"Man can live about forty days without food, about three days without water, about eight minutes without air . . . but only for one second without hope."  --Hal Lindsey

 

You are a holder of hope.

It is hope--your hope and your clients’ hope--that makes therapy a special place.  Therapy is and must be a place that is atypical for the client.  It must represent a change from their everyday interactions and conversations.  This is what makes the therapy room a sacred place.

I enjoy having conversations with other therapists about how we hold hope and care for our clients.  How do we each create a sacred place, a sacred relationship, for and with each client?

Why does it matter that we believe in our clients’ possibilities, as well as the possibilities of therapy? Well, research shows that therapist factors and client expectancy have a significant impact on therapy outcomes (Sprenkle & Blow, 2004).

Our influence on clients and the therapy process is a fact that is complex and multi-faceted. Thankfully, we always have the opportunity to take a step back and see what our beliefs and values co-create with our clients in the therapy room.

In today's post, I cover five ways to hold space and hope for our clients.  I titled the post "Therapist Integrity," because we are able (and called) to hold space and hope for clients in and out of therapy.  Just as we carry rules and boundaries for our most significant relationships, we can do the same for our clients, in order to protect the sacred place. 

1 |  Acceptance

Acceptance is the foundation of holding space and hope, because space and hope must be grounded in what is and not on what should be or could be.  As holders of space and hope, we teach our clients that they are okay right now. Their lives might be fraught with challenges or disappointments, but in order to move to new places, clients must have an understanding of what now exists. Our job then becomes to move into new places and spaces as clients invite us. One way to meet clients where they are, stay with them, and move with them, is to use the Solution Focused Brief Therapy client types in our work.

2 |  Suspension

Suspension is an aspect of practicing presence that allows the therapist to step away from “preestablished frameworks or mental models” (Senge et al., 2004, p. 31) in order to have a sense of clients’ experiences from their point of view. Our mental models and frameworks may be found in our pasts; our personal experiences with, or opinions about, clients' problems; our spiritual beliefs; and even our training. Suspension allows us to step away from our self-definitions, alliances, and other identity attachments in order to experience something new with our clients, found in the here and now, in our shared humanity. 

3 |  Facilitating Living

Byron Katie (2002) says, “If you are living your life and I am mentally living your life, who is here living mine? We’re both over there.  Being mentally in your business keeps me from being present in my own.  I am separate from myself wondering why my life doesn’t work” (p. 3). How many clients come to therapy because they are mentally living someone else's life? Katie’s sentiment has much to say about the people we see in therapy and their problems.  As we hold space for our clients' realities, we implicitly invite them to live their lives, and no one else’s.  As Katie puts it, " . . . to live life as a . . . student of [themselves]" (p. 7).

4 |  Setting Boundaries for Thoughts and Speech

In graduate school, I was taught the importance of valuing clients, their lives, and their stories. I was told that one way I could show value for the sacred space of therapy was to love my clients and to show that love by being aware and cautious about the way I thought and spoke about clients. As a supervisor, I ask my supervisees to speak about their clients respectfully and present cases thoughtfully, so that if clients were to overhear, they would feel not only respected, but valued. This isn’t a foreign concept in the field of family therapy:  Andersen's (1991) reflecting team, Narrative therapy’s outsider witness ceremonies (1996), and the Open Dialogue approach to network therapy (2003) all rely on this principle inside and outside the therapy room.

The way we think and talk about our clients impacts how we hold space for them, and how we, in turn, feel about them and our work. 

5 |  Staying in the Questions

Clients and therapists alike can have high expectations for therapy outcomes. Of course, therapy is a place for solving problems and making change; however, it is also a place for asking questions and waiting on answers.

We therapists can hold space and hope for our clients by staying in the questions just a bit longer--clients' questions and our questions. To approach life problems and the therapeutic process in a problem-solution linear conceptualization is to miss the complexity of problems and solutions, which is contrary to systems theory. Staying in the questions means that we honor clients' confusion--confusion being a very common feeling when life shifts--and stay with them in it  as long as necessary. We move with them as they invite us.

Summary

Therapy is a sacred place and space for being with our clients. Being with is different from empathizing or witnessing, because it asks us to have experiences with client in the now, rather than join with them from our positions as outsiders. To be with clients, we must recognize that we are in meaningful relationships with them--we can be influenced by them, just as they can be influenced by us. That is the beauty of our work.


Let's Chat

Let me know in the comments below:

  • What's one question that you have about how to hold space and hope for clients?

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References

Andersen, T. (1991).  The reflecting team:  Dialogues and dialogues about dialogues.  New York, NY:  W. W. Norton & Company.

Combs, G., & Freedman, J. (1996). Narrative therapy:  The social construction of preferred realities. New York, NY:  W. W Norton & Company.

Katie, B. (2002).  Loving what is:  Four questions that can save your life.  New York, NY:  Harmony Books.

Seikkula, J., & Olson, M. E. (2003). The open dialogue approach to acute psychosis:  Its poetics and micropolitics. Family Process, 42(3), 403-418. 

Senge, P. M., Scharmer, C. O., Jaworski, J., & Flowers, B. S. (2004). Presence:  Human purpose and the field of the future. New York, NY: Doubleday.

Sprenkle, D. H., & Blow, A. J. (2004).  Common factors and our sacred models.  Journal of Marital and Family Therapy, 30(2), 113-129.


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