STRATEGIES

Mickey Skidmore, AMHSW, ACSW, MACSW

When I began engaging in private practice work in Australia (not quite 10 years ago), I recall exploring the focus of the goals of their treatment with my clients and being struck by the frequency in which they related that they were looking for “strategies”. I also recall the visceral reaction I often experienced — and still experience today when clients share this with me. Specifically, this tends to evoke a significant sense of irritability and annoyance. 

Back then I chalked this up to possible cultural differences, and thought it to be important to patiently reflect on this further. The thought process that accompanied my emotional reaction was the view that by the time you found yourself in a psychotherapy office, whatever issue you were grappling with was likely well beyond seeking strategies. (Which is probably why I found these comments superficial or disingenuous). Most of my clients are bright and capable people. So I surmised that if strategies were the solution, or would address their concerns, most of them would have likely explored or even researched this on their own before now and implemented these strategies. Dr. Google has information and answers for nearly everything these days.

One of my clients (with an Aussie background) conveyed that this is not an atypical thought process in her view for Australians. Yet, she went further to suggest that it was a mechanism to cover for or absolve them from their laziness when things failed, as well as a saving grace for the therapist to avoid blame as well. Ultimately, I am aware there has not been much shifting in this for me over the years.

Recently I engage a new client in the therapy process. When I asked about his previous experiences with therapy he explained he had several previous unfavourable EAP experiences, who primarily only worked with him via phone calls. He went on to share a more detailed story of his therapy experience before that. He indicated he attempted therapy with a psychologist who was intent on inundating him with cognitive behavioural therapy (CBT) and then sending him off on his way to work on a range of worksheets on his own. He clearly found this experience to be lacking and in stark contrast to the engagement process he was experiencing with me.

As I have also serve as a casual academic for the past 5 years focused on the tertiary education and training of Social Workers in two University programs, I began to speculate that this may be a particular approach in the training of psychologists in Australia. While these examples may be overly limited or even unfair to make broad generalisations, it clearly highlights some compelling distinctions in the manner in which Social Workers in Australia are trained and prepared for professional practice. 

To be sure there may be times in the course of psychotherapy treatment where “strategies” my be introduced, worked on together with the therapist, or even modelled in the therapy process before suggesting therapeutic tasks beyond the therapy session to reinforce, integrate or apply to real life, in-vivo experiences. But I still maintain, if you find yourself in a psychotherapy office, whatever you bring to the experience will likely require something more significant than offering “strategies.”

I guess after devoting an entire career to the field of Mental Health, I see therapy as something far more significant, important and worthwhile than having it unintentionally reduced in this way. It is certainly not fair to over-generalise and speculate that all psychologists or counsellors operate in this manner. There are many Australian practitioners who revere the sacred process of psychotherapy. However, my concern is this may be occurring to enough folks that they begin to assume that this is the primary experience for most (this is partly how stereotypes are born).

I make every effort to demonstrate a unique (client centred) process and highlight an intentionally different experience for clients, marked by a broader contextualisation and understanding of the environment that they interact and function in (family, friends, school, work, faith community, and other organisations) more so than just “what’s going  between the ears” or psychologically with them. But perhaps most importantly, I unapologetically denounce this notion of “strategies” in favour of extending an opportunity for them to engage in a therapeutic relationship with another person in an effort to heal, overcome or otherwise address their concerns.