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What do you need to get out of this session?


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I've seen different therapists, but it is still a mystery to me what I am supposed to be getting out of it.  I have had therapists that recommend things to do.  I'm seeing one now, I have only gone a few sessions.  I like her.  She tends to rephrase what I am saying and understand what I mean.

 

But, she will ask me what she can do for me or what I want to get out of the session and I am lost.  I just talk about what is on my mind, but I have no idea what she could do.

 

Is this a typical question?  What would you say?

 

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I guess it's the therapist's way of asking what you want out of the sessions, ultimately. As in, any issues you want help in resolving, or any aspect of your life that you want resolved?

 

It's fine if you just want to talk about things with her at every session, but I guess it comes down to whether you are talking about an issue, or around an issue. It's like talking about how to cook food. You can talk about all the ways to do it, but eventually discussion will have to come down to - which method do you want to choose and how exactly do you want to prepare each step. 

 

It's a fairly typical question to ask, IMO.

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I think I know what you mean, but I have no idea what the options are.  

 

She is still getting to know me. She did ask about my social anxiety and how it has been since i started seeing her and actually it hasn't been as bad and I have been in social situations during the holidays.  But, I also have periods of sadness that come over me. I am used to anxiety coming out of the blue but not this sort of dip in mood.  Or I am just noticing it.

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My tdoc asks me that all the time. I always respond with some kind of blank stare while I struggle to figure out what to say. I want to... get better? But for this session? I don't know. It always throws me and makes me feel guilty for not having an answer. Even fleshing out goals is hard (ie "I want to get better at completing necessary tasks to maintain my life"), but when it gets to "What can I do for you?" I'm always doubly lost. I don't know what she can do. Talk to me about things? If I knew which psychological tools were needed for me to feel better, I probably wouldn't need therapy nearly as much, right? 

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She tends to rephrase what I am saying.

Unless overdone, that's a very good technique for her to ensure that she is hearing what you are saying, without having distorted or missed the point...

A verification by feedback.

But, she will ask me what she can do for me or what I want to get out of the session and I am lost.  I just talk about what is on my mind, but I have no idea what she could do.

 

Is this a typical question?  What would you say?

"This is where I am hurting/having trouble with my emotions.."

"Can you review my thinking here...(topic, situation.) Is that distorted or reasonable?"

"I get confused about/don't know how to handle (xyz)"

"If there's no crisis or elephant in the room I need to address, can we consider what my next step forward should be?"

Suggestions. Adjust to suit, or spark your own off from these, perhaps.

Chris

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My tdoc used to ask me if I had anything I wanted to discuss, she but never asked me what I expected to get out of the session. I think the reason she asked me if I had anything I wanted to discuss was to get it out of the way or to deal with it before it festered so that it was not an impediment to the therapy.

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My tdoc used to ask me if I had anything I wanted to discuss, she but never asked me what I expected to get out of the session. I think the reason she asked me if I had anything I wanted to discuss was to get it out of the way or to deal with it before it festered so that it was not an impediment to the therapy.

 

^THIS exactly for me.  I've never had a pdoc/therapist ask what I want to get out of the session, or goals I wanted to work on.  We just talked about things bothering me or that were going on, and worked on those issues.  When there wasn't much to talk about I cut back on how often I saw (this specific one).  The others we seem to have stuff to always talk about.

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Perhaps you could take a few minutes before each session to write down things that are bothering you (or keep a running list at home).  Sometimes there will be immediate problems you want to discuss, while other times you might think of something more long term that has been a problem for you.  But if you take time before each session to ask yourself that question, you won't be sitting uncomfortably when she asks that question.

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I don 't have trouble coming up with issues that have been bothering me. I think it might be the way it is phrased.  If it was is there anything I can help you with or bothering you, I wouldn't get as tripped up as "how"?

 

Thanks Emettman for giving examples

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My tdoc used to ask me if I had anything I wanted to discuss, she but never asked me what I expected to get out of the session.

 

 

I suspect that these boil down to essentially the same question.

 

It's a way to check what's on your agenda rather than tdoc assuming you share the same agenda.

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My tdoc used to ask me if I had anything I wanted to discuss, she but never asked me what I expected to get out of the session.

 

 

I suspect that these boil down to essentially the same question.

 

It's a way to check what's on your agenda rather than tdoc assuming you share the same agenda.

 

Thanks Wooster.

 

Maybe it's just the semantics.  One time I was talking and she asked something that I didn't understand and it derailed me.  But I asked her to rephrase it and then I got back on track.

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  • 3 weeks later...

This question makes me really angry. It's often asked after they've at least gotten some clue about how severely depressed and messed I am. So why the hell would I know what to do? That's why I'm there! If I knew what to do, I'd do it. 

 

I wish I could find a therapist who talks like a real person. All I get are the ones who sound like they're following a flowchart from a psychology manual. And I've read all the books so it's really irritating to hear her say, "Wow, it sounds like you're really struggling, I can understand why" and think "Ah, she's using validation of my problems." I hate validation. It makes me feel like a child and they sound condescending. Like yeah, no shit I'm depressed, Sherlock. I just explained that. Not to mention they always seem so surprised that you're upset... ugh. And once I "accidentally" called myself lazy and she said, "No, you're not lazy, think about what you tell yourself" and I thought "Ah, she's trying to get me to change my negative self-talk." It's all just so cookie cutter. And fyi, I don't think I'm lazy. I used it kind of off-hand and don't internalize it. I explained it was semantics and she kept harping on about how words matter. Whatever. All their strategies are so transparent, sometimes I really don't think any of them know what they're doing.

 

Sorry, kind of ran away with the question. I suppose you could be honest about how you feel, I don't think you should be pressured to come up with something. I think they're looking for specific things to work on, like "I'm stressed about a problem at work" or something, but I have no idea really.

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Perhaps you could take a few minutes before each session to write down things that are bothering you (or keep a running list at home).  Sometimes there will be immediate problems you want to discuss, while other times you might think of something more long term that has been a problem for you.  But if you take time before each session to ask yourself that question, you won't be sitting uncomfortably when she asks that question.

 

I really like that idea, and wish someone had suggested that to me back when I was still seeing my doc. It always made me feel so put on the spot and immediately everything would fly right out of my head. Plus, I never felt comfortable answering when I did know - often I had too many things I wanted to address eventually, and my doc would immediately jump right into the first item I mentioned and I'd forget to bring up the rest. Other times I was too afraid to get into the "really big stuff" so if he didn't push it after I got the guts up to mention it once, I'd never bring it up again. Looking back I can see a lot of why that was counterproductive, and having a list would have helped immensely. I could see that being helpful for anyone who doesn't know what to say or feels put on the spot with that question.

 

 

I hate validation. It makes me feel like a child and they sound condescending. 

 

I actually hate the validation too. I know, logically, that the things I was upset about were, in fact, reasonable things to be upset about. What I didn't know was what to DO about it. And the old, judgmental jerk I was seeing at the time never helped with that - when I brought it up he would ask what I thought I should do, and then he'd just "mmhmm" and "I see" when I answered. I didn't need him to make a decision for me, but maybe it would have helped if he could've provided a bit more direction or something. I always felt like I was giving a presentation to the class that I wasn't prepared for, and it made my anxiety worse, not better. So I stopped going, when really what I should have done is A) explain how it made me feel and maybe we could have tried a different approach, or B) find a different doc if he wasn't able/willing to try a different approach.

 

Sorry, this was more anecdotal than intended but my point was that I know what you mean about that question making you uncomfortable. I really like Phoenix's list suggestion - it might give you a good idea of what you want to talk about, and a way to pinpoint some goals with your doc.

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Climber, I wonder if you've considered telling your tdoc that you find certain forms of validation to feel less than validating.

There are ways of showing understanding that migt work better for you.

I'm pretty sure that any therapist working with you would want to know that what they are offering is missing the mark for you in the empathy/reflection part.

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  • 3 weeks later...

My tdoc recomended that I keep a journal of therapy, I put what we discussed as in topics, feelings I had about the session, where I struggled, what to discuss for next time and action steps if nesasary. Not every entry gets all of these, but it helps to see trends in issues as well as issues that become resolved in therapy and life.

 

My Tdoc only asked me once what I wanted to get out of therapy, and that was at the intake asessment.

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All therapists ask this and i never have a response to it, usually because I'm too unwell to say anything positive about my life and moving forward. It has actually made me not want to go to therapy at all, because sometimes leaving my apartment and talking to another human being can be a huge task when i'm ill and sometimes all i need is general interaction to make me feel better.

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Thanks.  I have started asking more questions when I don't know how to answer and she has been giving me examples.  It's easier for me to choose what is closest than to come up with something out of the blue.  

 

^YES!  For me it's like the difference between multiple choice and essay questions.  I definitely do better on the multiple choice.

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