Some years back, near the end of most appointments, I began to ask my clients, “Was today’s appointment helpful?” Asking this question was not an original idea of mine. I was at the time reading professional literature about brief or short term therapy, a model in which this question is practically a staple (partly to see if the client got the ‘help that was requested’ so that treatment can promptly end.)
A Simple Question?
It’s such a simple question, isn’t it? And hardly worth a fuss over whether or not to ask it! Yet few psychotherapists use it, even though several nationally recognized clinical educators recommend it. Why?
Perhaps therapists see an appointment like a visit to a medical doctor; you don’t usually feel differently right after seeing the doc. Or it may be because psychotherapy is assumed to involve too lengthy a relationship, so that the incremental benefit to the client of any one appointment is too minimal or abstract to easily report.
The question may indeed presume a brief therapy relationship, where there is pressure on therapist and client to produce ‘results’. That also fits in with treatment funded through health insurance, where speed, if not long term efficacy, is valued. Yet neither context is why I ask this question. It began to make sense for me for different reasons.
Helpful To The Client
For me, this question highlights a key purpose of psychotherapy, which is to be helpful to the client. I believe the question promotes several therapeutic dynamics. It reinforces:
- that the therapist values your time and sense of progress, and is continuously interested in your health;
- your responsibility to measure and evaluate the treatment plan, in sequential steps, rather than big ‘blockbuster’ breakthroughs
- your thinking in terms of what has been helpful, and will be in the future, creating a true collaboration with the therapist
- the client to avoid dependence on the therapist, to think independently and critically about the treatment
It’s an effective way for the therapist to learn about your values, your view of yourself, and what improved mental health and well-being are about for you. To a good therapist, that’s a gold mine of information for future progress.
A Shared Goal
The question establishes a shared goal – both you and the therapist hope for your greater well-being. This makes both of us accountable for the quality of the work – a true collaborative alliance. And it leaves you with a good idea of how to help yourself and solve your own problems after we’ve stopped working together on a scheduled basis.
But what is the true nature of psychotherapeutic help itself? This is an interesting and important topic. Trying to address it fully here would go way past the scope of this posting. I will close by saying that defining ‘help’ is a collaborative process, in which the the therapist’s and client’s best judgments must emerge.