health protection agency

10 Things I Wish Clients Knew Before Starting Therapy

I realized as I started to write this list that I could probably put way more than 10 things on it, so maybe there will be a part 2 eventually. Your suggestions/additions are very welcome! Of course, clients are very different from one another, but in general, here are some things I wish clients knew before they started therapy. (Credit to the anon who suggested doing this list!)

  1. Your therapist is not your friend. You and your therapist should have an important, close relationship, but it’s the not the same as a friendship. This is a good thing! (See #7). You want your therapist to be able to see you and your treatment as objectively as possible while being caring and empathetic about you as a person. This will help you two work successfully together. It’s okay if it takes time to figure out how your particular relationship will work, and if it is different from one therapeutic relationship to the next. 
  2. Start and work through treatment with the end in mind. Ideally, therapy should not last forever- you should begin with a goal or goals (see #3) and you and your therapist should figure out how to achieve those goals so that you no longer need treatment. Your therapist will probably check in about how close you are getting to these goals, and may set a timeline at the beginning of therapy or partway in. This is normal. We like our clients, we want to continue seeing them, but treatment is successful when they don’t have to see us anymore. 
  3. Goals are essential to successful treatment. Some clients would like to come in and do a “weekly review” sort of thing, or a “crisis of the week” sort of thing. The problem with this is that it doesn’t help them achieve a goal or improve their lives, it mostly just passes the time and maybe provides some social support. We’re not really doing our jobs when this is all that happens. That’s why goals- short and/or long-term- are essential. 
  4. There are infinite worthy goals. There are lots of things that are worthy of being a therapy goal. I usually group them into three categories: goals related to decreasing your distress (for example: decreasing anxiety), goals related to increasing your functioning (for example: having better social skills), and goals related to increasing meaningfulness (for example: pursuing hobbies, existential questions).  
  5. Structure is also essential. If a client has great goals, but they continue to come in with a crisis of the week, or are constantly distracted throughout session, it’s often hard to get things accomplished. Although it isn’t necessary to only discuss the therapy goal(s) 100% of the time (and sometimes it’s necessary to halt things due to crisis), it is important to have some kind of structure of make sure that treatment is progressing. Lots of different kinds of structures can be used (from almost nothing, to agendas, to manuals) depending on your needs. 
  6. Your therapist is not being mean to you when they enforce boundaries. Boundaries are necessary, to uphold professional ethics, protect the therapist and their family/loved ones, protect the mental health field, protect the agency the therapist works for, protect other clients, and most importantly, to protect you. It isn’t random, and it isn’t a punishment. We do our very best to be both professional and have a sincere relationship with you.  
  7. Your therapist is not judging you. Here’s the thing- you really are a special and unique person, with your own backstory. But as therapists, we have heard some weird and terrible things (it’s unlikely you’re going to top the list, for better or worse). It is our job to listen to those things and not judge. Since we’re not our client’s friend, we’re not thinking about judgement, we’re thinking about how to help, or how impressed we are that you trusted us enough to share, and so on. We’re in your corner. 
  8. The therapeutic relationship is important- and not off-limits to discuss. I always make such a big deal about the therapeutic relationship, and it is because it matters so much to client outcome. So pay attention to it. It’s okay to care about how things are in the interaction and relationship with your therapist. And if you are confused, or upset, or concerned, or pissed off, talk about it with your therapist. You are not doing anything wrong- this is key to the success of your treatment. 
  9. It’s okay to question and disagree with your therapist. Clients sometimes think that therapists are untouchable– sort of all knowing experts. It’s true that therapists are trained in specific things, and hopefully know how to do the things they need to do to help you accomplish what you want to in therapy. But this does not mean they know everything about you or will not mess up (we don’t and we will). So ask questions. Get more information. If you disagree, speak up. A good therapist is comfortable discussing the process and being wrong. 
  10. It’s okay to find a new therapist, but make sure you think about why you are doing it. If you do not like your therapist, it is okay to look for a new one. But- “therapist shopping” is sometimes frowned upon because we worry that you are looking for a therapist who will tell you what you want to hear about something, and a good therapist is willing to challenge their clients- which means their clients will sometimes be pissed off and uncomfortable. This means a good therapist is sometimes not the one who makes you feel warm and fuzzy all the time. So, find a new therapist if you do not like yours, but think carefully about why you are doing it. Make sure you work with someone who helps you reach your goals. (That’s why you’re there, right?) 

Clean water is essential to life – and the people of our states and the nation deserve the basic protections established by the Clean Water Rule, to ensure that the benefits of clean water are shared equally, regardless of state lines.

We won’t hesitate to protect our people and our environment—including by aggressively opposing in court President Trump’s actions that ignore both the law and the public’s paramount need for clean water.
—  New York Attorney General Eric T. Schneiderman and a coalition of attorneys general from the District of Columbia, Hawaii, Massachusetts, Oregon, and Vermont, in response to Donald Trump’s executive order to start eliminating the Clean Water Rule (also known as the Waters of the United States Rule).
The drinking water of more than 210 million Americans is polluted with nitrate, a key fertilizer chemical that has been linked to developmental problems in children and poses cancer risks in adults.

Happy Earth Day! In 1962, Rachel Carson’s Silent Spring was published, documenting the detrimental effects of the pesticide DDT on birds and bringing environmental concerns to the American public. The resulting outcry led to a nationwide ban on DDT for agricultural uses and inspired an environmental movement that led to the creation of the U.S. Environmental Protection Agency.

Is the mosquito menace growing in the UK?

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Mosquitoes aren’t something you’d consider to be particularly hazardous in the UK.  Annoying as hell, absolutely.  That high-pitched mozzie drone is enough to keep you awake at night.  And if like me you react rather badly to a mosquito bite then yep, they can be painful.  But hazardous to our health?

There are 34 species of mosquito in the UK, five of which are non-native and have been inadvertently introduced to these shores from other countries.  However, aside from the charmingly titled ‘nuisance biting’, none of these species pose a real health risk to humans.

BUT…..there are species lurking on the European continent that DO transmit diseases.  The worry is that as our climate warms, these species will find Britain an agreeable place to live and will start colonising from the south northwards.  Certainly the run of wet summers interspersed with hot dry periods are perfect conditions for mosquitoes.

The Asian tiger mosquito (Aedes albopictus, pictured above) is one notable species of concern.  Known to carry West Nile virus, Yellow fever and dengue, it has been spotted recently in Belgium.  The Health Protection Agency is continually monitoring its progress, but you’d have to reason that it’s only a matter of time before it shows up in large numbers in the south of England.

Original BBC article.