Therapeutic Fit
Beverly Simmons, PhD, LCSW
Who Comes to Raleigh Psychotherapy?
I work with people who have a variety of goals when they first contact me. My clients generally function very highly in one or more ways but seek help or change in other areas of their lives. My average client is a professional woman, aged 26 through 75. My work centers on personal growth, development and health across the lifecycle. I prefer to do more depth work, which allows for much more intense growth and longstanding impact than therapies which are strictly symptom focused. While I have significant specialization in treating mental disorders and developmental trauma, my practice also seeks to address women’s health issues beyond what is currently available within the general American health and mental heath systems.
Although symptoms of anxiety or depression may be an initial reason why people enter psychotherapy treatment, my passion and primary focus of practice is to help people achieve their goals of personal growth and development.
Common issues that I have helped clients work through in practice include:
- Working through specific relationship concerns.
- Addressing ongoing family challenges.
- Establishing healthy adult boundaries.
- Improving overall work performance.
- Understanding identity and creative process related to the art, work, business that you are developing.
- Recovery from past traumas that allows active presence and engagement with current life.
- Improving self-esteem and access to agency.
- Increasing independence by learning to separate one’s life choices from pressures felt from others.
- Identifying new solutions and strategies for approaching situations which create dread and impair the ability to act.
- Reducing internalized guilt and patterns of taking on inappropriate levels of responsibility for other people.
- Confronting issues impacting women’s sexual health and satisfaction.
The majority of my clients have worked with other therapists and/or coaches in the past but have not successfully addressed the depth of the issue in a way that produces their desired results. I center my work on helping each person to find the internal agency needed to accurately define and achieve their personal goals.
About Psychotherapy
Overview
Therapy is a complex process that requires commitment and accountability from both the therapist and the participating client. My practice is focused on forward growth for my clients. I do not aim to keep my clients locked in a dependent position. I also do not encourage excessive use of regression to levels which have a significant negative impact on functioning in my clients’ outside lives.
I find that my clients who are most successful in achieving their therapeutic goals are able to commit and be accountable for a few specific aspects of their treatment. This is a basic determinate of whether or not individual therapy will be effective.
Breaking the therapeutic frame or not regularly attending sessions during the agreed upon time is not only impractical for a therapeutic relationship, but also often a sign of deeper psychological issues that require very strict structure for therapy to effectively help the person.
My standard of practice is to confront frame ruptures, determine whether or not it is possible for the person to fully commit to their treatment with me and then make a clinical decision about whether or not to proceed with therapy or refer the patient to other treatment. If a client drops out of therapy for extended time or chronically cancels or reschedules appointments, I am unable to prioritize and hold a time in my schedule for that client.
Client Responsibilities
The client must be able to:
- Commit to a specific schedule.
- Attend regularly scheduled appointments.
- Use each therapy session to directly address some aspect of their goals, feelings, internal experience or relational lives.
- Accept the end of their appointment time.
- Take responsibility for payment of services.
- Mostly manage their lives between sessions.
Therapist Responsibilities
The therapist must be able to:
- Commit to a particular schedule.
- Take responsibility for keeping their outside life organized so that the therapy schedule is prioritized for the therapist to be available according to the agreed upon plan.
- Be accountable by not cancelling appointments (if this is a repetitive issue there is indication that the therapist is unable to adequately provide treatment to the client at that time).
- Protect the therapeutic frame by starting and ending on time.
- Be present, engaged and attuned to the client throughout each session.
- Be willing and open to direct discussion of the issues that the client brings to each session.
- Provide honest feedback to the client which can be integrated into the client’s life and treatment plan as an actionable goal.
- Hold the client accountable to the agreed upon treatment plan.
- Address new clinical material directly with the client as it emerges in treatment.
- Directly confront therapeutic ruptures, defensive and/or destructive behaviors and enactments that present in therapy.
- Set and hold effective boundaries to promote client growth.
- Develop and maintain clear systems to manage confidentiality.
- Invest in a clean, safe and organized office space to support clients in comfortably and safely processing relevant material.
- Maintain and protect appropriate medical records.
- Seek outside consultation/supervision wherever necessary as cases become complicated.
- Limit practice to areas where one has specialized knowledge and training.
- Be skilled and knowledgeable with making outside referrals as indicated to improve health and achieve client goals.
- Maintain adequate ongoing continuing education and current clinical knowledge.
- Mindfully set limits to one’s caseload in order to prevent burnout and ineffective practice.
- Practice sufficient self-care to ensure that s(he) is of sound and present mind during sessions.
- Effectively model a life that demonstrates a commitment to both physical and mental health.