One size of psychotherapy cannot fit all

My clients are sometimes unsure about exactly what sort of things will happen in psychotherapy and precisely how long it will take. I honestly cannot answer that question for you quickly. We will have to invest some time together because one size of psychotherapy does not fit all.

However, here’s The Big Picture about what we will do: You and I will work together to help you create a life worth living.

How will we do that? Easy- you do more stuff that works for you and you stop doing things that work against you.

Well, that sounds clear and simple, but exactly what sort of things should you start doing or stop doing?

Ah, that is a question that can take some time to answer wisely- that’s why I ended up with a Ph.D. and it is why I keep learning and improving how I work with people.

To change your life for the better we will work together to help you become aware of and disengage from ineffective patterns that make your life unworkable. We will work to discover what you might need to do more of to help advance your life in the direction you want to go.

However, we each have a unique biography and a unique biology. Plus, we exist in different social, economic, and cultural environments. What hinders your life might help someone else make progress. So, in the beginning of psychotherapy, you and I will talk a lot in order to determine where things are working well in your life and where there is some stuckness or dysfunction. Now and then I might ask you to fill out a questionnaire that might give us some clues about where the important issues are for you.

Next we’ll look at some possible plans to move your life more toward the direction you want it to go. Sometimes a solution might be as simple as changing your eating habits. (Simple does not always mean easy, btw). Sometimes solutions can involve long, deep explorations of painful inner turmoil caused by years of abuse. Sometimes the solutions might be to quit a job, improve your sleeping, or to stop giving in to an abusive person. It all depends on where you are at in your life and what resources you have to work with.

So, in short, one size of psychotherapy does not fit all. An emotionally immature 30 year old who is afraid to move out of her parents’ house will probably not need the same sort of psychotherapy as a 30 year old drug addict/prostitute who has been living on the streets for 15 years.

The Psychotherapy Continuum

We have to deal honestly and openly with the reality of where you are at when you enter psychotherapy. Some of us need a minor tune up while others need a major overhaul.

Here’s a continuum of psychotherapy objectives that can help you see the different levels of care that might be needed in your therapy. I got the basics of this from Marsha Linehan’s Dialectical Behavior Therapy. At the top of the continuum are possible psychotherapy objectives for those who are currently ‘mostly stable and mostly ok’ but not satisfied with some aspect of their life. At the bottom of the chart are the probable priorities for those who are currently ‘frequently unstable and frequently in danger’.

Continuum of Psychotherapy Objectives

(from less problematic to more severe)

• Creating a life worth living

• Developing the capacity for freedom and joy

• Affirming individual life goals

• Increasing love and respect for self and others

• Solving life’s “normal” predicaments- relationship problems, vocation, stress, priorities, etc.

• Increasing your emotional and behavioral skills that will help you build relationships, manage emotions more effectively and deal with various life problems

• Increasing anything that will enable you to start on the path toward a life worth living

• Decreasing the symptoms of anxiety, depression, learning disabilities, or any other mental-emotional problems that might trouble you

• Decreasing any of your patterns that seriously interfere with the quality of your life. Some examples: Eating problems, anger outbursts, not going to work or school, addictions, chronic unemployment, infidelity, etc

• Decreasing or eliminating patterns that interfere with your therapy. Some examples: Repeatedly missing your sessions, being chronically late to therapy, not doing your therapy homework, not investing any of your time or energy into positive changes

• Reducing or eliminating psychiatric hospitalization as the way you have to handle a crisis

• Decreasing or eliminating any patterns that are life-threatening. Some examples: Suicide attempts, suicidal thinking, self-injury, homicidal and aggressive behaviors, any behavior that puts you at high-risk for death or injury

So, as you can see, one size of psychotherapy cannot fit all. I have been practicing and studying mental health and personal growth for a few decades. I have worked with a lot of people with a very diverse different range of challenges. If you are stable enough to come to my office, I can usually help you move toward a better life, whatever that might mean for you at this time.

Want to know more? Let’s meet and talk about you and your specific needs. Feel free to email me at or call/text me at 901-763-0999.


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