Huh. Actually, I think this: CT first and psychodynamic later is kind of what I do. Only more DBT than straight CT, because lots of people with trauma.
But my general approach seems to be: "Okay, hi, what are the problems you're dealing with? Right, let's explore this. Here are some skills for identifying and preventing panic attacks/alternate activities to cutting/methods of grounding/methods of relaxation/steps you can take to get out of your terrible housing situation/ways you can deal with the paperwork to get yourself on disability/etc!
"Did that work?
"No? Okay, interesting. Let's look deeper at why not. (And also, here are some other things you can try.)"
My feeling is that it'll be most useful to get someone out of their most immediate crisis before we start looking deep. In no small part because in order for the deep digging to work well, they need to know me enough to trust me some. So we'll look at behavioral changes they can make first, but the point of it is immediate stabilization, demonstration of therapy as something that can make them feel better, and establishing rapport between us.
And, I mean, I check in-- if someone's been in therapy for three months and their initial symptoms are gone, I'll ask them if they'd like to stop. But I haven't yet had anyone take me up on it.
no subject
But my general approach seems to be: "Okay, hi, what are the problems you're dealing with? Right, let's explore this. Here are some skills for identifying and preventing panic attacks/alternate activities to cutting/methods of grounding/methods of relaxation/steps you can take to get out of your terrible housing situation/ways you can deal with the paperwork to get yourself on disability/etc!
"Did that work?
"No? Okay, interesting. Let's look deeper at why not. (And also, here are some other things you can try.)"
My feeling is that it'll be most useful to get someone out of their most immediate crisis before we start looking deep. In no small part because in order for the deep digging to work well, they need to know me enough to trust me some. So we'll look at behavioral changes they can make first, but the point of it is immediate stabilization, demonstration of therapy as something that can make them feel better, and establishing rapport between us.
And, I mean, I check in-- if someone's been in therapy for three months and their initial symptoms are gone, I'll ask them if they'd like to stop. But I haven't yet had anyone take me up on it.