Therapeutic Philosophy
I believe that therapy should be client-centered and compassionate (both of which I think most therapists do pretty well), but I also feel it should be focused, finite, and ambitious (all three of which I think are a lot harder to find). This philosophy is grounded in my training, my own experience as a client, my experience working with hundreds of my own clients, and my consultation with colleagues who have worked with thousands more.
How I define these terms:
Client-centered: Recognizing that each person coming to therapy has different circumstances, strengths, challenges, and goals that they bring into the room, and must be treated as the unique individual they are.
Compassionate: Respecting that clients are showing strength and vulnerability through the change process.
Focused: Therapy should be centered around a meaningful, measurable goal.
Finite: At some point therapy should end, and more importantly, reaching that end should be the central goal of therapy.
Ambitious means therapy should strive for big, meaningful changes on a short, efficient timeline.
Again, of the above, I think the first two most therapists get right, the last three not so much. In my experience, much of modern psychotherapy is:
Unfocused: Treatment often begins with no goal more concrete than “feeling better,” “talking through some things,” etc.
Indefinite: There is no discussion of an intended end point, and therapy ends not based on clinical considerations, but when a schedule changes, or insurance changes, or someone moves, or (very often) when a client gives up.
Unambitious: Therapist and client often expect nothing more than a vague, inconsistent increase in the manageability of life, often on a timeline so long that any therapeutic change is hard to distinguish from change due simply to the passage of time or other factors.
I find that, upon examination, ineffective therapy (and there is a lot of ineffective therapy going on in this world) generally tends to reveal itself as some combination of unfocused, indefinite, and unambitious. There is a large body of academic research supporting this.
I work very hard to avoid this with my clients for a couple reasons:
Transformative changes are what makes this job magical, and focused, finite, ambitious work is the way to get there. My best days doing this work are not just good, they are transcendent, but making those moments happen takes effort.
Ethically, providing mediocre care absolutely does not sit right with me (especially at private pay session rates).
Unfocused, indefinite, unambitious work is actually more emotionally laborious to provide. That sort of therapy pretty quickly turns into a weekly conversation that is purposeless and repetitive, and sitting through that over and over is for me very unenjoyable.
Most clients / potential clients are on the same page. No one shows up to therapy wanting to waste time, and most clients appreciate therapy they believe can get them places, even if requires them to regularly leave their comfort zone.