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Francine has been coming to therapy for about a month. Her parents brought her due to problems and conflicts she was experiencing boat home, school and in the community. Like many teens, Francine did not see the value of therapy and felt the problems were only her parents’ issues. Besides, if she needed to talk to anyone, she would speak with her friends.

I asked Francine why she was coming to therapy. She said because her parents wanted her to. I found this very telling because many disenfranchised and at-risk or defiant youth would just not come – often using all kinds of expletives to tell the parents why they refuse to come. Francine was different. Thought she didn’t want to be here, she still came “for her parents.” This was certainly a “door” to further open in her therapy.

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Many clients coming for therapy are self-referrals. That is, they recognize a problem and seek help for what is causing them difficulties in their daily functioning. However, many of my referrals are from third parties. That is, referred by a school, employer, the courts, lawyers or parents.

So, what should you do if the client really doesn’t want to be in therapy or is unable or refuses to see the merits of counseling? I know colleagues who refuse to accept these referrals. Either the client “buys” into the therapy by taking responsibility or they will not see them. Personally, I have a problem with this approach. There is a residential treatment program here in Toronto which will not accept a youth unless he or she is willing to voluntarily go into the program. However, for many of these young people, if they were capable of making that decision for their own best interest, they would not need the program.

So, what should a therapist do with clients like Francine? Most of us, if not all of us, have built in resistance to that which we find uncomfortable. If I don’t like doing something, I will either procrastinate or avoid the situation entirely. Let’s be honest – most of us do not want to talk about things that are confronting us, bothering us or painful for us. It’s only if we really trust or know that it will help, that we are willing to go down that road.

This reminds me of two stories: The first story is of a little boy about eight or nine who has a terrible sore throat. You know, one of those where you can’t even swallow without feeling like you’re swallowing razor blades. He went crying to his mother, who rushed him to an emergency walk-in clinic. When the doctor looked into his throat, he said it was infected and needed immediate treatment. That meant an injection, as oral medication would take took long exclaimed that the infection needed immediate treatment. He felt oral medication wouldn’t be effective quickly enough. As the doctor injected him, the little boy cried out in pain. As the mother and son were leaving, the son was heard crying, “I came in with my throat hurting so much and now my throat and arm are hurting so much”. We’ll return to this story.

The second story is of a little girl with a terrible toothache at the back of the upper left side of her mouth. She goes crying to her mother, who immediately takes her to an emergency dental clinic. The dentist seats her in the chair and begins his examination on the lower right side, proceeds to the upper right and carefully moves to the lower left side. So far the scared little girl is thinking that this isn’t too bad. Finally the dentist proceeds to the upper left side and touches the infected tooth. The child screams in pain.

What is the moral of these two stories? There is a common theme to them and I would like for you to stop reading for a minute to think this through. What is the moral of the stories and what does this moral have to do with going to therapy?

Sometimes in order to feel better what we do may cause more pain at the beginning. The extra pain is not done out of malice, but as part of the treatment. Also, if we go into therapy and touch on the non-effective issues (sports scores, weather, etc) it won’t hurt, but we also will not be dealing with the problem areas. In therapy, sometimes it might initially hurt more to talk about the problems and analyze what’s happening, but in the end the pain will be much less and we will function better.

I asked Francine the following questions: What is the difference between spending and investing? At first, she had no idea what this question had to do with her therapy. However, the discussion that followed really helped her to gain perspective about her therapy sessions.

What is spending? When we spend money it is to purchase something that we will have for a limited amount of time. For example, when I buy pizza it’s with the knowledge that once I eat it, its gone. I have spent my money and am left with nothing but the fond memories of the taste. I can buy a new suit knowing that after some period of time I will either be too small or not to my taste anymore. The same is true for whatever we buy. Most purchases have a time limitation. I know this going into the purchase and that is what I want and expect.

What is an investment? When I invest in something, say a stock or bond, I do so for one primary reason. I hope, and plan, to end up with more than I put in. This does not always materialize, but my attitude, my intent, is to leave with more than I put in. The probability is that the more I put into the planning and research, the better my investment and the more I will walk away with.

So, have you figured out the relationship in spending and investing with therapy? Did you figure out what Francine discovered in our therapy sessions?

What you get out of therapy depends on your intent or attitude going in. If I go into therapy, or even an individual session, with the plan that I will spend time with my therapist or I am spending time in the session, the probability is that you will walk out with very little, if anything, to gain from it. I spent my time, the time is up and now I leave (probably forgetting all or much of any discoveries I made). That’s because when I spend I don’t expect a long-term benefit or return on my time. On the other hand, if I invest in the time I am with my therapist, I expect to leave with more than I came in with. I expect my knowledge to grow and pay dividends. Speaking of dividends, I tell my clients that I don’t want to pay dividends once or twice a year, but rather I try to pay dividends every session. Those dividends are insights, good feelings, knowledge and a sense that we are one step closer to the big pay off.

I share this with you hoping that if you are looking to improve your life, to get more our of it and to function on a higher level, you will remember the importance of investing your time and energy as you search for the meanings of your life in whatever means you chose.

Mr. Schild is the Executive Director of Regesh Family and Child Services in Toronto, Ontario Canada. Regesh runs many programs helping families and youth dealing with personal and family issues in their lives. He is currently open to speaking engagements. He can be reached at 416-495-8832 extension 222 or [email protected]. Visit www.regesh.com. See our second website specific to our enhanced anger management clinic at www.regeshangerclinic.com.

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