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|Avoiding Clinical Drift - Page 4|
Cognition. Look for long-term patterns in the moment to moment thoughts. These are likely to work with a client whose life is full of challenges, but who also is able to see beyond these stressors to what she can commit to and do for herself. But remember, emotional enlightenment doesn't necessarily bring emotional relief. Behaviors must also change. There's more work to be done.
Action. Try assertiveness training and solution-focused problem solving. These will expand her behavioral repertoire and also serve to remind her of times in her life when she's been effective. However, action is less likely if she is crippled by anxiety and agitation. You need to dig into your toolbox again.
Relaxation. To address the corrosive influence of chronic distress and agitation, use simple relaxation-training exercises and meditation, and support naturally occurring activities, such as running, to promote healthy distraction and stress reduction. Keep in mind that you're putting a lot on your client's plate. The trick is doing this without making her feel even more burdened and criticized.
Emotional Expression. Try using emotional-validation strategies. This would help her express the hurt and sadness she's feeling. These experiences will also help her to see the "wisdom" of her anger, which is a recognition of what she really wants (security and justice) and what she needs to do to get them.
Harry Stack Sullivan, the renowned American psychiatrist, once said, "Therapy is a discussion between two people, one of whom is more anxious than the other, and it's not always clear who that is." That's clinical drift. We think that what transforms talking into therapy and anxious feelings into clinical data is a good clinical toolbox that promotes therapeutic mindfulness, focus, and flexibility.
David Bricker, Ph.D., is adjunct clinical supervisor at Albert Einstein College of Medicine in the Bronx, New York. He's the coauthor of A Client's Guide to Schema-Focused Cognitive Therapy. Mark Glat, Ph.D., Psy.D, is president and cofounder of Group Interactions, a clinical services development firm with a core expertise in the application of group methodologies in a variety of clinical and business settings. Sherri Stover, Psy.D., is vice president and cofounder of Group Interactions. She's served as director of internships in psychology and group therapy services at the Carrier Clinic in Belle Meade, N.J.