The Client Experience in Therapy

As a learned and experienced practitioner now after about 25 years of working with clients I have gathered some insights into client experiences which have helped me understand my clients from a more informed and conscious perspective.

First of all, as a practitioner, it is important to understand that different clients come to therapy with different goals, expectations and outcome ideas. It is crucial to assess the client for what THEY want for themselves.

The client experience is closely related to how the client relates to the therapist in the first 15 minutes of the session. Research literature abounds on the importance of building rapport with clients early on. In practice this sometimes can be quite a challenge.

Working in Mauritius, with a multicultural population, or in Australia with another mix of ethnically diverse populations I have learned that timing for rapport building can be different across cultures. For example, more traditional cultures may have customs and rules about rapport building with people from other cultures. For example, I worked with someone from Samoa when I was in Australia and we continuously had conflict relationships despite my attempts at trying out different strategies. Eventually turned out that in Samoa men usually assume the role of leaders and consequently are decision makers. As his leader this conflicted with his traditional values making it difficult for him to receive help from me. We problem solved by creating a rapport where he lead and I provided support based on the presentations outlined in that leadership. From then on progress and movement in therapy was noted.

Many clients I have encountered in the past have indicated that they come into therapy not knowing the mechanisms of how it works or what to say. "I don't know what to tell,..." is a phrase I often hear. As a therapist, I ease clients experiences by asking this very question at the onset of the therapeutic journey. If the client reports not knowing what they want to talk about I usually ask them to start wherever they feel they want to start in their stories. In so doing some individuals start by an introduction of themselves, others start narrating their stories from a chosen point, and still others outright spell their problem. Ultimately they fins out no matter where they start we always get to the core of the question that brings them onto the therapeutic journey to start with.

Whether the presenting case has clinical, developmental, or any other bases the client's experience remains the key factor in determining the success and future access to therapeutic services. Of course, as therapists, we also need to be sensitive to the places the clients are along the change journey. It is crucial for both the client and the therapist to define, develop a common understanding and definition of what change looks like so a baseline can be marked to allow for movement. This also harmonizes and homogenizes the change journey where both the therapist and the client work in a collaborative and cooperative manner to achieve the goals set for themselves. In so doing a common understanding of the story is essential.

It is my own experience as a person that the need for change makes itself a presence as a result of chaos, conflict, discomfort, or any feeling which causes the person to feel disruption in his usual being. As such, something in the person's common story no longer works for them causing somatic, physiological, physical or psychological unease. This in turn leads to an attempt to dislodge the cause of the ailment by talking about the current experience. The talking leads to an exploration of potential solutions and goes all the way to a decision as to how the person will attend to the cause for trouble. This is where, we as therapists come into play and start a new journey with a new client.