Annie Sloss, Therapist
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Don't be afraid to interrupt.

2/17/2015

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May I 
Interrupt 
your 
train of thought?

When people come to us for therapy it is all too easy for the conversation to be a repetition of the well worn discussion they have been having with family, friends and themselves.
It is our responsibility to ensure that this does not happen; no new understanding or change is going to come from a rehash of the already known facts.

It is difficult to refocus someone’s train of thought when they are telling their story in therapy because in social situations it is a very rude behaviour. It can be especially challenging when the person speaking is distressed or passionate and paying you to be a compassionate listener.
However the capacity to intervene and redirect the conversation is an essential skill for any therapist and it is absolutely crucial for every group facilitator.

When new people join my therapy group I always start by asking them, have you been in any kind of group before? And if so what were the good things and the not so good things about it? I do this as a way of orientating to and validating people’s prior experience and as a starting point to create group culture guidelines. Invariably the most popular ‘not so good thing’ that comes out of this discussion is the irritation of taking part in a group with someone who dominated the conversation and a facilitator who could not contain them.

It is easier to redirect a conversation if you forewarn the person that you will do so from time to time and negotiate how this could best happen.

Let them know that it is your responsibility to make sure the therapy session moves into new terrain so that the therapy is serving their therapeutic aims.

Listen for the pauses in the rhythm of person’s speech and step in when a pause no matter how slight occurs.

If no pauses are happening at all you will need to speak gently over the person and ask their permission to interrupt, a stop hand signal like that of a cyclist can help.

I use phrases such as “May I ask you to pause (hold that) for a moment?” “May I ask you about something you said earlier that caught my attention” “would it be OK if I just recap on what I have heard so far to make sure I am understanding you correctly?” "I'm curious about..."

Sometimes this will not be direct enough to interrupt a determined speaker who continues to talk over your attempts to redirect the conversation, so from time to time you may have to be quite assertive with your tone of voice, speaking more loudly and dropping the pitch at the end of the sentence.

Before the end of the session be sure to check in with how it was for the person to have their conversation refocused, and ensure they understand your motivation for doing so.


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My personal guidelines for maintaining therapeutic boundaries.

2/3/2015

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Some simple guidelines I follow in order to maintain clarity and safety within my therapeutic relationships.

Ask for consent frequently– Help your clients to maintain their own boundaries by asking permission frequently as you utilise different techniques or inquire into different aspects of their experience.

Stay in one room - when a therapeutic relationship exists in one physical location it helps define and contain the experience.

Refrain from physical contact such as hugs – physical contact can be very confusing or even frightening for some clients.

Time keeping – Try not to let the session go any longer than ten minutes over the scheduled time. 

Time and day – Seeing clients out of expected working hours can compromise our safety and our boundaries.

Support between sessions - Be clear about your availability for support in between sessions. 

Make sure you get paid a fair wage – Set your price for full fee paying and concession sessions and don’t make exceptions.

Be clear about cancellations and payment – Make your policy clear from the outset and stick to it.

Be mindful about what you wear- Consider what you clothing is communicating.

Get insurance and join your professional association – Being part of an official body can bring an important sense of legitimacy.

Get regular supervision – A supervisor needs to be someone you can trust when you are feeling unsure or vulnerable about any aspect of your work.

If you feel even slightly uncomfortable – about something that is happening in your work even if you don’t have any words to explain it talk to your supervisor or a team member about it. Nothing is too small or silly to pay attention to.

Have a conversation about what will happen if you meet outside of the therapy space – I try to refrain from anything more than saying hello.

Help your clients maintain their emotional safety – If you feel that your client is at risk of revealing too much to you in a session or too early in the relationship help them to remain safe by voicing your concern and helping them to stop.

Never agree to keep a secret from other members of your client’s treatment team – except within the legal bounds of confidentiality.

Avoid doing therapy with friends and associates – Be cautious about doing therapy with friends of friends as well.

Be cautious with self disclosure - just because you feel safe sharing something personal about yourself with your client does not mean that they will feel safe hearing it.


See my next post for more about personal disclosure.


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