Monday, May 16, 2016

Just Keep On, Keepin' On

It has been a long time since I have written a post here. Life, both professional and personal, has been very busy. Clearly! ;)

And I'm not thrilled about the content of today's post; it's kind of heart-breaking, actually. I was made aware by a client today that there are some really awful reviews of me online. One just posted last week. And it is hard to know how to respond to these. Well, in reality, there is no way to respond, and I guess that is simply what is difficult about the digital world; providers cannot respond to reviews like business owners can. The sites don't even make a space for doing so. So, I'm going to try to respond to some of the reviews. I'm not sure all the reviews are written by actual clients; only one can I actually identify who wrote it. And, sadly, there is an individual in my life, not directly connected to me, who has motivation to cause harm, so I can never know for sure if what is written is by actual clients, or by a non-client.

That said, I'll start by simply saying that if you are a past or current client with a complaint, I am more than willing to try to respond to your complaint as effectively as I can. I cannot resolve any complaints written on the internet, as they are anonymous. And even in the case where I know who wrote it, I really cannot contact the author without potentially then being accused of harassment. It's a tricky position, ethically. I WANT to be able to address concerns, but I don't know the avenue to do so.

So, to address some of the complaints:

When working with teenagers, I require family therapy. I will not work with a teenager without family therapy as part of the treatment process, and this has always been the case. Parents always see how I work with their kids, as they are in the session at least every other week. In therapy, I am equally confrontational of parents as I am kids; my goal is to address the problem and facilitate change, and never is a problem one-sided. As a parent, I imagine (and have experienced!) it is hard to be challenged, but it is equally challenging for the child to be challenged week after week to change dangerous behaviors. I also will not continue to treat a client that is not getting better under my care. Because I treat eating disorders, a higher level of care is always available, and if a client is not improving within 2-3 weeks, I refer to a higher level of care to ensure progress.

Another review boldly states I identify myself as atheist and have no tolerance for any other views. I am not atheist, and never have been, and I feel that alone adequately addresses that review (yes, I'm a little frustrated by bald-face lies). Quite honestly, it has never mattered enough to me to identify a religious stance (it's possible my Facebook page actually says, "H*&% if I know") My goal in addressing religious issues is to allow the client to process his/her own beliefs. My beliefs are not remotely relevant to a client's work, though I will answer when asked my if I believe in a particular religion or thing.

A couple reviews refer to me being immature. I guess I don't know how to best respond to that. I hope that is not the case, but it doesn't really make sense for me to claim I'm not. So, I guess all I can say is that, I'm confident I'm immature at times, but I welcome contact with anyone, and if I am then determined to be immature, I can respect that.

I would agree with those who say I am reactive and rigid. These things are true. I am reactive to my clients doing harmful things. I am reactive to clients lashing out at me, in the rare instances...less than 5...where that has occurred. I am reactive to people treating other people poorly. I am not a therapist who believes in sitting back and just listening; if I see something that i think is interfering with my client enjoying his/her life, I respectfully (or at least that is my intention!) challenge him/her. I fully understand my job would be "easier" if I just wouldn't challenge as much as I do, but I honestly cannot stomach taking people's money to mostly just listen. People hire me to help. And at times, my help is listening. But it is more than that also, especially with the population I treat.

Now for rigidity...I am rigid as a person. I tell clients this often, in fact! It works for me in this career as it is beneficial to be rigid with eating disorder behaviors. The other place I am rigid is in expecting clients to pay for services and for missed appointments. I understand that other providers let things like this go, and I am fully aware that my adherence to a strict payment policy opens me up for criticism. After all therapists are supposed to be always understanding and compassionate, right?! But, we also run businesses. It is surprising to me how therapists are often not seen as the professionals we are. And we are running a business. If a client late cancels or no shows, it effects our business. I go over my policies repeatedly so clients are fully aware of charges for late cancellations and no shows, but still, some are offended when I adhere to those policies. But, I believe that if we, as therapists, continue to allow people to cancel on us without consequence, we are only reinforcing that our time is not important. Now, this is not to say there are not valid reasons for late cancellations, and there is some flexibility in applying charges, but overall, I'm quite rigid with the financial policies. I do not want to be accused of favoritism, so all clients get the same penalty, which has frustrated a few clients. Overall, my time, a therapist's time, is important; not MORE important than anyone else, but equally important. I have managed to flub my schedule a couple times in my career (being rigid helps avoid this problem also). And, each time, I have given myself the same penalty I give clients, meaning I work for free when I next see the client. I am rigid, but equally rigid; I expect the same of myself that I do of others.

All therapists make mistakes (I hope!). At times, I have put myself in the position of apologizing for a reaction or an action, whether that was in group or in an individual session. I see those situations as (difficult and) an opportunity to demonstrate that repair is possible in relationships. I care deeply about the work I do, and the clients with whom I work. At times, the best action is to end a professional relationship due to incompatibility with a client, but the majority of the time, there is much to be learned from working through conflict/disagreement/hurt feelings, etc. Nobody is all good, or all bad. The vast majority of, if not all, humans are good with some kinda bad, and some really bad moments. I have had some really bad moments in my career, and for each one, I have tried to initiate repair. If that is what I am teaching clients to do, it is what I must do myself, even though it's hard.

To have my work, identity, and personality attacked is painful, but part of the job, I guess. I treat eating disorders. I do my best to not anger my clients, but to instead make it clear I will stand strong and fight their disorder tooth and nail. Sometimes, maybe that comes across in an unintended manner. As far as I know, I have not made as many clients angry as there are negative reviews, so that is part of what leaves me unsure of the reviews themselves. Regardless, I hope that this really long post (!) is in some way beneficial. Earlier today, of course I was tempted to just hang it up, take myself out of the public eye, but then, as I went on a walk to try to ground myself, I realized that what I would advise a client would be "keep doing what you are doing, with whoever wants you to do it with them, and let the rest of it go." If I do good work, I'll help people. If I don't, my career will die a natural death. If it dies a natural death, it is likely for the best. All this "being grounded" stuff is hard, but it's what I advise clients to do, to practice, so here goes....