How do you decide what to focus on in therapy? Do you start with the events of this past week? Do you focus on depression and anxiety, or start with trauma?
Today, I present a much simplified view of the essential three topics in therapy, and which of them to start with.
- Safety Concerns: If there is a significant concern of thoughts of suicide or thoughts of harming others, this is the number one focus. After all, for any client to get better from mental distress, they must first remain safe. Especially since the topics of therapy can be difficult to explore, clients staying safe is required to any progress being made in therapy.
- Anything that interferes with the therapeutic process: Including difficulty opening up, conflict between therapist and client, avoidance via not completing homework or canceling/rescheduling appointments. Failing to address any of these factors can severely hinder the progress of therapy.
- And a distant third: whatever the client came to work on. This may be counterintuitive, but a client’s expressed issues can only be focused on when 1 and 2 have been addressed.
Perhaps a controversial take, so I welcome any feedback you may have.
