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04 March 2011

Help me with a possible askme question: The kindest way to deal with a student therapist.[More:] I have this psychotherapy class where we have to be a therapist to one student and a patient to another. My therapist is especially bad. She has done about everything she can do wrong. She always wants to know if I'm going to be the same patient or another patient when it would have never occurred to me to be another patient. She has gotten to the point with the current patient where the patient's next step will be to leave her. Do I let her start up with a new patient and confront her more on the mistakes she's making this time around, or do I have the current patient tell her why she is leaving and point out what she is doing wrong? Which is the actual kinder option, to give her an easy out with a new patient or to let her know how badly she is screwing up?
Some background, the patient I am playing presented with what seemed like social anxiety disorder and the first thing out of her mouth was to blame the patient's husband. She does not even know the husband's name and the patient is somewhat dependent on the husband. The therapist has his bad habit of squinting and staring at the patient and it looks very judgmental. I think it's just what she does when she doesn't know what to do but she ends up doing it most of the time, just squinting and staring at a patient who has a problem with being judged. I've unconsciously started to stare at her when she does this and I just noticed because it causes her to jump and blurt out a pointless question. She asks the same questions over and over, I assume because she can't think of anything to say. There are other things, like she explained relaxation therapy totally wrong to the patient, but am I being too harsh on her? Right now I feel like the patient should leave and explain to her why she is leaving but she could just take it personally and not learn anything at all. This is already the second patient I am playing because she wasn't getting anywhere with the first patient.
Maybe I'm being obtuse, but could you raise your concerns with your professor and maybe have him/her observe one of your "sessions"?
posted by youngergirl44 04 March | 18:07
Every session is burned onto dvd and only shown to when the therapist wants constructive criticism on that they are doing. I do not believe she has watched any of the sessions. In bringing it up to a friend, he commented that she may not know she is doing the squinting and staring, which is probably the only reason I am leaning toward explaining things. It's driving me batty and will end up coming up this way or with the next patient.
posted by ethylene 04 March | 18:24
I've already thought about giving her the option of continuing with the patient or starting with a new patient, as last session is the first time she has not asked if I was still going to be the same patient.
posted by ethylene 04 March | 18:31
I'm not sure I understand the dynamics fully, but is there a way for the current patient to say, "I don't think this is working for me. Here's why -- I don't feel heard, I don't get what you're saying about relaxation therapy, etc"?
posted by treepour 04 March | 22:23
Are you just an actress helping train the student therapist in part of a larger program or are you actually supposed to be providing feedback and evaluations of her therapy during this process?

If you are part of a larger training organization, tell her bosses what she is doing wrong with you and let them address it.
If you are supposed to be giving her feedback, tell her directly that patient 1 has left her because xyz (why she is bad) and that now you are patient 2 with some other problems and offer her the fresh start with the new one.
posted by rmless2 04 March | 23:01
This sounds like what professors are for. It's a class; someone is teaching it. That someone should be able to guide you.
posted by galadriel 04 March | 23:47
I agree with talking to the professor, if necessary.

I'd also say that having done a lot of those role plays myself, it was close to impossible for me to do a decent job as a practice-therapist when the other student was pretending to be someone other than herself. (We were generally encouraged to pick some stressor we actually had in our lives to do practice-therapy with.)

Someone who's role-playing an imaginary-to-them issue just generally doesn't provide the nonverbal/emotional cues that help direct a therapist toward the actual important aspects of the problem. And even if the practice-client is a great actor, when the practice-therapist knows it's not a real issue that practice-client is talking about, practice-therapist probably isn't going to be tuning into the nonverbal stuff, because it can put practice-client on the spot with her acting skills, which are not the point of a therapy class.
posted by occhiblu 05 March | 01:50
The point of the sessions for the professor is a focus on the therapist, not on the patient except as experience for the therapist. I agree that you can only get so much out of practice therapy this way but it's what I'm stuck with. Even though we are being imaginary patients, we still are relating to one another, and right now, playing this patient is very stressful.
The biggest problem really is that the patient doesn't trust the therapist and I really want to explain this to her, besides all the things she is doing wrong, if the patient can't trust the therapist, it's never going to work, and she has made it impossible.

You write therapist that many times and it just looks like "the rapist."

I have a week off for spring break before I have to deal with her again but it's been preying on my mind. After an evening out, I finally got a break from thinking about it. There is a lot more to this whole situation than I've explained but those are still the only two options I can come up with to deal with it. So I'm wondering about making it clearer and just getting opinions on askme about which is the better option.
posted by ethylene 05 March | 16:40
Someone who's role-playing an imaginary-to-them issue just generally doesn't provide the nonverbal/emotional cues that help direct a therapist toward the actual important aspects of the problem.


I'm in a supervision group where we do this kind of thing all the time, only the whole point is to identify with the patient to the point where you can provide those cues. Without that, though, I don't understand what the point of the exercise would be.
posted by Obscure Reference 05 March | 21:48
Lounging attire || It's time for another Friday Night Question!

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