A Transformative Roadmap for Therapy: For Those Who Have Been to Counseling and Those Who Haven't

Praxis Podcast with Rhett Smith

One of the things that I hear as a counselor a lot, typically near the end of an intake session with a client, is the question, "How is this going to look?" The question can be asked in a variety of ways, but what is implicit is usually either some form of anxiety over the next steps, or just a general curiosity about what people are signing up for when they enter into counseling.

Counseling can vary greatly from counselor to counselor, and with that, there can be a variety of varied expectations then that people going through counseling have. Some people have been to a lot of counseling and all their experiences are different, while some people have still not been to counseling, and wonder what that experience will look like.

Something I have tried to do a lot more in the last 4-5 years of my private practice is properly set expectations with clients when they come into see me for the first time. Whether they ask the question first, or I initiate the conversation, I usually try to walk clients through a general "roadmap" or "pathway" of what counseling might look like. I let them know that things can always change, and this is only a first session, but here is what I think will work best based on what you are telling me, the goals you have, and the experience that I bring to our sessions. I also always follow up with every client via email after the first session (usually within a few hours, but rarely longer than 24 hours later). In that email I talk about our first session, what I heard, the goals that I think they have, the issues we could explore together. And in that email I lay out a big overview of the counseling process, listing the significant pieces, as well as narrowing down on the next steps. And I usually always attach some type of "hoomework" in that initial email so that client's can begin engaging in the process.

Based on all my experience as a therapist both pastorally and clinically, as well as my experience in training and sitting across from a therapist in my own counseling, here is what I find to be most helpful in terms of a "roadmap" for counseling. Now of course, I hope to continue to grow and learn as a therapist, so these thoughts are only a point in time, but I think most of the framework will always exist for me, with tweaks along the way.

First, I think it's important that the therapist helps the client engage in some type of work in and out of session that involves the work of insight, which is simply, the capacity to gain an accurate and deep intuitive understanding of a person or thing. This type of work can be done in a lot of ways, but for me it usually involves work around one's family of origin issues (i.e. family genogram, etc.), as well as walking through someone's personal stories and experience.

Second, I do the work of helping a person take that insight, and I help them identify and create their Pain Cycle. This Pain Cycle is often referred to by other names, but in the work I do with Restoration Therapy, that is what it is called. It's essentially the process of helping one identify their negative pattern of behavior by helping them locate their core feelings and the coping behaviors that flow from them. This is often us in our most primal, reactive state. When you think of fight or flight, and the amygdala getting triggered, this is the pattern that comes up. Though not all of our reactive states are negative, a lot of them are in relational conflict, which is what I work a lot with both in my work with individuals and couples. If I frame it from a faith perspective, this is the old self at work that Paul refers to in Ephesians 4:22.

Third, I do the work of helping a person take their insight, and I help them identify and create their Peace Cycle. The Peace Cycle is also referred to by other names in other theories, but in Restoration Therapy this is what we refer to it as. The Peace Cycle is ourselves when we are emotionally regulated. Think about what you are like when you are living in your truth, or think of yourself in a centered and grounded state. When you are in this place, what actions flow from that. This is you in your Peace Cycle. Again, if I frame this in a faith perspective, this is the new self at work that Paul refers to in Ephesians 4:23. The Pain and Peace Cycle is part of the work of insight, and the Peace Cycle is the step that helps up a person move from emotional dysregulation to emotional regulation.

Fourth, as we are doing the work of insight and the Pain and Peace Cycle (because though I'm laying things out in a linear fashion...therapy, or growth itself is not always linear. I find that all these steps are engaged consecutively in the therapeutic process), I help clients find ways to practice the insight that they have. What I believe is that you can have all the insight in the world, but if you don't practice it in some way, you don't change. You don't get transformation. In the Restoration Therapy model I use the 4 steps to help clients practice: 1) Say what you feel; 2) Say what you normally do; 3) Say your truth; 4) Say what you will do differently (your action) and do it. This is one way that I help clients practice. I literally map out their Pain and Peace Cycle on my whiteboard in almost every session to some degree. I also draw up their cycles and steps on a large poster sheet that I ask them to take home and hang up in their closet so that they see it everyday and start to not only become more aware of it, but practice it. There are lots of other ways to have people practice insight from a variety of tools to experimental exercises. Regardless of what tools I give them to practice, I believe practice is essential.

Fifth, we come to transformation. I believe transformation is the culmination of taking one's insight and putting it into practice. And though we could think of transformation as the ultimate goal, it's really just the beginning. Once someone experiences transformation in one area of their life, then they often become excited to seek transformation in other areas of their life as well. So if there is a visual roadmap I give to clients and that I work from...in short it is something like this.

Insight + Pain Cycle + Peace Cycle + Practice = Transformation.

There are lot of details and nuances in these steps, but this is what I have found to be most helpful. So if you come work with me in my private practice in Plano, Texas, you will most likely hear me talk about something like this.

Whether you come in for marriage counseling or individual counseling around anxiety and depression, I will probably lay out some roadmap for you that looks like this.

Check out this podcast to find out more about this process. In this episode I discuss:

• the importance of a therapeutic roadmap
• the work of insight in therapy
• the Pain Cycle work in therapy
• the Peace Cycle work in therapy
• the work of practice in therapy
• transformation in therapy

Resources Mentioned in this Episode

Restoration Therapy: Understanding and Guiding Healing in Marriage and Family Therapy by Terry Hargrave and Franz Pfitzer

Grit: The Power of Passion and Perseverance by Angela Duckworth