What is Collaborative Therapy?

You may have noticed that I consider myself a collaborative therapist.

So what exactly is collaborative therapy? I’ll start by describing what it’s not, because people tend to be more familiar with that. Imagine the following scenario:

You’re sitting with your therapist, describing the mental health challenges you’re facing. Your therapist listens intently, taking copious notes and asking blunt questions. Once you finish talking, he reviews his notes and tells you where your problems came from. He then offers instructions on how to overcome said problems, which you take home and put into practice.

If you’ve ever been to therapy, you may have experienced something like this.

If you’ve never been to therapy, you probably envision it this way, since it’s basically how therapy is portrayed in popular culture.

The process I just described is an expert-driven model — you speak to a mental health expert, who diagnoses your problems and offers you solutions. While this model can work for certain issues, a simple “tell me what’s wrong and I’ll fix you” strategy is often inadequate when it comes to mental health. Over the past few decades now, there has been a shift away from the traditional expert-driven models and towards collaborative models of therapy.

As a collaborative therapist, I don’t claim to be the expert in your life. I know that you are the expert in your own life, because there is no way I will ever understand you as much as you understand yourself. As such, my role isn’t to tell you what’s wrong with you. Rather, it’s to ask thoughtful questions and encourage you to self-monitor and self-reflect, so that you can figure out what’s wrong with yourself.

I imagine the process as a maze of doors. As you share your story with me, I formulate ideas for where our work together may take us, with each idea represented by a single door. These ideas are based on my training and experience, but there is no guarantee that any one door actually leads anywhere. And so, I ask questions and offer suggestions, and then it is up to you to decide which door you want to try. If you’re not sure, we discuss and decide together. And with every door we walk through, a new array of doors presents itself. At certain points, we may even decide to step back and try a previous door that we had skipped.

In practice then, a collaborative therapy session might look like this:

Let’s say that you’re having a hard time fitting in with your coworkers. You’ve been at your job for a few years now, and the stress is becoming more and more difficult to manage. You decide to seek therapy, and you end up sitting with me, sharing your personal story.

Based on what you describe, I may wonder what your coworkers do that causes you to feel excluded and what you perceive their intentions to be. I may wonder if you had similar feelings of being an outsider in the past, and if there ever was a time when you didn’t feel excluded. I may wonder if there’s something about your sexuality, race, or gender that may influence your coworker’s treatment of you. I may wonder if you want to train yourself to ignore or accept your feelings of exclusion. Or I may wonder what exactly it means for you to “fit in,” and what the importance of that is.

It would be presumptuous of me to decide that I know the answer and say, for instance, that it’s obvious you’re having a hard time fitting in because clearly you were rejected as a kid. (The irony here is that if I did say that and just happened to nail my diagnosis, you might think I was a genius, when I was actually making a haphazard and inappropriate guess.)

Instead, I may ask you if you’d like to explore how your previous experiences might impact your perceptions of fitting in at work. That’s one door I open, leading us into the past. I may also ask you about the ways you interact with your coworkers. That’s another door I open, this one staying more in the present. Or I may ask you what your life will be like when you feel confident that you do fit in. That’s yet a third door I open, this one looking into the future.

I open the doors, but it’s always on you to choose the ones to walk through.

In this way, collaborative therapy is like a Choose Your Own Adventure book. Of course, unlike a Choose Your Own Adventure book, we’re writing this story together as we chat and the endings are never fixed.

So really, therapy is just making it up as we go along.

Just kidding …

Sort of.

We may have an end point in mind (say, for you to feel comfortable around your coworkers), but how we get to that endpoint is for us to explore together.

Having said all that, collaborative therapy may not always be the best approach. Certain clinical issues — especially ones that have a clear neurological basis — may be better treated with more traditional approaches and/or medication. This is why I leave the option of pursuing a more directive model like Cognitive Behavioral Therapy. But even then, this is a path we’d choose together, not one I’d impose on you.

In this respect, therapy is like consent in BDSM — if I start bossing you around, it’s only because you asked me to.

Hopefully now you have a better understanding of what collaborative therapy entails. Click here to read more about the history and academics of collaborative therapy. And if you have any questions, leave a comment below or drop me a line here.

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