If I read, "client arrived and departed", my first thought would be that the client walked through the door and promptly dropped dead.

@Jojo_lifeisbliss

3 жыл бұрын

😂😂😂😂😂

I had a good laugh at some of those progress notes...."Client was awake." ... 😆

@wc8-administration687

5 жыл бұрын

OBVIOUSLY! Unless the patient sleptwalked to their appointment. 😋😂

@karok474

5 жыл бұрын

I laughed my head off :)

@ladymopar2024

4 жыл бұрын

That was funny

@jeanettewaverly2590

4 жыл бұрын

Dhuum Client notes: Counselor was awake, for a change.

@daffygreen7249

Жыл бұрын

@Dhuum that cracked me too! 😂

When dealing with victims of abuse it is a mistake for the therapist to display anger at the abuser. What the client needs is a safe space where they can process their own emotions.

@annamolnar683

5 жыл бұрын

@@katie52255 I agree! Sometimes seeing your therapist react a certain way makes it easier for you to express your similar feelings you otherwise would downplay.

@RonLarhz

4 жыл бұрын

@@katie52255 Mine was opposite. Mine was angry at me for being disapproving. She wanted me to validate my lying father about him not being violent when it was his turn to talk. Totally reaffirm my decision to not continue to see her.

@tupelohoney622

4 жыл бұрын

@@katie52255 , I agree with you. I was sexually abused as a child for over 7 years. I had no emotions regarding the abuse, just numb. My therapist expressed anger at the abuser and the situation. I found the therapist's anger fascinating. It had never occurred to me that it was acceptable for me to also be angry. As I improved, it felt safe to express the rage bubbling inside during my sessions because my therapist had modeled anger first.

@ladymopar2024

4 жыл бұрын

You are totally spot-on

@paturban8558

3 жыл бұрын

Tupelo Honey d

"I'm bad at relationships so you lost me at sister in law." That was surprisingly savage in a really funny way, it threw me off so bad I chuckled out loud.

@mariaorourke5866

Жыл бұрын

I think sometimes/often a client has so much they wish to communicate and maybe have not had an opportunity before to talk about openly and safely that they want to say almost overwhelms them and gets kind of tangled up in the telling. Perhaps a situation or relationship or other difficulty or hurt has been a long time in the making and other things have arisen subsequently that are consequent on the original circumstances/events. A bit like Hydra with all the many heads. Maybe things are deeply distressing and it is hard for the person to fully recall them coherently and order them in time, especially if feelings have been bottled up or denied for a long time.. II think it helps if the counsellor can slow it down a bit, perhaps ask for clarification, maybe summarize and check understanding. Maybe identify themes to explore further either now or in the future. I think it helps to think of it as a joint search for meaning between counsellor and counselled. Just some thoughts.

My therapist took NO notes and never remembered anything I told her. No longer working with her

@stephenpowstinger733

4 жыл бұрын

Far too common. The therapist treats her profession as a nine-to-five job and doesn't want to be involved with clients.

@MW713

4 жыл бұрын

Same here

@ladymopar2024

4 жыл бұрын

Too bad too cuz there are really good counsel's out there I hope you find one that works for you

Video began and ended

@melissaforgiven2825

5 жыл бұрын

Lol!!!

@macmedic892

5 жыл бұрын

Very good. See you tomorrow!

@wc8-administration687

5 жыл бұрын

😂

@kathrinjohnson2582

4 жыл бұрын

Hahaha

@kathrinjohnson2582

4 жыл бұрын

Hahaha

1) 1:07 Counselor gets a new client through intake and assumes previous diagnosis is correct and skips the assessment. There may be a change in the client that warrants an assessment. 2) 3:06 Counselor takes awful progress notes. 3) 6:29 Counselor overreacts to revelations of the client's problems. 4) 7:49 Counselor excessively notices client's non-verbal behavior the moment that they happen. 5) 9:38 Counselor pretends to follow the story. 6) 11:12 Counselor does not admit to their sincere therapeutic mistakes.

I had a therapist who was from a minority group where English was not his first language. He confused the meaning of "beat around the bush," with, "song and dance," and told me to stop doing a song and dance when talking about suicide. Big difference dude. Big difference.

Dr. Grande killing it as always. I’ve noticed many of these mistakes made anecdotally with family members. Also, many states people can claim they are a “therapist” with few credentials and perform poorly at a scientific level. Counselors themselves that are licensed clinicians perform much better but I’ve seen bias and poor assessment go as high as prominent psychiatrists with good reputation. The scientific method helps keep this in check and a clinician should constantly be checking their relationship with the patient is proper and objective and that proper assessment may take time and develop over time. Love this particular video and clinicians could learn so much from re-evaluating their counseling methods and staying current with new research! Your videos are addicting thanks so much for these free lessons.

@DrGrande

5 жыл бұрын

You are quite welcome!

@Marnee4191

Жыл бұрын

Can it be considered a "mistake" if a family member does it when they are not acting as a therapist?

@shawarmaboy4844

Жыл бұрын

@@Marnee4191 What? The video is about therapists

Admitting mistakes is really important to me as a client. It makes me feel a lot more safe calling the therapist out when they say/do things that upset me. I've also had a therapist who very specifically wanted me to be doing that, because it's such an important skill to have in relationships, and one of the goals of our therapeutic relationship was for me to be able to advocate for myself appropriately in all my relationships.

@whitefang238

5 жыл бұрын

that sounds really nice. She seems to be a good therapist.

@do9138

Жыл бұрын

The last thing I want is more arguments. Therapy was great in the 20th century. It's all CBT/DBT now, and it sucks.

Thank you Dr Grande. I’m a new counselor and have learned a lot working with highly traumatized patients. I’m always looking for more tools to be the best human being for that patient who is present and validating. I listened to your video about mistakes that counselors make. I think that counselors need to do their own work to be able to be present for the patients. It’s horrible that the counselor has more unresolved issues than the patient. 😵

I was seeing a counselor who was one year out of college. I knew she probably did not have the experience and skill level that I would require but I gave her a try anyway. At one point I observed that her attention would change from looking at my face to watching my hands move while I was explaining something. I asked her why she did this and she said she was observing my body movements. I expected her to become less obvious in her observation after pointing this out as it was uncomfortable and distracting but she didn’t. Yawning without an apology or explanation while your client is talking is not always the best thing to do. Little to no feed back can be frustrating as well. Needless to say my original assessment of this particular counselor was correct. She’s new, she’ll learn 👍

I had a few sessions with an old psychoanalyst who was like Sherlock Holmes, except that she got almost everything wrong.

@whitefang238

5 жыл бұрын

did she also INSIST she was right and tried to make you fit in the boxes she had set for you? This bothered me so much. I was extremely vulnerable and depending on how they did this, it would feel like some sort of violence. Like, when I'm stable and ok, this does not get to me at all and I simply explain to the person why they are wrong and if they are stubborn I just ignore them lol. But when I'm in that state of very deep depression this was like an attack. I needed help and I this person was not listening to my reality and misinterpreting everything.

@MrX-rk9or

4 жыл бұрын

Sounds like she was more of a "Inspector Closeau", then.

@joeblow9657

3 жыл бұрын

It's almost like Sherlock Holmes is a fictional character and that no one can actually be that right without having good info.

@NoelleMar

3 жыл бұрын

@@joeblow9657 Sure but some people are more observant and “logical” in that way than others lol.

@joeblow9657

3 жыл бұрын

@@NoelleMar Yeah but no matter how smart you are you can't magically deduct things with Holmes's extreme accuracy irl unless you basically have insider info

Overreacting is definitely not my problem, and in fact I have developed such a good poker face that sometimes I under react. I definitely need to work on "appropriate reacting". Another mistake that I make at times is my resting b**** face. I've often been told that I look like Im mad a lot. In counseling I know that my nonverbals are important to the client. I appreciate this video as I have made all of these common mistakes throughout my career and I definitely want to make improvements.

I've also had issues with counsellors being unwilling to discuss areas that aren't their strong suit, which ties into the not admitting mistakes issue. Also one therapist was overly impersonal (cold), created their own explanation for my gender identity based on trauma and generally said very little.

I love your videos so much. A couple of years ago I was seeing a male marriage counselor and then switched to a female (he pushed her on me and it was really awkward, they were friends) within the same practice as I had already used him for marriage counseling so he couldn't be my individual. I had expressed that I preferred a male counselor and I have trouble opening up with females due to different traumas. I didn't want to make anyone upset (I am a people pleaser even when its to my detriment) and so I accepted her for individual counseling. In our first session, knowing that females made me uncomfortable, instead of trying to get to know me, she proceeded to ask what I thought of my previous male MARRIAGE counselor......She even went as far as to say "What do you think of so and so?" (referring to this male counselor) "He is a young handsome guy"......I was so confused and felt so violated. It was so disrespectful not only in general, but because I am also married. It was just bizarre. I even tried multiple times to get off the subject by saying "Yea, he was nice; let me tell you a little about my history"....It was just bizarre and honestly SUPER sexist. When I said I preferred a male counselor over a female one she immediately started testing me to see if I had a crush on my male counselor which is so inappropriate. Just because I am female and prefer a male counselor doesn't mean I want to screw them? I don't get that logic at all. I know plenty of males that prefer male counselors as well and I bet they don't get treated like that. It was just bizarre.....I never opened up to her and only say her a couple of months.

@k.ambriz9789

5 жыл бұрын

N. Johnson that sounds very discouraging. Sounds like she may have unintentionally reinforced your preference for male counselors too.

@blueeyes6852

5 жыл бұрын

N. Johnson. I apologize for being so late to the party, but I felt compelled to write to you. I too, will always pick a make over a female in all settings (I'll bet my avoidance is based on trauma too). I only tell you this, so you know I really understand what you're conveying here and really applaud your position! I sincerely hope you've found someone that's perfect for you! Remember friend, you're the paying customer! That was totally bullying you! Poor thing! I'm just very sorry! Cheers to you and have some fun this weekend!😘🌷🙋🍀🍀🍀🍀🍀🍀🍀🍀🍀🍀🍀🍀🍀🍀🍀🍀🍀🍀🍀

I live in Ontario Canada so we have universal health care. Most of the psychiatrists I have had, have many, many patients. Taking good notes is essential. This point resonated with me. I use my middle name, always have. You would be surprised how many of the doctors I had been seeing for years still called me by my first name. Sometimes when I am called in the waiting room I don’t even answer because my first name is not the one I hear. One of the ways I have found most useful in combating this overall problem (not just the name thing) is when I first start seeing someone and until they remember who I am I hand the doctor a sheet of paper (generally in some fluorescent colour) with typed notes. These include name, diagnosis, past, family names, current difficulties or present situation and my concerns. It works on the same principal as an outstanding job resume that you want someone to remember. It seems to help.

I really liked how you highlighted the fact that not only is admitting a mistake in counseling common courtesy, but it is also a valuable learning experience for both the counselor and the client. The relationship you model between you and your client should be one of unconditional positive regard and respect. Some individuals in counseling may struggle with interpersonal relationships in their own personal lives, and they may begin to use how their counselor treats them as a model for the way they should expect other people to treat them.

@tamarabakergibbons5715

5 жыл бұрын

It just points out that we are human and mistakes are inevitable. I like how counseling is moving away from the dynamic of "expert and patient" to "helper and client". I would imagine that the client would feel respected, valued and more opened to help.

Working in a bachelor's level environment, I have seen a lot of these mistakes being made and have even made some myself as a neophyte counselor. I can identify with over reacting to client disclosure. When first starting as a substance abuse counselor, I had to be very intentional with controlling my nonverbal behavior and disclosure with clients. Many of the clients I worked with were uncomfortable with the counseling process or were not willing to disclose, and I didn't want to hinder the therapeutic relationship by making the client feel embarrassed or ashamed. I can appreciate videos like this one because it is helpful to have an explicit reminder of how one should not act when working with clients.

@do9138

Жыл бұрын

You are a counselor WITH ONLY A BACHELOR'S? Wow. What state do you live in that allows that?

Here's some mistakes i've seen throughout my many many years of therapy: I've had a lot of therapists just flat out not believe me when i tell them what im struggling with. the one i see currently says that I don't really have a binging problem, even through ive told her numerous times that it's been the most troubling thing in my life as of late. This is the worst one to me because it discourages us patients to not tell them anything because we're afraid of them not taking it seriously. (i need to get a new therapist because of this but whatever) I've had a therapist bring me a power point presentation on what the "root cause" of my issue was literally the first time she met me. that same one wanted to meet and talk to both of my parents before ever meeting me. I've had a therapist spend her entire hour with me playing Uno. I've had a therapist give me a diagnosis upon the first session (it was inaccurate) I've had many therapists try to argue with me about how i "really felt" about a situation. for example I had one try to tell me that I actually enjoyed a debilitating symptom of my disorder because they said I "liked feeling a little crazy". When I tried to dispute this she wouldn't have any of it, and changed the subject. moral of the story: don't trust every therapist. some of them do shitty shitty things

@whitefang238

5 жыл бұрын

this not believing thing is also horrible, it happened to me as well. Also very traumatic. I actually believe he saw my diagnosis and did not want to treat me. I was very vulnerable, I had been living on the streets cause my family was very abusive. I came to him and he immediately imposed some conditions. He demanded that I was accompanied by someone. I explained I had no family and could not force a friend to take care of me in that way. He insisted he wouldn't treat me. I was staying in a friend's house and she saw how distraught I was when I arrived and she offered to go with me. Then, after the session, he asked to talk to her alone. He told her a relative should be doing this, not her. Then when she replied my family was violent, he said: "this is what she said". It was pretty horrible. I never went back, but the problem was: I was trying to get on welfare in light of what I was going through and I needed a doctor to be assessing me and reporting to the government and I had already spent every bit of money I had left on his appointments, there were deadlines I couldn't meet and I was even worse after seeing him. Everything turned out ok in the end because that one friend helped but had I been alone, I'd probably not be here. If not dead, at least on the streets

@multuminparvo5

4 жыл бұрын

I think you should report him. This sort of willful incompetence feeds the human trafficking industry. He needs to learn that such behavior is very dangerous. Your family has no right to be there, and by speaking with your friend alone about you he was treating her like she was your handler and you were property, her slave. A church outreach minister started treating me like that and I eventually found he was helping cover up child sex abuse. I'm trying to get well enough to report him and some healthcare professionals to the FBI because I've uncovered a systemic cover up locally. Best wishes to you--I'm so glad you had a friend there. Many of us don't.

@ryanc2286

3 жыл бұрын

i like the one with the uno

@DR-nh6oo

Жыл бұрын

By your experiences, and mine, it would seem that most can be pretty shitty.

@do9138

Жыл бұрын

"You don't have problems. How you think is the problem. Here, sing the lyrics of 'Whistle A Happy Tune.' That will be $200."

As someone with a history of addiction, I went thru many counselors who would react so strongly to some of the stories I would tell them and it just made me feel judged evil. I knew these things were bad but I didn't need to be scolded about it. Finally I found a wonderful woman who when I was telling her these things, she just stayed very calm. She just kind of would nod and had an interested, curious expression. Like she was assessing the situation and how beat to help me. No judgement or anything. She was taking in what my situation was and what I needed. It was amazing. It was so freeing and I finally felt like I was in a safe place.

@do9138

Жыл бұрын

They DO judge. They pretend they don't, but you should hear what "healthcare professionals" say about patients. They're as bad as anyone else.

Thank you Dr. Grande. I really had some good loud laughs, while you were telling about some particularly mistakes. It made me feel like I was watching an episode of the most funny home videos 😂 Your sence of humor is again much appreciated. Of course mistakes can be made, because nobody is perfect. Making an appology when needed from the counselor is a good sign of maturity and being respectful to the clients. I didn't noticed you told any lies I think watching your nonverbal language.. hehehe

@DrGrande

5 жыл бұрын

Thank you for that - when I release these videos, I'm never sure if my sense of humor is perceptible!

@pocoeagle2

5 жыл бұрын

@@DrGrande Well it sure is often very much notable to me sir and I appreciate it. Lot's of issues about mental health problems is nothing to laugh about of course. So a video now and then with humorous interpretations of you is always welcome 👍

@lauratheexplorer6390

3 жыл бұрын

There should be a new show called “Therapists say the darndest things.”

@quarteracreadventures855

3 жыл бұрын

@@DrGrande Sense of humor x 4!

Dr. Grande raises some great points in this video. Overreacting to a client revelation could cause that person to avoid opening up to you in the future. I have also wondered about the reading of body language myself. I tend to fold my arms when I'm cold, even if I have no intention of being closed off from anyone. Great insight for a new counselor like myself.

the one about the notes I got a chuckle out of

I enjoy your videos and appreciate your insight. I’m not a therapist or counselor but have to do progress notes for all sessions with clients, including a section specific to mood, adjustment, well being. I realize I’m a bit too detailed at times, it slows me down, yet it’s a pet peeve of mine to see notes that can’t give me a good picture of what’s going on with a client other than obviously they were awake. Lol. I’m learning to be less wordy, less concerned about perfect notes and focus more on quality of time during interaction on visits. I can honestly say that after so much study on narcissism, I do get the extreme value of accountability. I agree that humility, showing you are human, owning mistakes, consideration for the time of others, etc is key for an authentic working relationship. Thank you for the tips, Dr. Grande. :)

@DrGrande

5 жыл бұрын

You are quite welcome!

"I'm really bad at relationships..." Was that a slip Dr. Grande?

@DrGrande

5 жыл бұрын

Lol, you would think a counselor would be good at relationships.

@jeanettewaverly2590

4 жыл бұрын

Gregory G Getting a little Freudian there.

Dr. Grande spoke and I listened. . . . Good to know I'm not making these common mistakes. Although, I do overreact but only with clients who I have a rapport with and it's only used to empathize with the shock my client feels about something that happened to them. Many times my client will say, "Crazy, right?"

I know exactly what you mean about tracking. I was working with a "client" during a recent role play and I had to ask for clarification. She stated that was great to ask, and great tracking. The mistakes you stated appear to be easily made. Thanks for sharing.

@kristinblake9294

5 жыл бұрын

Christiana, tracking a conversation can be difficult when a client is downloading all of their thoughts and feelings. However, it seems more effective to take moments to pause the session to track the session to be sure a counselor is on track and understanding the story appropriately.

I can remember the days when a therapist would simply note, "No complaints" as a progress note! Hope those days are long gone.

@marksanchez4230

3 жыл бұрын

that is laughable

Dr. Grande, I think you're among the most level headed and informed Psychologists I've ever seen, very objective and strikingly honest. I figure since this is an open comment section, I should call it as I see it. Thanks for the vids, I'll often refer to them when I need to broaden my knowledge. 🖒

Thank you for sharing these common therapeutic mistakes. Overreacting and overanalyzing information, nonverbal behavior, or a client's statements can cause a client to fall back and stunt the growth of a therapeutic relationship. Tracking is also very important. As an upcoming counselor, there are times in our role plays where I have not stopped the story because I wanted the client to complete their thought. Through practice, I have recently become more comfortable with interjecting.

@jessicavickers3946

5 жыл бұрын

I know what you mean about not wanting to interrupt. There is such a fragile balance that is needed for tracking and more often than not its more difficult to identify when is a good to to interject.

I’m a LMFT in private practice, your videos are great! Thank you, thank you. We are listening.

@kellytrowhill681

4 жыл бұрын

I'm a new MFT in a location where most people in the two offices I work at didn't know there was such a thing as a marriage and family therapist. Clients that come in by themselves ask if I know how to treat them as individuals. I'm thankful for Dr. Grande, Dr. Durasula and Dr. Fox. Great help to a newbie.

Sending patients home with some type of diagnosis of someone in their family when they didn’t talk to or examine the person. They based it solely on what they were told by the patient.

@ilkim9665

3 жыл бұрын

I had my wife who has very heavy trauma background, that I feel is trying to distance me from my family and friends come home from doctors appointment telling me that I am a narcissist. I haven't had a single word with the practitioner, we have been in couple's therapy for months without any inclination of any other professional considering me narcissist.

@johnthomas6849

3 жыл бұрын

Wow, same thing happened to me. How do you know that she isn’t just saying that to use to manipulate you somehow? I still wonder.

As a paramedic, we use A&O x 4: person, place, time, and event. We use "event" as a "why are we (the paramedics) here?"-- "I see your head is bleeding... what happened?" If they're in a car crash and there's a starburst windshield, and they tell me "I hit my head on the windshield" it tells me one thing... if they tell me "I don't know" or "huh?" that's very different indeed.

@DrGrande

5 жыл бұрын

Using "Alert and Oriented x4" seems to make sense for your profession. I'm not sure why counselors tend to use Oriented x3.

Thank you for these examples, very informative. I personally experienced the over action from a therapist when sharing information about substance abuse. This reaction made me feel uncomfortable, the following week I returned and when the topic came up, I lied. That was my last session with the therapist. It made no sense to return if I couldn't be completely honest. I'd rather not develop an expensive "lying to therapists addiction."

The first therapist I ever had would stare at me with sad, furrowed eyebrows and sigh really heavily after I talked about trauma. I'm a therapist myself now and am really careful not to make my clients feel like I can't handle their experiences. Really enjoy your videos Dr. Grande. Thank you for your content.

There were 2 times in my life that I went to see a counselor for myself. Unfortunately it seemed that neither one really engaged with me so all I felt like I was doing was "confessing" about the latest emotional state I was in and paying them to listen. Both times I ended up walking away from them and walking over to the self help section in Barnes and Noble! When I saw the Sopranos and how Dr Melfi was so verbally engaging with Tony, I wondered "How do I get a counselor like her?"

A big one: believing one side of the story. When somebody says some things about somebody else, even a parent about their child, it isn't true by default!

It was interesting to learn some of the mistakes that are made by professional counselors. As a counselor it is imperative that one understands the effect that their mistakes can have on the client. I also enjoyed how Dr. Grande presented the examples of the bad progress notes he has seen were comical however I did not expected professional counselors to make such mistakes after extensive training.

The biggest thing that I was able to take away from this list was the central theme of not striving for perfection - but more so striving to do the absolute best that you can in trying to help clients. I think that specifically for today's society, perfectionism and always striving to "be the best" permeates many areas of our lives and makes it difficult to admit to mistakes. I liked the perspective provided of a "learning opportunity" being presented when mistakes happen, and that it would actually be a disservice to clients to not be open and work through any mistakes/missteps.

ok, so... even though I have a mental problem, this video made me feel like: I'm not crazy, I did have bad therapists. All of these were done by every therapist I saw. One of the items you mention describe two therapists, both made me shut down. The first was actually traumatic, I left the session suicidal. The other one I managed to continue going for a year, It didn't have a huge impact on me, I just felt, Idk, maybe adrift and couldn't really share more and I felt like the process had come to a halt and that is way I stopped going. One of the problems in my life back then that was literally making me sick was monogamy being imposed on me. But I didn't even know there were alternatives to monogamy, its origins and I was just suffering, confused and trying to fit in and go along with the norm. But then, as I started researching online I found out I was not alone in this and I went even further and found out there were complete studies and I started thinking: "hang on there. this actually makes a lot more sense than monogamy. I am not crazy or inadequate, this exists, this makes sense." So, the next session I brought up the issue. And even though I had been suicidal and very depressive I had found new hope and energy, there was some excitement with this discovery and I was telling him that maybe that was the way to go for me. And he immediately started rebutting and saying that he was more conservative, that that was indecent and illogical, that my then husband should stop looking after me(I was really in need of care at the time, I was in bed and self harming) and that he didn't see how I would find other people who thought like me then he started saying that was a mechanism in me to manipulate my husband into loving me more and to not feel insecure. But this was so wrong and so I tried to say that was not the case at all, but he put his finger in my face and said, raising his voice: yes, it is. That was really traumatic to me and it is actually kind of hard to type without crying. The other one was a moment when we were having a breakthough, I had just shared something new and it really helped and then she said (her demeanor was extremely excited): "why don't you tell me these things? this is what you should have been telling me". I can't really even understand or describe how I felt or why that was not ok, but I explained to her that I didn't really know what to say, what would or would not help and that I did not hold anything back on purpose and that some things just either don't occur to me or are just too hard for me to be able to talk about so easily. I wasn't comfortable the next session to continue on the same thread and despite her reaction in the previous session she didn't make an effort to go back to that point either and i felt like any progress got stuck. JUst so as nobody who bothers to read all this don't worry: Today I'm relatively ok, I am stable most of the time, I hardly ever self-harm or get suicidal. I am very happpy in a free non monogamous relationship, I only get like that if there is a trigger to a traumatic event and even so it usually doesn't last long. The only thing is that I can't work anymore cause it seems like I don't get much better than this and the fact that there day when I can't sleep or I speel too much or I have panic attacks out of the blue and can't leave the house or have to stay in bed due to lack of energy. But bottom line is: even though I'm not cured, I'm quite happy and ok now. These were years ago.

@kristaokon2359

4 жыл бұрын

I am really glad you got better. I wish you the best in life.

@do9138

Жыл бұрын

I am so touched by what you went through and so angry at that "therapist." INDECENT? He told you a lifestyle WITH CONSENTING ADULTS that would work for you was INDECENT? Tell him to go back to his fundamentalist church and "counsel" other judgmental morons. These jerks who think heterosexual monogamy is right for everyone ignore that both gender identity and sexual orientation lie on continua; they are not binary. Therefore, our emotional needs are individualistic, not culturally dictated. The whole marriage concept sprang from men's desire to try to ensure children were theirs. We're past that, and if this jerk isn't, I feel for his wife, not your husband. If everyone involved in an open relationship is in agreement, it's beautiful, AND IT IS NO ONE ELSE'S BUSINESS. I'm glad you're feeling better and escaped from that arse.

My only therapy experience I didn't even have an intake assessment at all. When I went to a local psychiatric symposium (current grad student in counseling) one of the speakers talked about how he started doing the initial assessment after one or two sessions depending on how the client was doing. His reasoning was that when a client first meets you, often times they need to do a giant verbal release to just get a lot off of their chest and he wanted to allow them to do so in a safe space. I found that interesting and I wonder if others work this way? Where I am currently employed (work with kids) the clinicians always do the assessment the very first appointment. Just some thoughts.

That was very helpful. I wish I found this many years ago. I was under the impression, or told, "They don't keep notes," because "if they were ever called into court (if I ever sued the person that hurt me) than "all other personal information would be forced out of them that way", which made sense. What if they decided on your first visit, without a history, or any records, "what had happened to you? A "premature diagnosis" that shocked me at the time, of something, "They thought happened to me" and "Told me what happened to me by suggesting I read a book".. That book totally leveled me, when I checked it out of the Library, ( the title written down didn't inform me) I began to read it at home later. It were a correct diagnosis, but "I wasn't aware yet of what happened to me yet, meant that". Can anyone know something before you tell them, or before YOU know what happened to you, if there never was a record-diagnosis previously?

The therapeutic mistake that most resonated with me is pretending to follow the story. I struggle this at times and usually attribute it to not being fully in the moment. You made a great point that sometimes it is just hard to follow the story and connections. Recognizing that we are allowed to interrupt appropriately is helpful.

@remygooch1393

5 жыл бұрын

I think following the story can be difficult at times if we are not focused or have other stressors as a counselor. This is where mindfulness and stress management comes in to play so we can be at our best during session. I have trouble with keeping a story straight when complex relationships are involved as Dr. Grande mentioned, and it is comforting to know that it occurs and is acceptable to stop and make sure the story is tracked.

@stephanieboley4760

5 жыл бұрын

I agree that it can be difficult especially when you have a client who is giving you a lot of information and making a lot of connections. I know interrupting is something that is “frowned upon” but like you said, we have to remember that we’re human and we need a moment to essentially catch up and make those connections ourselves

Dr. Grande, when you mentioned "pretending to follow the story," two thoughts crossed my mind. A counselor needs to be present and a counselor needs to know when to interrupt. We need to be present in hearing the client and being there with the problems and emotions. Furthermore, in that presence also having the ability to interrupt the client and ask for clarification or confirmation so that the counselor may continue to be present with the client. thank you for your insight.

@jeanettewaverly2590

4 жыл бұрын

Jose Liz One of the best counselors I’ve had would appropriately interrupt my babbling to make sure she was following my narratives. I resented this at the time, but now I realize that she did it because she really cared about me and about what I was saying.

I have a friend who quite frequently breaks into my stories to clear up small details. Not necessarily always when I've just strung together several different relationships--other types of details as well. I'm not sure how to handle it, because, number one, I recognize it as a sign that she's self-aware enough to know that she has trouble keeping up with small details, and I appreciate the effort on her part to make sure that she's following along. But on the other hand, I get thrown off of my train of thought really easily by interruption, especially repeated interruption.

Client arrived, was awake. A&Ox3. Client spoke; therapist responded. Client left. THERE. IS THAT DETAILED ENOUGH FOR YOU? XD

@kathrinjohnson2582

4 жыл бұрын

😂😁🤣

I had never thought about how it is a mistake to assume a previous diagnosis. It is always important to check and make sure this diagnosis actually fits. I enjoy these videos so I know what to avoid in my future practice.

@JamieB

5 жыл бұрын

Verifying previous diagnosis is something that I haven't thought about either. Its easy to assume that just because someone is a professional that they couldn't have made a mistake. It happens and we should be double checking so that we can be most effective in our jobs.

Important AND funny video .☺ I agree 100 % on the 6th mistake .

‘Client was awake during the session’ 😂😂😂

I really enjoyed this video and will probably reference back to it from time to time. The jumping to nonverbal was something that really stuck out to me. We are trained to be highly attuned to them but like any other skill, you can definitely overuse it to the point of impeding progress. I also think getting a the balance of progress notes is key. You want just enough to help you remember for good continuity but want to avoid being so vague that you can’t remember who this client is or what you were talking about before

Such thoughtful content. As a counselor in training myself, this kind of professional wisdom is greatly appreciated. Keep up the good work Dr. Grande

In the video, Dr. Grande was thorough in explaining several factors that counselors or therapists may potentially make. The first, and in my opinion most important, that was mentioned is that the current diagnosis is correct and still relevant. While this could still be the case, it’s also possible that diagnosis/diagnoses have changed since the client's last visit and it’s the therapeutic individual's job to ensure accuracy in this by doing their own intake/assessment with the client. I also found Dr. Grande’s information on writing progress notes very interesting. While I understood that details are important in a progress note, Dr. Grande did a great job of explaining the difference between too much information and too little information. This video really resonated with me, especially in regard to body language and having a counselor make assumptions based on it as well as assuming the clients lying. It’s frustrating when a family member or friend does it, however, it can be devastating to someone who is vulnerable and cause the client to completely close themselves off to the therapeutic relationship.

@marisamaguire8136

5 жыл бұрын

Danielle, Many of your comments really stood our to me, specifically in reference to ensuring the correct diagnosis is being made. I never considered this concept until watching Dr. Grande’s video presentation however it makes much sense. I find that it is important for counselor to avoid making assumptions, and view each new client as if they know nothing about them, even if there have been prior diagnoses made. In doing so, it allows the counselor to determine whether or not the diagnosis still stands true or if new information/symptoms etc. need to be considered in order to provide a more accurate diagnosis. In another respect, I appreciated your comments on body language. In some cases, it seems as though counselors are quick to comment or overthink their clients nonverbal behaviors. While it is necessary to consider patterns of nonverbal behavior/body language, it can be damaging to the therapeutic alliance if the counselor assumes too much, or uses such observations as a constant vocal point of discussion.

This is so true. I was originally diagnosed with depression but that wasn't the complete story. I actually had Autism and complex trauma

Dr. Grande, amongst many other things, I truly appreciate you for not being judgmental or quick to make an assessment of people’s common body language. For example, people tend to think that one is guilty if she/he doesn’t cry in a certain criminal case, that one is closed off if she/he crosses her/his arms during a conversation, etc. (Once I was in a very tense conversation with one of my best friends. I was being honest , genuine and open, but very uncomfortable and nervous given she was offensive and loud. She accused me of being closed off and offensive. I told her that it’s because I was desperately sensitive to her tears and her not accepting my honesty. That friendship ended by her choice). Also, thank you for this video. I’m having an intake appointment with a counselor in two weeks, and your info will help me prepare to be an effective client to help us both. I will take good notes before and after each session myself.

This was helpful and enlightening to some of the downfalls with counseling and relationships with clients. I particularly liked the area of counselor admitting flaws and imperfections to the client. This can be a great bridge to help the client see you as not only their counselor but sets example to show good character traits in the counselor. It speaks to the care that the counselor wishes to give to the client by being vulnerable also.

All of the mistakes you mentioned are truly doing a disservice to the client. Skipping the assessment or assuming that the previous one is correct seems lazy and unethical. The inability to recognize that individuals as well as their diagnosis can change overtime implies that the clinician lacks knowledge. My first experience in taking notes was as an intern and they were awful. My notes were very detailed and the supervisor drew a line through everything and made me reduce them down to the most vague statements to "protect" the client. Great advice to not be surprised by or overact to human behavior. Thanks for the video.

@brittanyhoffman8068

5 жыл бұрын

Tamara, I agree with you that it seems lazy and unethical to assume the previous diagnosis is the diagnosis now. People are subject to change. There's also a possibility the client was previously misdiagnosed and just assuming the diagnosis was correct could do damage to the client. Thank you for sharing!

I had a Therapist fall asleep during a session one time. How would you deal with this? I waited for a few minutes and then asked if I was boring him? He woke up for a minute and fell back asleep again so I got up and left. The next day, I called and cancelled the remainder of my appointments. I never heard from the man again. I kinda laugh about it now. Especially after putting in 17 years in the mental health field as a Targeted Case Manager. Still, it did make me feel a little uncared about and I wondered what I did wrong. 😊

@cicely2084

4 жыл бұрын

Wow! 😂

My doctor sensed that I wasn’t telling her everything. She didn’t force me but I was able to open it up to her because she provided me with a safe space to tell my story. She actually said that it would be challenging for her to help me and for us to work together if she cannot see the bigger picture. After I told her, she thanked me for sharing it to her since she knows how challenging it is for me. She also acknowledged that the info I provided was crucial to the treatment plan. I appreciate her for that. Not forcing me but providing assurance that I can tell my story.

Thank you for this, Dr Grande! I'm a trainee counselling student who is beginning placement work next year and I absolutely don't feel ready for it, and I'm totally nervous. This reassures me that it is okay for me to be human and mess up as long as I am congruent, attentive and thoughtful towards my clients.

I didn't want to see my counselors notes of fear to be dissapointed of the scarcity of notes and not being able to recognize myself or the session from them.

WTF! HOW CAN ONE PERSON NOT LIKE THIS? THIS IS SUPPOSED TO BE EDUCATIONAL AND INFORMATIVE! 😒

@whitefang238

5 жыл бұрын

probably a bad therapist lol

I love your videos dr grande I’ve been in and out of hospitals for mental illness and I’ve been with so many therapists psychiatrist social workers and I’m telling you so many were horrible I can say I’ve had 4 terrific drs and therapists over more than 20 years you are just great 😀

I've learned so much from your insights on this channel, truly invaluable, thank you

Sister in law's cousin - had to really start thinking 😂! This video is very interesting because it brings the human aspect of a counsellor into the open. Thank you Dr Grande once again. Have a Happy Weekend ☺️

I think this would be a really good video to continuously "check-in" with. We often seem like some of these mistakes are blaintly ridiculous however, I bet more often than not some professionals have been practicing for so long they feel things such as progress notes or assessments or non-verbals are something they have "mastered" that skill.

@deniseswindell2175

5 жыл бұрын

I found this to be a helpful tool in checking off some of the things that I may do in session to be self aware. I really liked sharing with the client honestly about your own short comings as a counselor when you may not have had all the answers or lost your focus for a minute and admit this to the client showing your human and vulnerable.

Dr Grande thoroughly went through the counseling process of a counselor and gave good information as it relatea to the counselor role when dealing with different clients.

I found it very interesting that it would be a missed opportunity for counselors to fail to admit that they have made a mistake. Due to the importance of the relationship between the counselor and the client I feel as though it would only benefit this relationship to admit such a thing. I had never considered this prior to watching this video and have spent some time contemplating the way that I interact with my current clients and the ways in which I will strive to be with clients in the future. This includes being open and honest about any missteps on my part in an open dialogue. Thank you for the thoughts!

@lisanoland5134

5 жыл бұрын

I had a similar reaction to this information and will also consider using mistakes as a means to be authentic moving forward.

Hope you've taken some time to relax and smell roses! Loved this video too! So, this brought me around to the question of, how can soneone be a better client (besides the obvious, being on time, telling the truth, not omitting important information and of course paying on time)? I know my son will need in-depth counselling and want him to know how to be a good patient. If there's anything else I haven't thought of, and you have time, could you let me know in the next year or so (he's still in prison). Are you licensed on the east coast or west coast? Thank you Sir, as always! Some people in Washington state, all think you should start a tip jar😉!

I once admitted something to my therapist that wasn't honorable, and she spent the remainder of the session scolding me for it. The thing is, I already knew how messed up it was, so her rubbing my nose in it was particularly damaging. At once point I must've smirked out of nervousness, and she picked that out and asked me if what she was saying was funny or not serious. Worst session ever.

As a counselor , I think your points are excellent and really helpful reminders.

Thank you for another insightful video dr.Todd, this was great. I am shocked over some of the progress notes you have read. I would be getting that note rerouted right back into my email in .234 seconds if my supervisor saw something like that, lol! I also like the one about being careful not to simply continue working off the pre-existing diagnosis the client may arrive with. I work in a psychiatric hospital and I am always researching assessments to find the etiology and life of the preexisting diagnosis. I stay skeptical and I am glad you think this is important too!

@DrGrande

5 жыл бұрын

Thank you so much!

Your yu tube videos has been very helpful in my counseling and psychology classes. Am grateful. Keep them coming

This info is so helpful! Thank you!

These six therapeutic mistakes were informative and a good basis to go off of for what to be conscious of. I have to agree with Dr. Grande that I too struggle with keeping track of stories when complex relationships are involved. The sixth mistake, not admitting therapeutic mistakes, could be a struggle for many people and is something that should definitely be reflected on by a counselor to prevent it from occurring. I think taking responsibility for ones mistake is a big step and will help with a relationship in case the client picks up on it and the counselor doesn't address it.

@jackiedeleonardis1153

5 жыл бұрын

I agree with you Remy regarding the sixth mistake. I think it could be difficult to admit that you've made a mistake, but we're all humans and everyone will make a mistake so there is nothing wrong with taking ownership of it. It doesn't take away from the counselor's abilities, as Dr. Grande said, it adds to their abilities because they have accepted ownership of their mistake. I actually think it shows growth and is something that you could learn from.

@BillNgaiTube

2 жыл бұрын

Not being able to follow the client's story may be informative in a psychological way. Perhaps pay attention to yourself in how you are unable or unwilling to pay attention to the speaker. Disclosing your own process in a therapeutic way could be helpful to the client.

Quality content as always, Dr. Grande!! :)

@DrGrande

5 жыл бұрын

Thank you!

Another awesome video, thank you!

@DrGrande

5 жыл бұрын

You're welcome!

First, I would like to say that these 6 mistakes by counselors are insightful. It is very important that the counselor gain the theme and/or pattern of the session. It is helpful in the next session you have (if you have many clients in between- stories can often get jumbled) with the appropriate progress notes, it helps formulate a more effective treatment plan and continue that continuity of care. I also would like to express that it is important to watch your reactions towards others because to them it is a huge deal that they are being judged by others for and it is important for counselors to have an unbiased judgement. I really found this video helpful and spot on, as working in the current field I see a lot of these mistakes being made.

So nice of you to discuss these issues

One of the most significant topics that stood out to me during Dr. Grande’s video presentation was that of admitting mistakes. As Dr. Grande mentioned in his discussion, there is a significant amount of pressure on counselors to be perfect and all knowing. However, this is an unrealistic belief. Counselors are human as well and can make mistakes. I can definitely see where it would be challenging to admit a mistake to a client in fear that they will no longer be confident in your abilities as a counselor. However, I appreciate Dr. Grande acknowledging that it can be beneficial to admit your mistakes and being opened to talking it through with a client. In doing so, you may summarize the discussion, get on the same page, gain clarity about a topic being discussed etc. which all can benefit the therapeutic alliance. Another topic that stood out to me was that of overreacting to a revelation of a client. I feel as though it can be common for a counselor to respond in this way without realizing it. For example, there have been times when working on role play demonstrations that the counselor will respond to the client by stating “wow.” To the counselor, they feel as though they are acknowledging the client’s background and story. However, This term can be tricky depending on the context in which it is used due to the fact that it can make a client feel as though the counselor may be placing judgment or shock towards the clients situation. Overall, I think it is important to have awareness of one’s own behaviors when working with a client. In doing so, you are able to acknowledge when you have made a mistake, when it is inappropriate/appropriate to respond to a client in a specific way etc.

Dr. Grande, your first point is so true. Sometimes at different intakes, the person changes what they choose to share or what is on their mind. Also, the last person to diagnose them might not have been wholly competent in doing the assessment.

Great video, thank you.

@DrGrande

5 жыл бұрын

You're welcome!

"The client entered. The client was awake, alert, and oriented x 3. The client left." Dr, I've developed an addiction to your videos.

@celesteisneat

3 жыл бұрын

I mean maybe other people have #’d it . I should look

First one, right off the bat, has happened to me practically every time I've changed agencies or therapists. They just go with my past major depression diagnosis. But as I'm reading more and watching your videos, I'm pushing the current agency I'm dealing with to reassess me (I think BPD is a likely second diagnosis based upon both discussions with my last therapist and independent reading I've done) because I've become more aware that past approaches therapists took haven't helped much, and I'm concerned that the therapeutic plan could change significantly if my diagnosis is clarified.

This vid was really interesting. Not sure if you meant to be funny, but if so, then well done. Thankyou Dr.

Thank you a lot, Dr. Grande.

I had the weirdest experience with a counselor whom asked me if I was super sensitive cuz I came in feeling trauma of my apt. Manager exploding on me by yelling rants and she would write notes and do you know that the apt. Manager found out I complained on her and she was confronting me by telling me "we have supersensitive people here in the apt. Building. What shitty thinking they have!!!

@SilvaMorasten

4 жыл бұрын

what?? isn't the counselor supposed to keep the secrete?

@siyaindagulag.

3 жыл бұрын

Yeah. No shit. Everything I've said in counselling has come back to me from low-level authoritarian sources.Almost word for word.

Thank you so much, Todd ❤️

Great insight, Dr. Grande. Could you also consider making a video on how a therapist can minimize resistance during the consultation session

This video was a great way for a counselor to do a self assessment that he or she is operating at fully and effective capacity. Assessing a client properly during intake ensures that the client is fully abreast of a client's diagnosis and that it is in fact correct. Dr. Grande made a great suggestion to be sure not to include identifying information in notes from the session that the client may not want others to know. He also mentions the counselor's reaction to nonverbal behaviors. Being too quick to try to finding meaning behind a client's nonverbal behavior can cause issues within the therapeutic relationship. Being aware of these mistakes builds a more competent counselor.

I've had enough counselors to say that you're not always going to "mesh" well with every one you attempt to go to. But, the next counselor might. Where I lived before the counselor during intake literally told me flat out I was "exaggerating the truth for her sympathy"... I thanked her for her 10 minutes of time and walked out

I have a problem getting along with people but you have been right on with your comments on this and I think I could work with you. I was seeing a guy who had a PH.D in the field. I had never been able to talk to anyone about the sexual abuse I had endured but one session I actually brought it up. He told me he didn't believe me. Not sure how he came to that conclusion since I can guarantee he had not been there during the abuse. It really set me way back.

Very interesting at times REVEALING cheers

I can’t stop laughing at those awful notes you talked about in the beginning. “Client was awake during the session”, “client arrived and left”. 😂 SO bad!

Lol that superpower comment had me rolling. This channel is awesome.😆

@DrGrande

5 жыл бұрын

Thank you so much!

A therapist I went to, when I first went to her, did not let me tell my whole narrative... It takes about 2 hours, so two sessions, to tell my story (the main facts and events, that I think are important)… she kept cutting me off and at the end of that first 45-minute se ssion she showed me some blob art and had me say associations. How much time should a councelor give their client at the beginning to tell their story??

In my opinion- 7:50 to 8:58 That's our Dr. Todd taking a dig at Fritz Perls (reference: Gloria and Perls interview) without mentioning his name of course. Someone had to point out this important mistake that some therapists think is correct and needed, thank you!

Yes to skipping the assessment. I had to diagnose myself (figured out I was having psychosis from estrogen while all the doctors were saying I had bipolar with psychotic features.) I have PTSD, I had my ovaries removed and don't have psychosis anymore, and my mood swings and medical issues on meds stopped once I stopped taking medication. My doctor finally accepted that I was probably right about myself after 10+ years.

How the patient can have copy of this reports. Because reports can be mixed up or whatever, so the patient needs to know what's going on these notes.

I like how mental health has changed within asking what's wrong with you. That changed to ask what happened to you.