WHO NEEDS HELP?

     That's a crucial question whether it is about you or about your child.  The simple answer is that you need help when whatever you are trying proves to be ineffective.  That doesn't mean you are helpless.  It means you have run through the alternatives that are familiar to you and now you need more input.  Once you gather more information you might decide to go it alone again or to seek more active help.

     After my initial sessions with clients I ordinarily suggest that they consider the things we discussed, talk it over with someone close and then decide whether or not they should be seen by me.  That doesn't mean they are deciding whether or not they need help.  That means the decision needs to be made as to whether or not I feel like a good fit based upon our initial interaction. 

     Often individuals come for one visit only.  In some of those cases they do not return because I was not a good fit.  Other times they got what they needed in one visit.  Most often they got some of what they needed and then wanted some time to try it out.  Many of those individuals come back later.  In every case it is important for the person being seen to see this process as something under his/her control.  It is my responsibility to tell clients what I think.  It is the clients responsibility to decide if what I think matches what he/she needs.

     With young people it is most common for them to have one visit then wait a bit.  Making them set a return visit immediately, if they are hesitant, is often counter-productive.  It sets up a power struggle which detracts from the reason they are being seen.  It also takes the responsibility away from the young person which is a crucial element for the success of any therapy.

     Most often the young person listens to what i have to say and then goes out and tries to make things better.  If they are not successful it is then best to enter into active treatment.  That might mean making an agreement to come in for a set number of visits.  If medication was discussed as a possible alternative it also means going to the doctor for a medication evaluation.  Especially with young people, medication alone is not sufficient.  Medication helps relieve symptoms but it does nothing to educate as to cause and to set up plans to prevent relapse.  Both approaches are necessary.  The goal of active treatment is to eventually take responsibility for ones own self and to proceed independently.