A question I often get asked when I am training or supervising other therapists is, “What do you mean by, ‘meet your clients where they are at’?” They express concern that it’s about being some kind of an accomplice to their client’s eating disorder or supporting their “disease thinking.”
In my work of helping people, I strive to subscribe to a compassionate and collaborative approach. This means that the client is part of their own treatment team. Thus, meeting the client where they’re at means embracing a variety of therapeutic interventions and types of therapy – along with offerings such as food experientials and other workshops – that are appropriate for this person.
Yet we choose treatment modalities carefully; we don’t just mix things up haphazardly. We have a plan that we create together. Eating disorders are a complex combination of psychological, physical and spiritual, and require a thoughtful approach.
It’s important for us as therapists to always be learning and growing. I continuously further my knowledge and update my credentials. I know there are always new things to add to my toolbox of therapeutic interventions that could help my clients.
Over the years I have learned much from my training and mentors, but I have learned even more from my work with clients. They are my best teachers, as Dr. Kelly Flanagan expresses so beautiful in this open letter from a therapist to his clients.
Most importantly, I don’t practice outside the scope of my training. I would never attempt to do equine therapy, for example, because I know nothing about equine therapy, or horses for that matter. But if I felt someone would benefit from this therapeutic approach, I would refer them to an expert.
I believe that the highest form of ethics is to treat someone in the way that our training tells us would work best for them. That may mean referring them out to a specialist just like a physician would, or using a therapeutic model I have the skills in, even though it may not be my favorite.
Sometimes the best solution is not another expert at all, but self-help books or self-help groups. I look for signs that the person is currently in a place where they have it within them to recover with that kind of support. A supportive, peer-led group of people in recovery who understand, relate, and provide hope can be very therapeutic.
In meeting a client where they are at I always customize therapy to their personal needs. While one person may benefit from an individual session once or twice a month, someone else might need twice weekly individual therapy along with regular family sessions. Someone else might need nine hours of week of intensive outpatient programming, or to start with a residential program – this may literally save their life and/or get them started in recovery.
As therapists, even though we’re dealing with serious disorders, we can apply creativity in helping clients choose the best therapeutic intervention. This brings openness and lightness to our work. To clients, this shows that we’re trying something together, exploring together, creating together. I see therapy as a collaborative approach with me as a change agent, or a guide at times, offering my professional input foundationally to help clients get AND feel better.
Therapists are also free to discard something that’s not working and come up with another intervention or technique. If talk therapy and traditional journaling don’t work, we try approaches without words, such as yoga-based psychotherapy or an art journal. Maybe it’s not about words right now. We can be creative together.
Just as there are different types of therapy and support, there are a variety of possible settings where we can work as therapists and refer potential clients. I just came from working as the executive director in a residential treatment center, and I’ve also had a long-standing private practice. I dedicate about a third of my time to providing consulting services, sharing my expertise with a variety of treatment centers.
Now I am adding to my private practice, offering an expanded list of services to clients, therapists and treatment centers. I have added yoga-based body image and self-esteem therapy for clients and yoga teachers, supervision for pre-licensed mental health counselors (Florida) and training for professionals to become a CEDS (certified eating disorder specialist).