Positive change in the therapeutic space.
Article Type: Essay
Subject: Work environment (Personal narratives)
Business relocation (Personal narratives)
Medicine (Practice)
Medicine (Environmental aspects)
Author: Rosenberg-Javors, Irene
Pub Date: 09/22/2008
Publication: Name: Annals of the American Psychotherapy Association Publisher: American Psychotherapy Association Audience: Academic; Professional Format: Magazine/Journal Subject: Psychology and mental health Copyright: COPYRIGHT 2008 American Psychotherapy Association ISSN: 1535-4075
Issue: Date: Fall, 2008 Source Volume: 11 Source Issue: 3
Accession Number: 187049622
Full Text: [ILLUSTRATION OMITTED]

Several months ago, I moved to a new office. The relocation was rather uneventful, and my clients quickly settled into the new meeting place. Within a few weeks, routines were established for client sessions, and all seemed to be going well.

Then, summer hit with a vengeance and my new office turned into an electrical and air-conditioning disaster area. Fuses blew out and brownouts occurred daily. A critical situation arose for my colleagues and me--Where do we see our clients? How do we lessen the impact of daily disruptions to routines?

We worked out a sort of "musical office" plan wherein whatever office had air-conditioning and was available for the designated hour was used without hesitation. This meant that for a period of time, the traditional frame of working in the same office each session was no longer operative.

In response to this situation, I decided to take a mindfulness approach and just observe my own responses as well as those of my clients. I figured that all of us could learn something about ourselves as a result of this situation.

As the days went by, I found that most of my clients adjusted to changing offices and took the whole predicament in stride. Other clients, who have trouble dealing with any change in their lives, predictably were not happy with having to meet in a different place weekly. Whether the client was able to easily adapt or not, I encouraged clients to talk about their feelings regarding the break in routine.

During this time, I also monitored my own thoughts and feelings toward what was happening in my office. I found that I was not so much upset about the air conditioning not working but that what was really getting to me was that I felt anxious about having to disrupt what I had been taught was the proper frame for doing therapy--seeing a client in the same space at the same time in order to establish consistency and security.

I began thinking about the concept of the therapeutic frame in private practice. My earliest training emphasized the importance of establishing an ongoing routine for working with a client in terms of time, place, and space. I was taught that the therapeutic space was a hermetically sealed bubble protected from the dangers of the outside world. After some 35 years as a therapist, I am questioning the routines of therapy. I actually think that in today's nanosecond universe, therapists need to help both themselves and their clients learn to develop greater resiliency in dealing with change. What the air-conditioning debacle in my office helped me to more fully realize was that I could do the work of therapy on a park bench or a coffee shop if need be. What really mattered was my ability to respond to the situation effectively and help my clients develop skills not just to survive, but to thrive, in less-than-desirable conditions. By not getting stuck in a place wherein my focus was "this shouldn't be happening," I chose to accept what was happening and find a way to do what needed to be done.

As therapists, we are faced with the challenge of providing clients with safe spaces. However, we need to be aware that safety can turn into habit and routine and serve to undermine growth.

The good news is that the electricity is back on and the air conditioning is working. So, it's back to the old routine--or maybe not. Maybe I need to change the times that I see some of my clients--for more change and more growth.

Irene Rosenberg-Javors, MEd, Licensed Mental Health Counselor, is a Diplomate in the American Psychotherapy Association. She is in private practice in New York City. She can be reached at ijavors@gmail.com.
Gale Copyright: Copyright 2008 Gale, Cengage Learning. All rights reserved.