The Therapeutic Skills that Matter More Than Grades!

First and foremost, I want to say that I completely empathize with the feeling of needing to academically perform. The external expectations we get in graduate school tell us that we need to be able to perform–to be able to balance classes, an internship, jobs to pay the bills, professional relationships, personal relationships, friendships, family, the list goes on and on. The standards to balance it all can be quite high, and because of this, it can be hard to feel like our academic performance does not matter.

However, grades, in my opinion, are the lowest indicator of a therapist’s skill in the therapy room.

We, who have had the privilege of going through the world of education, have learned (especially when we hit graduate school) how to navigate the system. How to get assignments done efficiently and effectively, how to get the grades we need to get through it. As therapists, those skills are only helpful in very specific situations: when completing documentation tasks, when following rules and laws regarding reporting, etc. These tasks are important, yes! However, they are adjacent to the therapy, not the therapy itself.

I believe there are many key skills that every student therapist or pre-licensed therapist needs to have when they are working with clients. Here are three I would like to focus on:

One: The ability to actively listen: Therapy begins when we are learning about who our client(s) is and what is bringing them in the room. If you are unable to pay attention to what you client is saying, provide cues to show that you are listening, reflect your observations to the client, and operate from a place of empathy and accountability(rather than unconditional positive regard). These key steps allow for clients to feel understood, even before you implement any sort of intervention with the client.

Here are two ways I have built this skill:

1. I watch therapy sessions from master therapists: On Youtube, there are many therapists who model sessions based on the modalities they are teaching. Studying their body language and implementation of the modality will help you figure out how you can authentically sit with clients. I am not saying that you should be a clone of these experts, but find the golden thread that is making their work(especially with rapport building with the client) effective.

2. Even after grad school, practice with a friend or colleague: I find that if I am able to practice with someone who I know (with a hypothetical case or tv show), they are able to give me the real feedback that I should not ask a client for. A friend or colleague can point out the areas that you may not naturally see. I would even recommend recording these practice calls to see how you look. It’s like reviewing game tape as an athlete: the more you see yourself, the more aware you are of what you are doing and how that impacts clients.

The ability to build trust and rapport with clients; be a human with other humans: This may seem obvious. However, it can be very easy for us, especially when we are nervous, to tense up and build rapport in the way that we think the client wants us to build rapport. Being relaxed in session acts as a mirror that allows your client to experience some level of comfort working with you. If you’re nervous or very stiff in session, your clients will be able to tell and in many cases, it can cause nervousness in them.

Here are two ways I have built this skill:

1. I seek honest and transparent feedback from my mentors and supervisors: As a therapist, I believe that the perspective of others truly makes a huge difference in how we do our work and how we show up with clients. If you are in any working situation where you do not feel comfortable speaking with a supervisor, this may be a wonderful opportunity for you to connect with a mentor calling someone that you were able to choose on your own terms that can support you.

2. I assess my retention with my clients: If I am finding that I am having a hard time retaining my clients, it may be because of the difficulty to build trust and rapport with them. It takes knowing how to check in with them as human beings, before, during and after doing the hard work of therapy.

The ability to be self aware: Self awareness is key in the profession of being a mental health therapist. It requires you to not only reflect on how you utilize the tools and skills that you have learned and continued to learn. Being self aware forces you to be aware of how you are showing up with clients and what parts of yourself are entering into the room. As a therapist and supervisor, I am the last person to argue that you should leave everything at the door. However, clients meeting your most authentic professional self should still remain the center of the work that you are doing. Our humanity matters and if we are unaware of how we show up we can cause a significant amount of harm.

Here are two ways I have built up this skill:

1. Write a few sentences before your session about the story you tell about who you are as a therapist: This exercise, which is based in Narrative Therapy interventions, is one that I like to do when I am feeling like I need to check my awareness in the therapy room. This is because I like to see how accurate my story is versus the story that I hope to hold. If there are drastic differences between the story that I would like to hold and the story that I do hold, that tells me that there is a gap in my awareness that I need to work on, and make intentional decisions on how I should adjust.

2. Watch Your Recorded Sessions: Remember how I mentioned recording earlier? This is another reason why I believe in the power of recording your mock sessions and taking those sessions as seriously as you do your actual sessions. When you do, there are opportunities for you to see what you are doing in your sessions that is a blind spot. Some therapy programs require transcribing sessions, however, I think that (especially with the limited time we have) watching a recording can be much more accessible.

As a therapist and a human, you bring so much of yourself into the work that is so important. With this in mind, it is important to remember that the time you spend in school is the time you get to learn the academic stuff, but being in the field requires such a different level of skill.