What Happens Between Sessions

The other day, as I wrapped up session with a client, he casually asked,

"What do you do when you're not seeing clients?"

Well, there's a lot we do when we're not in session. I came across this quote that sums it up perfectly.

This is the usual sequence of events that occur after a session:

1) Unwind - Depending on the nature of our conversation, I may need some time to recoup. If we just had a heavy session, it takes me some time to unwind from this. I may give myself half an hour to switch gears and watch a fun YouTube video, I may sit with the emotion until it leaves me, take a few deep breaths and exhale my stress or call up a friend to just chat. Unfortunately, there are times where I'm seeing another client right after. If this is the case, I'll take a quick walk to the bathroom, take a few deep breaths, ground myself, and get back in there.  If our conversation is a bit on the lighter side, I sit with the joy that came out of that conversation, knowing that the session went really well and I'll give myself a little pat on the back.

2) Session notes - We are expected to complete our session notes within 24 hours since seeing our client. I often do not complete notes right away. I find that it undoes all the unwinding I have done. Instead, I give it a few hours (a day - realistically) before it's time to tackle it again. This way I conquer it with a relaxed mind and it helps me only write down relevant details. 

3) Research - At the conclusion of my sessions, I try to leave my clients with homework or an activity between sessions. I make a note of this and then research how I can build on the skills that we are trying to develop. Research helps me with staying current with literature, may give me different perspectives or theories to work with, reassures that we're progressing as expected, and gives me different ideas to bring to the table. Some times clients leave me with questions in which I ponder over to discuss for our next session. It helps us both learn.

4) Treatment planning - Now that I have expanded my knowledge with research, I think about how to incorporate that into session and think about when it's appropriate to do so. It all depends on the goals that were outlined in our first session and whether or not these contribute to the goal.

5) Supervision - My practice is to attend monthly supervision meetings. During this 2 hour period, we talk about YOU! My supervisor and I (along with other therapists) get together and talk about treatment plans and steps that we have taken so far. The role of my supervisor is to validate the approach, ensure that we are practicing ethically, and using her experience and knowledge, share her ideas on how to proceed.

6) Draw analogies and examples from real life - I love when I experience something that my clients tell me about. When I experience travel anxiety, I can't wait to tell my client with travel anxiety about it. If I attend a mindfulness workshop, I'm excited to share this story with my client who is a yoga instructor. I bumped into my fifth grade teacher last weekend and I couldn't wait to tell my client (who is a teacher) about this experience to reassure her that teachers make a difference in the lives of their students. I find that this really helps normalize their feelings and enhances our therapeutic relationship.

7) Follow up - If we've had a tough session, it's not uncommon for me to reach out in a few days to see if you're supported between sessions. As much as I try to deescalate your emotions near the end of our session, there's no telling what can happen after session. I check in to see how you're doing. For clients who have wrapped up therapy, I have an open door policy. Clients are welcome to come back to therapy as they see necessary.  After a few months of not seeing you, I may pop in with an e-mail to check in and see how life's been treating you. I love the feedback I get!

Even though you may see your therapist for an hour at a time, best believe you are often residing in our minds, well after our time with you is over. Isn't that special?