Dr. Heide Schlack

I have so many clients who tell me they are nervous before our first appointment. I usually normalize that. We may “chat” for a moment about every day matters or current events. I tell them that I will probably be asking them a number of questions ( in relaxed conversational style). I ask if they have done any counseling before and do they have questions of me. I like to start introducing this as a collaborative process.

I try to listen carefully to their reasons for coming to therapy, their goals and expectations, how they talk about their goals and how they seem to feel about working on them. If they’ve had a recent loss or major stressor, we may spend much of our session processing their emotions. I don’t try to talk them out of their feelings, but my CBT/trauma informed mind listens for negative, untrue stories they may have constructed about themselves or their lives from the trauma or negative feelings. I challenge the stories with them, start giving them tools to examine negative narratives.
Whatever strategies I use, I try to embed them within an atmosphere that feels safe and non-judgemental, with positive regard and active listening skills to help them feel heard and willing to continue (Carl Rogers).

I find that with the development of rapport and trust, I have become more direct in “confronting” clients or challenging them. They don’t see it as aggressive and often appreciate a question or statement that makes them stop and think. These can be productive moments.

I find that CBT ( or CBMT— I’m a fan of mindfulness) and DBT offer many useful tools. I am more familiar with CBT tools. My favorite one is probably the thought record. I think it can be a very useful way to process and better understand an upsetting event. It brings feelings and thoughts more into awareness, then the thoughts can be challenged. It often brings relief and more helpful ways to continue to understand the experience.