Therapeutic Authority
What’s the difference between a therapist that keeps all or most of the clients they get and one that has a hard time with retention rate? I wish it was clinical ability or even the ability to connect. I don’t have any hard data to prove this, but in my experience as a group practice owner and supervisor, I’ve seen it time and time again - the secret sauce is confidence.
If a therapist comes across as confident, they are more likely to exert a certain amount of authority for the process. This authority translates as safety and security for the client. You could be using any kind of model (even one that we all hate and think should be banned), but if you have therapeutic authority - your clients will thrive under your leadership. Also, it doesn't hurt that you’ll do well in your business.
Therapeutic authority is essentially good leadership. It’s a lot like being a good parent. Do you remember what we learned in grad school about the different parenting styles? I’m going to take these and apply them to the therapy room:
Authoritarian Therapist: rigid, strict - all authority, no collaboration or real conversation. This therapist has high demands and low responsiveness. I doubt many of you show up like this in the therapy room. This therapist bullies their clients, “calling them out on their stuff” and assigns a lot of homework. Ironically, though - because there is authority - some of these therapists actually do really well in business.
Permissive Therapist: says yes to everything, asks permission even though they’re “in charge”, afraid of upsetting the client and is more likely to be friends with their client than exert boundaries. This therapist is highly responsive but makes few demands. I suspect this is where most of us lean in the therapy room if we don’t feel confident. This description is an extreme one (far on the spectrum of permissiveness), but if you feel you lean in this direction more than authoritarian, it’s worth a pause. Keep reading and I’ll share some tips to lead with more authority.
Uninvolved Therapist: this is what most of us would consider neglect (both in parenting and in a therapist/client relationship) - low responsiveness and low demands. If you show up like this in the therapy room - you might be burnt out and on your way out of the field. Chances are, you’re not retaining many clients.
Authoritative Therapist: This type of parent (and therapist) has high demands and high responsiveness. They have clear boundaries and structure around the work, clear expectations and communication about the process and are also nurturing and engaging. This is what we’re aiming for!
The more you can be like an authoritative parent in the therapy room - the more your clients will see your office as a safe haven and secure base. You are the space in which they are safe enough to grow. That requires a solid leader who is sturdy and kind.
Let’s make this practical! As an EFT therapist - there are five ways you can immediately practice therapeutic authority (remember: high demands, high responsiveness).
BEFORE THE FIRST SESSION
When you get a new client - communicate clearly and quickly. Take the time to have a system in place for how you do this every time. Do you have an email template- something you can automate that lets clients know the next steps to therapy with you? Is there a system for getting back to people (how soon and how many times do you reach out)? If you do a consult call, do you have a clear call to action at the end of the call? (i.e. “Would you like to look at the calendar now to book a time, or would you like some time to think about it? Would you be ok with me reaching back out in 2 days?”)
FIRST SESSION and THE END OF EVERY SESSION
Take your time in the intake. Listen well and get a clear sense of your client’s goals. Make sure you communicate what you think you heard and how you think you can help them. Most therapists stop short at what they think they heard. The “plan” of how you can help them is KEY to retention. This is why having a solid understanding and belief in a model really helps with therapeutic authority. The model you’re using is your plan. Your ability to communicate the plan in a way that matches your client’s goal is the thing to practice. The more you can make this conversational and non-clinical, the more likely your client will engage and buy in. This is also something you need to refer back to during the process of therapy. I like to incorporate this in my move 5 in every session - typically done in the last 5 or so minutes: “So, we’re right on target. What you did today is so important for our overall goal which is XYZ…and this is one step closer to that…Next time we’ll XYZ.”
BEGINNING OF EVERY SESSION
Always start with a strong and specific opener. This opening question should align with your overall plan. Of course, you want to maintain attunement (keeping the balance of tuning into your client and being flexible for where they are), but don’t lose your focus on the overall plan. That is the authority piece that most therapists miss. They start with too broad an opener (“So, how are you?”, “What’s your week been like?”, etc). Set yourself and your client up for success. If you make this a habit and do it every session, you naturally get amazing traction.
MIDDLE OF ANY SESSION
At any point in any session, when things are getting out of control, reactive or just confusing - be explicit. Interrupt in order to track. Do not let the client lead the session. I did an entire Superpower Alliance webinar on this (check out the April recording for a role play on how to interrupt with therapeutic authority).
IF YOU’RE STUCK
Ask for what you need. If you’re feeling stuck, there’s a temptation to just fake it til you make it. That’s a mistake (and bad leadership)! Use your own nervous system signals and get brave. Learn a therapeutic way to name what's happening so you can pivot. Maybe you need a moment to pause in the session.
“Hang on a second, I need to look at my notes and make sure I know where we are.” “Let’s slow down - this is moving fast. Let me get my bearings here.”
The pause that you need might be more of a meta-process.
“I need some time to think about this - let me consult my supervisor/mentor and get back to you.”
“Let’s have a session to re-evaluate the treatment and make sure I’m still relevant for your therapeutic goals.”
Admitting you need to pause at any point in the process is the vulnerability of therapeutic authority. Don’t we all respect that, though? Think about leaders in your own life. Who do you want to follow more? Are you drawn to the ones that act like they know where they’re going at all times and need nothing or the ones that are transparent about what they need and are brave enough to initiate a conversation? Of course it’s the latter. Me too.
Here’s to YOU and your therapeutic authority! It’s in you. It’s time to hone that part of you that knows what you’re capable of and bring it!
*If the mention of the Superpower Alliance webinar peaked your attention - by all means, check it out! I have almost 2 years worth of webinars for you to peruse. All of them are labeled by topic - we spend time each month with one specific EFT skill. Like I said before, last month we focused on interrupting with therapeutic authority! There’s a great role play on what it feels like when there’s no therapeutic authority (that was fun to do) and then one on what it feels like when there is. Contrast the two and see how they feel in YOUR body. The therapists that joined live had a lot of energy in their reaction to how “not to do it.” It’s motivation to do it well!
Special shout out to my Superpower role play volunteers: Mandy, Ciara, Alex, Anna, Jamison and Jeff - I couldn’t do it without you!
Click here to join and get access to all the past Superpower Alliance webinars.