David McPhee's Blog

Are therapists allowed to call the police?

One day, after what I thought was a really good session—glad I had videotaped it—Oscar announced as he was leaving, “I’m going on a run now.” (Meaning he was about to run away). What the hell? I was clueless. I tried to talk him out of it, adding that I’d have to call the police. He said, not in a smartass way, “That’s OK, most of them know me,” and left. Actually running.Continue reading

How well does CBT work in therapy?

I never did CBT like a class, as if the client were a student, with the lessons and the worksheets, following a manual. That’s psychoeducation, possibly helpful and interesting, but absolutely not psychotherapy. But if you’ve got a good working relationship with a client, based on trust and commitment, CBT-type interventions can be great. Continue reading

How do therapists help depressed clients who struggle to engage because everything is bad and nothing is ever enough?

The client showed up for therapy. That is huge. They keep coming. That is more huge. I’d say the client has engaged, plenty. Still, they keep saying everything is bad and nothing will ever be enough? OK. Then that’s where we start, supporting the client as they find ways of expressing it fully and in different ways, all the feelings and the thoughts.Continue reading

 

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