Why homework is so important

I’m not a big fan of homework for kids.  Actually, I’m a big anti-fan of homework for kids.  School is long enough.  When kids finally come home it’s time to play sports, read, draw, talk with friends and just chill on the couch.

Homework after a therapy session, however, is a completely different matter.  In some ways, this is the most important part of the whole project.

Why is giving and doing homework between sessions so different from homework from school?  Here’s my list.

1. School lasts 7 hours or so a day.  Therapy is 1 hour a week (or so).  That’s not enough time to learn, practice and do.  Thus, practice and do homework.
2. The goal of school, in many ways, is to learn to do school well.   However, the goal of therapy is to learn to do LIFE well.  So, bringing therapy home is key.
3. Changing habits is hard.  It takes a lot of practice to do one’s life differently.  Therapy homework is a way to structure this practice.
4. Therapy is expensive.  Homework is a way to get the most out of each session so you can use the least sessions possible!

What makes for good therapy homework?  Good therapy homework is decided on as a team with both therapist and  client(s) deciding what the assignment will be.   Good homework feels do-able so that it’s a way to succeed.

And, perhaps most of all, good therapy homework, all-in-all makes time instead of taking time.  It makes time by fostering healthier, happier ways of doing this project called life.  Because, it’s not just our kids who deserve a break at the end of the day!

The First Session . . .

Making it to a first therapy session takes guts.

Really, it is an odd thing to sit in a waiting room wondering about this person, this random therapist you found on the internet or heard about from a friend,  with whom you are about to share the intimate details of your life.  If you’re like most people, these are thoughts and feelings which few people, if anyone, in the world knows about.

I hope this post can alleviate some of that waiting room anxiety.

So what does happen in a first session?

For me, a first session actually starts before the first session.  I encourage my clients to complete a comprehensive welcome packet.  In addition to telling my clients about myself, I have them fill out a pretty long questionnaire about their concerns, past experiences with therapy, recollections of themselves as a child etc.    Why?  Simple.  Because this way I don’t have to spend precious minutes during the first session asking all these questions.  Instead, by the time a client walks in my door, I at least know a little bit about them and why they are coming to see me.

The first thing I, and every therapist, talk about during a first session are the legal and practical details of therapy.  I explain what confidentiality is and its limits.  I make sure that I have explained my fee structure and cancelation policy.

And then it’s time to roll up our sleeves and get to work.

Often, the next thing I like to do is to create a laundry list— that is a list of all the things that, if they all were fixed, would tell us all that it was time to end therapy.   With couples and with parent/child combos, I’ll be the note taker while the two talk together about what goes on the list.  This gives me a chance to see where their skills are at the same time as we’re making the list.

As we have a pretty comprehensive list, I generally shift to talking some about what it will take to get from here to there.  I might ask how long a client thinks it would take them to resolve everything on the list if they had great help doing so.  Or, we might explore how if magically everything on the list was fixed when they woke up the next morning, how would my client know that everything had been fixed.

Sometimes with couples or parents and children at this point I also like to give each person a few minutes alone with me to check-in if their are any pieces they would like to add to the list which they weren’t comfortable talking about with their spouse/parent/teen in the room.

While many therapists like to use the first session for a lengthy history taking, I prefer to jump in and geting working.  I already have the critical historical pieces on the paperwork.  I’ve found that details relevant to therapy will come out on their own.  And those that aren’t relevant– well, why would someone pay to tell me about something that isn’t going to help solve their problems or leave them feeling better.

“So, which item on the list do you want to start with?” I’ll usually ask.  At this point, I may also have a something to put on the “agenda” for the session.  Perhaps it’s teaching a skill where I noticed a glitch, or perhaps it’s infusing some optimism into what looks like an impossible situation.  With an agenda laid out that incorporates what everyone wants to use the session for, it’s time to get to work.

By jumping in like this by the end of the first session not only have we created a clear road-map for treatment — fix everything on the list — we’ve also actually started helping things. Ideally, I’ve learned a lot about my clients and they are going home hopeful, not on blind faith, but because we’ve actually succeeded in moving forward on something from their list.  Hopefully, as well, clients leaving from a first session are as clear as I am about what we’re going to do together, about how long it’s likely to take, and how this whole process is going to help them.

Too much anger!

I got an invitation this week to attend a talk by Peter Wood about his book “A Bee in the Mouth.”  While I haven’t read the book, the description caught my attention.

Why are Americans so angry? Politicians launch preemptive strikes against their opponents; journalists pursue vendettas against public figures; talking heads spit venom at each other on wrathful radio and television shows. In the past, we disagreed with others, sometimes strongly, but we heard them out. Now we want to obliterate their opinions. Our public life seems more and more dominated by expressions of ungoverned rage.

Yes, why do any of us tolerate so much anger?  Why we like it in the public domain is for Wood to explore, I’m more concerned with how much trouble anger in our private lives causes.

Nothing ruins a perfectly good marriage faster than anger.  In fact, I put together a video all about the topic a few weeks ago for Power of Two Online.

Without further ado, my top 10 ways that anger can ruin a perfectly good marriage (or any other relationship for that matter!).

Stressed out kids

Today’s New York Times front page featured an article about how stressed out college students are.

You can read it here.

The article inspired me to write a post for our Power of Two Blog about how families can help build resilient kids.  Here’s where to find that.

At the same time, I also work with teens and college students who are struggling to hold it all together.  Here are two conversations we almost always have.

Conversation 1: What is the worst case scenario?  What are you most anxious about?  What would make you even more stressed about this?  And then, we tackle that problem first. There’s nothing like a solid plan to relieve stress.

Conversation 2: What are you doing to build healthy, happiness-inspiring activities into your life?  Do you exercise?  Do you chat with friends?  What hobbies do you enjoy?  And then, we work together to build a life that incorporates these routines into every day.

Marriage, Depression and Your Health

While feeling happy and having strong, satisfying relationships likely won’t prevent one from becoming ill, there are clear indications that both of these can be potent tools in the recovery toolbox.

Here’s the a non-physician’s summary of the emerging literature.

Finding 1:  Immune system functioning is compromised by depression. Basically, depression appears to both slow down immune responses and increase the production of proteins which increase inflammation.  Both of these make healing from a wide-variety of injuries and illnesses longer and slower.    Click here for the technical details.

Finding 2:  Marital stress and fighting is bad for health and healing. Two striking studies on this front.  The first demonstrates that women in high-tension marriages evidenced slower recovery from breast cancer and showed more symptoms of illness than those in good marriages.   Here’s a nice Washington Post summary of the study. The second study looked directly at the impact of marital conflict on healing.  Again, more conflict, less healing.   New York Times columnist Tara Parker Pope has an excellent review here.

So, while an apple-a-day may have it’s benefits, noticing marital strife and depression, especially in the context of a physical illness or ailment, and then getting help to improve the marriage or lift the depression,  can be a potent tool for enhancing recovery.

And hey, what’s the worst that can happen?  One might end up happy with a great marriage!