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Designing the Therapy Session

For those unfamiliar with the therapy or design process, I want to bridge the gap between the accessibility for those that want to seek counseling and the construction of the therapy process.

If this is your first time looking at a therapist website, I encourage you to search for one; and as you do, try to envision the experience that you might of that person. Do you see this being an accurate reflection of what it might be like to sit in a room with them? Would you feel immediately comfortable sharing your most vulnerable self, and being receptive to their thoughts and solutions? Hopefully the answer is yes, but in the chance that the answer is no, which is more common than one would expect. The discrepancy is mainly due to the current state of the accessibility for counseling and the stigma associated with counselors that are perpetuated by poor design. 

What is seriously lacking in the counseling profession is the use of a design mindset  that is not problem-focused, but solution focused and oriented towards action in order to create a preferred future. Design Thinking draws upon logic, imagination, intuition, and systemic reasoning, to explore possibilities of what could be—and to create desired outcomes that benefit the consumer. Design is the action of bringing something new and desired into existence—a proactive stance that resolves or dissolves problematic situations by design. It is a compound of routine, adaptive and design expertise brought to bear on complex dynamic situations. Most people make the mistake of thinking design boils down to what something looks like. People think it’s this veneer — that the designers are handed this box and told, ‘Make it look good!’ That’s not what design is. It’s not just what it looks like and feels like. Design is how something works.

Like many other businesses, finding the right fit for you as a consumer can come to you in many ways. Public advertising, social media, databases, or word of mouth. Finding counselors and therapists follow this strategy too, but with very unique constraints surrounding the content and style of their advertising. Unfortunately for counseling, the field continues to struggle with perceptions and images put forth through mainstream media. Soft voices, sweater vests,and Freudian couches are probably some images that come to mind. I would imagine, in your searching for other therapist websites thus far, that perhaps you can imagine how those sites fit into that mold. I have to clarify too, that if that's the experience you need or want, I support you in full. I only mean to say that the problem that this uniformity presents goes back to accessibility for counselors and therapists that serve the wide diversity of people and personalities that need help. If all therapists market and present themselves in a fashion that only appeals to upper middle class people that come from various positions of privilege, the rest of those in need are left unserved and a service that would otherwise be helpful to them, continues to be seen as "not my thing." Whether you are a person of color, an artist or creative, or someone coming from a marginalized group, you should be able to access counselors that resonate with you if you so choose to. That power and choice should be made available to you as equally as it is available to the majority. This, in short, is a problem related to design.

Thankfully, there are people like Jeff Guenther of Portland Therapy Center who noticed that the options for counselors to get themselves out there to serve their target population was in dire need of help. He designed a website that got the word out there using the principles of good design. Clinicians and practitioners design websites that are often generic and stagnant, thus it maintains a certain level of accessibility to people who see those websites as appealing. Not everyone is interested in mindfulness or meditation, not everyone feels compelled to "share an intimate and safe space so that you can discover and express your truest self." We need practitioners that can be real and relatable. The realization that you and that clinician may be good fits often comes when you first speak to them, and ultimately when you first meet with them. Ultimately, you will sit in that room with someone, and figure out if what you see is what you want or need - which can be hard if you're dealing with something intensely emotional. As a person that values transparency, I find it important that you have a clear vision before sharing your vulnerability and issues that you or your partner may be dealing with. Not only do I think that this is a practice of good and safe boundary making, but also for clarity in the experience and accessibility of the many different faces and personalities behind the people that you share those moments with.

This is where I tell you something about what makes me different, and stands out above the rest. But to do so is a little "on the nose" at this point. I have shared enough information and thoughts for you to hopefully understand the importance of good design and accessibility. I will say that the single most important concept of design that has stuck with me through the years is to be consistent, not predictable. One thing I have not shared is something that typically remains unknown about the people sitting in the chair across from you. And it is that their expertise comes through a combination of personality, lived experience, education, and theory base. Some value transparency and disclosure more than others, while some choose to remain in the position of power. Although I should say that there is always a live action balancing act in the mind of the therapist during a session. We seek to discover your pushes and pulls, in order to better understand what you may need in a moment. Sometimes you might not want someone to give you a directive when all you need is an ear, or maybe you are in a space where a simple affirmation and confirmation will give you what you need to enact change. This process of decision making and assessing current needs in the moment is different from clinician to clinician, but is often worked out between client and therapist over the course of therapy. Yet it begins before that, it begins when you decide that you want to seek help, and it begins when you decide that this person, can and will do you a service in helping you through everything they bring to the table. Hence, like entering any relationship where emotions are involved, it’s best to start off by having a very clear understanding of what that experience is going to be like.

-Icahn Saelao, Licensed Professional Counselor Intern.
Heals & Feels.