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A Surrogate Partner's Perspective on Therapist Involvement
By Andrew Heartman
Surrogate Partner Therapy (SPT) is always
a collaboration between a therapist, a surrogate partner,
and a client all working as a team to help the client reach
their goals. I have learned first-hand the importance of the
therapist in SPT. I would never see a client without it. Even
if it weren't required by my
training and my Code
of Ethics, I would still never see a client without it
for the following reasons:
1. Some clients are not appropriate for SPT or are not likely
to benefit from it. I do not have the expertise to identify
contraindicating conditions and to make that assessment. Therefore,
I depend on the therapist’s clinical assessment of the
client’s overall mental health and their determination
of whether this client is appropriate and likely to benefit
from SPT.
2. Many clients feel ashamed or embarrassed about whatever
issue causes them to be in SPT or even that they are in SPT
at all. They may not feel comfortable telling any of their
friends and family that they are doing it. Consequently, they
may not have access to their normal support structure. It
is therefore absolutely essential that they have the support
and expertise of the therapist to discuss, process, and integrate
whatever happens in the experiential work. The therapist is
the client’s primary ally and support throughout the
process.
3. The expertise of the therapist is critical to help the
client acquire the cognitive underpinnings that allow the
new experiences to be fully integrated as new ways of being,
thinking, and living. The therapist helps the client to generalize
the experiences to future relationships.
4. Most clients seek SPT because they have not been able to
resolve their issue(s) through their own life experiences
or through verbal therapy. Most likely, they have patterns
of thinking, communicating, or behaving that are not conducive
to maintaining fulfilling relationships. As I form a relationship
with the client, these patterns show up in her relationship
with me. This is an important part of the therapy because
it allows any issues with intimacy and relationships to be
seen and resolved.
There are, however, times when these ineffective relationship
patterns can interfere with therapeutic progress. The client
may find it difficult to be honest with me because of the
role I am playing in her life and her habitual ways of relating
to men in that role. In this case, the therapist can say,
"Why don't you tell Andrew what you just told me?"
Similarly, the client may be able to hear suggestions or information
from the therapist that she would be resistant to hearing
from someone with whom she's forming a relationship. I have
experienced situations where the involvement of the therapist
was crucial to getting the therapy back on track to a successful
completion.
These are my personal reasons why the
involvement of a therapist is better not only for the client,
but for me as a surrogate. They all hinge on the idea that
I want the client to benefit from the work, and that is more
likely to happen when the therapist is actively involved in
the case.
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