A Question from my followers

Question:

​ "How fast is a therapist able to tell whether his new client is traumatized or not when the client can‘t truly open up?"

Answer:

 Therapists and mental health counselors have several methods of behavioral and psychological assessment that assist with diagnosis and case conceptualization. One of which is assessing an individual’s participation and receptivity to treatment. Willingness to engage is often included in assessment criteria and provides information on factors like prognosis, motivation, and insight. 

As a therapist who works with traumatized clients  I will ask myself: 

Does the client answer questions directly or in a round about way? Is the client agreeable? How much consistency is there between the clients symptoms and their narrative?

For example, an individual may come into treatment with symptoms of depression, relationship issues, and chronic feelings of physical sickness and when asked how things are going they will say “good” or an individual saying that “they had a good childhood” when both parents struggled with addiction and they witnessed domestic violence.

Things are not “good," nor was your childhood. Obviously.

In some cases, clients will flat out say that they don’t want to talk about something.

Willingness to engage along with known exposure to adverse situations can provide information into a client’s psychological state.

In fact, avoidance of topics related to a traumatic event and incongruent affect can be indicative of Post-Traumatic Stress Disorder (PTSD). If a client “can’t truly open up,” they may be traumatized.

Therapists, psychologists, and counselors are skilled professionals trained to identify mental health disorders. In a standard assessment, mental health professionals will use specific questions to elicit disclosure of thoughts and feelings to make a diagnosis.

Sometimes the absence of self-disclosure can provide a lot more information than the information given by what the person is actually speaking about or willing to say; like, when and on what subjects is the client deflecting?  Non-exploratory or answer avoiding behaviors can give a treatment provider a lot of insight into how a client is dealing with or feeling about a problem, situation, or circumstance. 

​Do you: Deny your feelings? Avoid topics? Fear criticism? Stay in the positive? Intellectualize everything? Worry (or not worry at all) about what people think of you? If yes, you may be someone who finds that they "can’t truly open up."

In my experience as a mental health provider, I have found that clients “who can’t truly open up” are those who tend to be more traumatized.

Traumatized individuals or people who suffer from PTSD have common symptomology and share similar reactions to traumatization, difficulty opening up is one these symptoms. 

Ultimately, any skilled or seasoned therapist would quickly identify feelings of trauma in their client regardless of the client actual disclosure or sharing of the event. 

If you or someone you love has experienced a traumatic event and is having difficulty opening up, please visit www.TherapywithRaquel.com for more information. 

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Raquel Buchanan is a licensed therapist (LMFT #118976) in Palm Springs, CA. Raquel offers both in person and online counseling to individuals, families, and children. She is a trauma informed provider and holds numerous hours of continuing education in trauma related disorders. For more information on counseling or therapy services, please visit www.TherapywithRaquel,com for more information or call (818) 839-2032. Raquel offers a free 15 minute phone consultation to help you decide in therapy services are right for you.