Your first sessions in therapy are likely to revolve around collecting details of your life. What your family tree, your childhood friends, or a major illness may have to do with your current situation may not be apparent at first, but there’s more to know about taking a client history.
The Power of History
As a counseling student, I had the chance to watch a video of family therapy featuring several different therapists, each one utilizing a different theory of family therapy. Each therapist would have one session with the same family, presenting with the same problem, and thus demonstrate the different theories for the students.
In the first two sessions, the therapists sat with a family of four. The son had been acting out at home and at school and everyone in the family was unclear about what was happening or why it was happening. In these first two sessions, the therapists seemed to be running in place, not getting anywhere at all. Then, in the third session the therapist asked what seemed, in retrospect, an obvious question: what was going on in the family when the son started behaving badly. Instantly, mom volunteered that a third child had died tragically!
I think all of us in the class felt our jaws drop open in surprise at this development. The crucial fact was not touched upon by either of the previous therapists, but once the third therapist uncovered it, therapy took on new life. The boy suddenly became animated and vocal about his feelings towards the tragedy. The rest of the family responded to him and the stale, frustrated tone of previous sessions evaporated.
At first, my reaction was admiration for the third therapist in unearthing a key detail that unlocked the presenting problem. Only a little later did I reflect on how ineffective the first two therapists seemed simply because they lacked essential information. In truth, I can’t say I learned much about theories of family therapy, but I’ll never forget how important it is to gather a complete history on every client I see.
History from the Therapist’s Chair
As I discussed in an earlier article (see “Kinds of Therapists”), there are all kinds of different approaches to therapy and some approaches place historical facts in high regard while others downplay the value of history. Freud, and those who followed him, put a huge emphasis on early childhood experiences. Contemporary theories such as Solution Focused Brief Therapy (SFBT) actively avoid history in favor of a present- and future-oriented perspective.
Client Beliefs about History
Clients think about the relevance of history every bit as much as therapists. And their viewpoints are just as diverse. Some clients jump right into history for a number of reasons. They may have preconceived ideas about what therapy is, and want to meet those expectations to conform or please their therapist. Others may dive into history because this is their habit of thought. Being locked into reliving the same story over and over again might even be the problem they came to therapy for in the first place.
Other clients shy away from history, perhaps out of shame for something in their past. Others may feel the distant past is irrelevant and echo the beliefs of the SFBT therapists. Still others may want to minimize or avoid the depth of their problem, namely for how many years the problem has persisted.
Whether a client revels in history or recoils from it, I try to help clients develop a healthy perspective on their history. Being able to see past events from an elevated perspective instead of being overwhelmed by the past can provide a lot of relief. Overgeneralizing or avoiding patterns can also be problematic. The jilted lover who concludes they can never love again is the victim of history every bit as much as the battered partner who fails to recognize the string of abusive lovers they allow into their life. In my mind, the most important question about history becomes “is this story useful to the client in their present life?” If not, it may be time for a reexamination.
All clinical material on this site is peer reviewed by one or more clinical psychologists or other qualified mental health professionals. This specific article was originally published by Dr Greg Mulhauser, Managing Editor on .on and was last reviewed or updated by