Being a therapist is truly hard work. The intense emotional demands (all day, every day), the sheer number of clients and all of their unique concerns, and not to mention all the required paperwork…! I often find myself searching for things that can enhance my clinical practice and make my #TherapistLife a little bit easier. Here are some of the tools that I find myself thanking the counseling gods for throughout each of my long-but-fulfilling workdays.
1. DSM-5 with tabs
This is my beloved DSM-V, with color-coded tabs, that I used to configure diagnoses for my clients. When I tell you it makes my life so much easier, I mean it! I’m typically quick to “control + F” an electronic document, but for some reason, having my physical DSM-V with these color-coded tabs is more appealing (and a lot easier to navigate than the PDF!) to me.
I purchased the tabs from diagnostictabs.com and it took me about 20 minutes to attach them to my DSM. These colorful tabs truly speak to my Type A, “Judging” (on the Myers-Briggs Type Indicator), organized and tidy soul! They are just perfect. Getchu some!
2. Rapport-building Jenga
So I purchased a traditional game of Jenga, and added my own little spin to it! Although I work primarily with children, I have found this game to be received well by adult clients too.
I created a Word document of various rapport-building questions, printed it, and cut and taped each of the prompts to the individual Jenga blocks. I suggest tailoring the questions to what would be most well-received by your specific clientele.
I typically use this game in the first or second session (after the heap of paperwork) to break the ice and get to know the client in a non-interrogative way. The questions are typically light-hearted and seemingly surface level, but can give you some insight into the style/approach of counseling that may work best for each client, as well as subjects that may be pertinent to the client’s past experiences and presenting concerns. For example, the prompt, “Describe your mom,” might be light-hearted and surface-y information from one client, but for the next client, they may describe their mother as someone who possesses negative traits or behaviors that could have caused/led to or exacerbated the effects of the client’s presenting concern. The possibilities are truly endless. I have played this Rapport-building Jenga countless times, and each time, each block generates a different kind of answer!
*Bonus tip*: If the client is ends up being the person who causes the tower to crumble, you can process their reaction with them. On the flip side, if you end up being the person who causes the tower to topple over, it can be helpful to observe the type of reaction the client has to your “failure”. It can be a good segue into counseling.
Rapport-building Jenga really allows clients to open up in a non-intimidating way. I love it!
3. Social Identity Profile
I was first introduced to this activity by a mentor of mine, and it easily became one of my favorite things to do with my own clients. (Click here for my spiel about the importance of mentors.)
This activity would be most appropriate with mature adolescents/teens and adults.
I have clients work column by column, starting from the left:
- Look at the different social identities.
- Write in their own group memberships for each of the identities.
- The “additional” row at the end leaves a space for clients to input any other identities not captured above that may be salient to them.
- Using a check or “X”, mark only 1-2 identities for the remainder of the columns, based on the headings.
Each column can yield a conversation exploring the client’s indication of group membership as well as each box they marked. I typically encourage the client to “think out loud” when filling out this profile, so as to assist in the processing portion of this activity. Specific things that may be helpful to explore:
- Groups that were easier to identify with vs. ones that caused the client to have to think more about
- Identities that are visible vs. those that are “invisible”
- Ambivalence about choosing to mark one box over the other
- Patterns in marked boxes
- Identities that received the most/least amount of marks
- How this activity relates to the client’s worldview, and their presenting concern
- The answer may not be obvious, so you may have to help them diiiiigggggg it out!
I strongly suggest completing this activity yourself, before doing it with clients.
4. Paper and drawing/writing utensils – Life Timeline Activity
I always keep blank paper and writing utensils on me. Paper and writing utensils can be used for pretty much anything under the sun, but my favorite thing to do with them HAS to be the life timeline activity.
- Have the client draw a line that extends across the entire sheet of paper.
- Mark “birth” on one side.
- Mark their current age/year/grade level about 3/4 of the way down the line.
- Have the client create “notches” for each age/year/grade level in between.
- Have the client fill in the timeline with salient moments from their life; good, bad, and in between!
- Assure the client that they do not have to note traumatic experiences they are uncomfortable writing down. Instead, give the option of writing “something bad happened” or “traumatic experience” in place of a detailed occurrence.
- My favorite part… Have the client write in where they hope to be in the future, with the remaining 1/4 of the timeline they set aside earlier!
- This can be a great segue into treatment plan goals, or even serve as a summarizing/termination activity for the client to assess their progress and highlight the progress and good things to come.
With older clients, you can even spice up this activity by asking that they construct a hierarchical rating of their noted experiences. For example, the client will mark the happiest event/moment of their life to date near the top of the page, while marking low points toward the bottom, and filling events in, in between.
This is also an activity for which I ask that the client “think out loud” to allow for processing of the material. It may take more than one session to complete this activity, depending on the client’s age, life experiences, and willingness to share. The processing possibilities are endless.
Last but not least is my beloved whiteboard. If you’re blessed enough to have a full-size whiteboard in your counseling space/office, awesome! However, for my agency or mobile counselors who do a lot of counseling on-the-go and may not have a designated office space with a board, this may be a more realistic/accessible option. I purchased my handy-dandy whiteboard for about $8 from Target and I find that my clients absolutely love using it in session. Totes worth it!
So here’s how I utilize my whiteboard:
Part I: MAPPING
- Have the client write down all of their concerns, using key words and phrases, so as to visualize them.
- Ask them, “Have you noticed any themes?” Or say, “I’m noticing a few themes… Is it okay if I point them out?” And identify 3-5 major themes surrounding all of their concerns.
- Examples of themes include: anxiety, relationships, anger, perfectionism, etc.
- Ask them, “Can you prioritize your top 2-3 themes that we could work on together in counseling?”
Part II: FUNNELING
- Going one theme at a time, ask the client open-ended questions to narrow down the issue.
- Ask the client, “Do you have any ideas on how you can improve your _____ (insert theme)?”
- Use this conversation and funneling technique to develop treatment plan goals and objectives. This can also be used for treatment plan reviews in assessing the progress of previously set goals and objectives, or in termination for the client to reflect on their progress and therapeutic accomplishments, giving them hope for tackling future concerns. (For termination, I typically have the client do a side-by-side comparison of a resolved or improved concern, and one that may still be in progress.)
Note: Having the client utilize the board themselves can be an empowering and accountable experience for them, encouraging them to “do the work” in tackling their issues while providing them the guidance and assurance necessary.
Another note: I also sometimes have the client take pictures of their maps and funnels, if possible, to revisit during later sessions.
Okay last note: The reason why I do this activity on a whiteboard and not a sheet of paper is because once the mapping is complete, it’s helpful to focus on the themes and funnels, and not the other stuff.
Another way in which I utilize my small whiteboard:
- Having the client “put a pin in” issues/concerns that come up during the initial — typically time-sensitive — assessment. I ask client to write down the issue on the board, for us to come back to following the assessment, so that the assessment is completed on time and the client is assured that their concerns will be heard. Yay, Bio-Psychosocials, haha!
So that’s it! These are my 5 must-have items. If I’m rushing out the door in the morning on the way to work, and want to ensure I’m prepared for the day’s sessions, I’m making sure to grab these! I know that these 5 tools will have me covered and make my day a whole lot easier.
What are your counseling toolbox must-haves? Have you tried any of the above activities? If not, could you see yourself putting them to use? I would love to hear from you.
Be well. ♥