Philosophy of Care

Psychotherapist Garry Waterman, LMSW, implements a lot of his methods from Dr. David D. Burns of Stanford, which you will read about in this blog post. To read more about Dr. Burns’s work, visit his website (https://feelinggood.com).

The Initial Visit

It can be a little nerve wracking anticipating your initial therapy appointment, especially if you haven’t previously been in counseling. You might be wondering what will happen on your first visit. When you make an appointment with Garry Waterman, LMSW, there are a number of things you can expect.

Before treatment will actually begin, Garry has some paperwork to fill out. Some of it is administrative, but most is designed to get to know you so Garry can start to tailor which techniques will work best for you in treatment.

During your initial visit, Garry will discuss your issues and evaluate you to develop your care plan and detail what he has in mind to achieve the mental health outcomes you are seeking.

The Concept of Self-Help Memo

Garry believes in homework.

While Garry appreciates that we lead busy lives, he says it is important to be working on your mental health between sessions. Think about it like piano practice. You can meet once per week with your teacher and improve, but if you don’t practice outside of your session – or only once per week the night before – you won’t make progress like you would if you were at it every day.

Garry wants to see patients succeed. He will do everything he can for patients, but ultimately patients must work with him as a team.

The ultimate goal is for you to feel better. However, it is also important to understand why you were feeling depressed or anxious so that when it happens again, as it likely will, you will have the coping mechanisms in place so you can quickly get back on track.

It’s great if you solve a problem in therapy; but after you solve that problem it won’t be smooth sailing for the rest of your life! Life always presents us with problems to solve, no matter whom we are or what our current circumstances may be.

The goal is for you to feel better long term. That involves being able to deal with the problems life throws at us effectively.

Practice doesn’t make perfect, but it certainly makes things easier!

Self-help

Each client is different, so each patient’s treatment will be different. Garry employs a variety of self-help strategies, using the ones that he thinks will be most effective for you. This is part of what you can expect for homework.

Some of these methods include:

Organizing your time
Keeping a journal of your feelings
Reading about distorted thinking
Finding activities that you enjoy
Reading self-help book(s)
Studying the “Five Secrets of Effective Communication”
Making decision pros/cons list
Listening to taped sessions

Barriers to self help

There are many reasons patients are resistant to homework between sessions. Here are some common excuses.

Thinking you will get better, if only you were loved
Not having time to do homework perfectly
Worrying you won’t do a good enough job on the homework
Procrastinating
Being upset at the therapist
Feeling like getting better is hopeless and futile
Resenting people telling you what to do
Believing that moods are controlled by fate
Believing that your problems are a result of other people and you don’t need to change yourself
Feeling shameful of your problems and having a hard time putting it on paper
Thinking medication is the only answer
Thinking that the world is depressing in reality, so it makes sense to be depressed
Being reluctant to give up negative feelings because they also carry some positive benefits
Feeling frustrated
Being reluctant to have others (a therapist) help you because of the belief that that means you are weak
Lacking and waiting for motivation
Feeling over committed to obligations
Having bad associations with homework
Feeling overwhelmed
Thinking that talking is enough
Feeling helpless
Having a fear of change
Feeling comfortable with the way things are
Being resistant to the idea that therapy should be for such a short duration
Not wanting to admit that you are responsible for how you feel

Premature termination

Garry, and therapists in general, discourage premature termination of therapy.

There are a number of reasons why patients decide to end counseling prematurely:

Feeling shame when discussing issues
Having low motivation
Feeling stuck
Don’t feel counseling is helping
Possessing unrealistic expectations
Feeling hopelessness
Having a financial hardship

Shame

It’s hard to discuss intimate problems, especially things we feel guilty about. However, Garry isn’t there to judge you. While it may be difficult, discussing your feelings is an important step to recovery.

Low motivation

There are many reasons patients have low motivation when it comes to therapy. Oftentimes these reasons are related to their underlying problem.

Frustration

Some clients get frustrated that they aren’t improving fast enough. This does not mean the therapy isn’t working; only in very rare cases is one session all that is needed to improve.

Conflict averse

If you are frustrated with how therapy is going, it is important to discuss it with Garry. It might be difficult to bring up (as we humans tend to avoid conflict), but insight from the conversation can lead to more effective ways for you and Garry to get you on the right path. Garry will not be offended! Your frustration could also be a symptom of a larger problem and dealing with frustration can lead to progress. If you feel it is necessary, however, Garry can also refer you to another therapist to continue treatment.

Relapse

Some patients feel better and then relapse. As a result, sometimes they believe this indicates that their chances of recovery are hopeless. However, relapse is common and not out of the norm for patients. It is important to stay committed to therapy.

Be prepared

Even if you are feeling better and don’t think you need therapy, it is good to have a closing session. Garry wants to make sure that, even if you solved the problem that brought you in in the first place, you have developed the skills needed to effectively tackle similar problems in the future.

Financial problems

Discuss this with Garry to figure out a solution.

T.E.A.M.

T.E.A.M. is a relatively new therapy. Developed by Dr. Burns, Garry uses this method in his practice.

T.E.A.M. stands for: Testing, Empathy, Agenda Setting, and Methods.

T: Testing

E: Empathy

A: Agenda setting

M: Methods

Part of T.E.A.M. includes patients taking self-assessment tests concerning their depression, anxiety, and relationships. You will fill this out at the beginning and end of every therapy session. In this way, Garry can track your progress and get immediate feedback on how effectively his methods are working and readjust accordingly.

Contact Garry Waterman

Garry Waterman (LMSW, ACSW) graduated from the University of Michigan in 1990 and has been helping clients improve their mental health ever since. Garry is a licensed social worker and therapist. If you think that you or a loved one could benefit from therapy, contact Garry today to get started.

Midland Office

1205 E. Wackerly Street
Midland, MI 48642
(989) 832-9161

Mt. Pleasant Office

115 S. Franklin Street
Mount Pleasant, MI 48858
(989) 832-9161

Resources:

David D. Burns, MD’s Therapist’s Toolkit, 2007, 2009.

What to Expect in Therapy