Treatment Tuesday - Fictional Therapy Session How-To

Recently, Nicole O'Dell, a published YA author and creative mind behind Scenarios for Girls and interactive fiction where the reader chooses the ending, wrote in for my opinion about an excerpt from her current WIP. Essence of Lilly, which releases in Spring 2011, features a scene with a therapist and a family.

As a result, I had the thought to do a little how-to post on writing a fictional therapy session in your manuscripts. So here are a few tips to consider when a therapy session makes it way into novel.

1) Consider how the therapist will approach clients in session. I never approach people in the same way. For younger children, I'll go for Miss Jeannie instead of Mrs. Campbell. For teens and adults, I usually go with just Jeannie. I want to build rapport the fastest way possible with whoever I'm seeing. Children are so used to calling their friends of parents Miss Janice or whatever that they are comfortable using this terminology. They also understand when I ask them to call Miss Jeannie instead of Mrs. Campbell that I want to be friendly. They call their teachers at school Mrs. Wilson and Ms. Buckley. So right away, they put me on a different intellectual level...like a family friend or church member.

2) Consider what role the therapist will play in the story. If the therapist is just going to be minor secondary role, then it's not important to go into credentials or framework of therapy (how the therapist conducts therapy). If the therapist will have a recurring role, then it's more important to give them more of an introduction. Readers will want to get the idea that this therapist is someone who either knows what they're talking about or not. How do you do this? See #3.

3) Give the reader a glimpse into the therapist's office. This is an easy way to paint the therapist as an ally or enemy, intellectual or wacko. Have the characters notice the degrees on the wall, or the nice furnishings to suggest business is going well for this therapist. Vice versa if you want to set the therapist up to be incompetent. Picture frames on the desk, crayon masterpieces on the wall, papers piled high or not a one in sight...each description gives the reader just a little bit more about the therapist as well as gives you a chance to share the main character's internal thoughts.

4) Don't write too much of the actual therapy session unless it really moves the plot forward. It's way too easy to start the session with introductions and mindless chitter-chatter. I sometimes don't start actual therapeutic stuff for 10 minutes. that doesn't make the initial 10 minutes void of worth, but it's setting up the bond between the client and me. It's crucial to having a good session. A reader won't necessarily be interested in this portion, though. Get to the meat of the session and don't give the reader any new backstory while the clients "fill in" the therapist on why they are seeking help. Just skip that portion...readers will get it.

5) Identify who the client(s) will be. A therapist can see an individual or a family or any combination of family members. But if therapy will play a large role in the book, then it's important not to mix clients with therapists. In Nicole's book, the father was seeing a counselor who recommended for the family to get counseling. This is an appropriate referral, because once you've started to see a person individually, they are the client, not the family. It would be too difficult to include the entire family when your loyalties already lie with one member. When an entire family comes in for counseling, that counselor can see one child or both parents for individual or marital counseling and that's okay. The idea with those sessions, though, is to always bring it back to the family. This might seem a trivial distinction, but to anyone in the field, this is a really big deal. You want to look like you've done your homework.

6) Things to do while in session:

• Notice body language. Eye rolls, staring off into space, head down, arms crossed...these are great visuals that therapists definitely notice (well, good therapists) :)
  
• Use silence. Nowhere is it written that every second of every session has to be filled with talking. Silence is actually very powerful, so don't be afraid of using it. You can have a great tension-filled moment with silence, describing the uncomfortable shuffling and hand fluttering that can happen.
• Think of family therapy as group therapy. It's appropriate for the therapist to bounce from one to the other and ask, "What are your thoughts on what X just said?" A therapist will be interested in the individuals in the family have to say and think about the other individuals in the family.
• Throw questions back at clients. You really don't realize how often clients ask therapists questions. They come seeking some sort of magic response to fix their problems. But instead of answering, therapists frequently throw the question back at the client. Little tool of the trade...I say, "What do you think?" quite frequently.
  
• Never give advice. A therapist wants the client to arrive at their own solutions. Plus, if a therapist did give advice and the client took it and had negative side-effects from it, the client would blame the therapist and it could effect the rapport between them.

Hopefully this gives you a starting off place to write in authentic therapy sessions. Feel free to add in the comment section any other specific questions you might for your WIPs.

This service is for fictional characters only, so any resemblance to real life examples is entirely coincidental. Any other fictional character assessment questions can be directed to charactertherapist (at) hotmail (dot) com.

Q4U: Have you written in therapy sessions in your manuscripts? Did you include any of the above suggestions?