Ten Ways to Use Therapy in Becoming Your Own Advocate

by Shonnie Brown, MFT

Self-advocacy: knowing what you want or need and having the ability to speak up for yourself to get your needs met. Self-advocates know their strengths and weaknesses; they take responsibility for ensuring their needs are addressed.

One of the things I enjoy most in my online practice is working with young adults who suffer from anxiety and social anxiety. Many children, teens, and young adults don’t feel competent in the skillset required to survive in social situations. Because of a history of anxiety, shyness, poor self-esteem, and a well-developed inner critic, at their foundation they are not comfortable advocating for themselves and often don’t even know how to begin.

Recently, while working with a young man who I will call Jeremy, I realized how deeply interwoven were his social anxiety and his inability to take advantage of his time with me. I then thought of other young adult clients with similar issues. With clear goals in mind––such as becoming self-motivating, taking risks, developing positive self-esteem––I created a list of ways that my clients could use therapy to practice self-advocacy. All of these suggestions came from my personal experience of what clients were doing and not doing for themselves in our work:
  1. Use therapy to practice the four Rs: Respect, Responsibility, Reliability, and Relationship. All of these are important life skills. Use this opportunity to practice being respectful and appreciative of what is offered––including my time and commitment––and expect to be treated with respect in return. Be reliable by showing up for a scheduled session. Honor the therapeutic relationship by letting me know well in advance (at least 24-48 hours) if you will not be showing up for your session, as this time slot is yours. Be responsible with homework by knowing that becoming your best self is always my goal.

  2. Advocate for yourself by deciding before the session how you want to use your time. Ask: What do I most want/need help with today? Show up prepared to ask for what you need.

  3. Be prepared to take notes during the session. We may come up with a plan, a social anxiety exposure, or homework assignment. It helps to write these things down yourself. That way you are taking responsibility for carrying through on a goal you have set for yourself.

  4. Ask questions. Tell me when you don’t understand or need more information. If you don’t fully understand something, ask me about it. This will make it easier for you to ask questions at school or at your job.

  5. Think in terms of goals––small, reasonable, doable.

  6. Utilize planning, organizing, and goal setting. Print out daily, weekly, and monthly calendars (found online) and plot out the due dates of school/work assignments and exam dates. Use a daily calendar to plan how much time is needed each day—and set small, doable goals. Manage your anxiety and overwhelm by thinking only about what must be done on that one day.

  7. Use therapy time to create plans, goals, and practice anxiety exposures. Tell me if you have an anxious situation looming. We can practice together and I can give you tools to practice yourself. Good stress-reduction is planning in advance by creating scripts, making notes, and listing questions.

  8. Help create your own next step. Think about what you need to do next. Offer your opinion about things we discuss and plan assignment and exposures with me that feel doable to you. Follow through on homework assignments and anxiety exposures. Keep challenging yourself and taking small risks.

  9. Know your limits. Tell me if you feel overwhelmed or anxious. Did you feel anxious this past week? Before our session? During the session? Am I asking too much of you? My goal is to help you gain control over your life by working at the speed you need and being there as your support. If you feel unexpectedly anxious during the week, message me and let me know. Ask for help if you need it.

  10. Give yourself praise for every step forward—no matter how small it may seem. Develop the habit of praise and self-appreciation, talk positively to yourself, and share your accomplishments with me as well.
Here are two examples of ways I encouraged self-advocacy with young adult clients:

Scenario #1: Jeremy
Jeremy was a no show for our phone session. He responded 20 minutes late because he forgot. He apologized for his lateness while telling me that he didn’t finish his work project due that day. He got lost in overthinking, self-imposed pressure, and resulting anxiety. He didn’t know what he needed help with.

I inquired further, and Jeremy told me about the pressure he felt to perform in the workplace. Everything felt unmanageable, and overthinking had led to catastrophizing. (He irrationally focused on the worst things that could happen in future situations.) I knew that he feared repeating a recent panic attack.

I suggested he get a pen and paper to take notes while we talked. Rather than mentioning his lateness, I suggested we make the best use of the time we had. I structured the session by checking in on his therapy homework from the previous week. He first focused on the unfinished project and his poor use of time. When I asked, he mentioned that he had called a work colleague he barely knew and asked for clarification––something we’d talked about for weeks. Knowing that it was difficult for him to own this victory, I did not hold back my own excitement and encouragement!

After celebrating his victory, we talked about easing the pressure by breaking down work projects into small, manageable goals. I suggested using a daily calendar to write down everything, to plan and organize his time. We discussed how to manage stress by setting doable daily tasks. When Jeremy focused on that day’s tasks only, he felt a reduction of stress. When he shared his schedule with me he could see that he had followed a plan of his own making.

Scenario #2: Maggie
Maggie was overwhelmed and preoccupied with all the planning she had to do for a family vacation. Her relentless anxiety and overthinking hindered her sleep and her ability to keep up with her college courses. She was needlessly anxious when she should have felt excited.

“What’s the worst thing that could happen?” I asked. “Your planning and packing doesn’t have to be perfect.”

Maggie had already made a long list of things to check off. We talked about prioritizing tasks and using a calendar to focus on daily goals, rather than creating overwhelm by ruminating on the large picture.

“Talk to yourself,” I suggested. “Look at your daily schedule. Say, ‘this is what I have to do today.’ Focus only on that and let the rest go. Reduce your stress by setting doable, small goals in advance.”

Together we came up with a list of positive self-talk for her to use each day that week. She wrote down these affirmations. We also talked about the fact that we were working on life skills.

“Having to manage your time by making lists and breaking work down into smaller tasks is something you’ll use every day. Remember, anxiety is all about feeling lack of control,” I reminded her.

“I’ve just been creating worry for myself,” Maggie reflected. “I understand what your saying, but how do I stop that?”

We reviewed several tools I’d given her previously––relaxation and calming techniques, positive self-talk, challenging irrational thinking and the false notion of perfection. Maggie was dwelling on feelings of guilt for taking a vacation in the first place. “I don’t feel like a responsible adult,” she stated.

“Let’s challenge that,” I suggested. “A responsible adult takes care of herself by scheduling time off to have a balanced life. I think your inner critic just doesn’t want to let you off the hook.”

“I don’t know why it’s so hard for me to feel deserving,” Maggie echoed my thoughts as our session came to a close.

She had introduced a foundational issue. I validated the importance of her statement and made a note to return to it the following week.

 

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