Hi my name is Ciara and I'm a LMFT that practices Dialectical Behavior Therapy. Through telehealth I have the unique opportunity to engage in exposure to task avoidance. Clients will come to me about tasks that they are avoiding and that are distressing them: mail piled up, trash that hasn't been taken out, or a message they are waiting to send. Behavioral therapists know that avoidance momentarily decreases distress but ultimately reinforces the avoidance and increases anxiety in response to the feared task. So after other attempts to resolve the avoidance don't result in them completing the task I tell my clients to do the task in session. "Go get the pile of mail and let's see what's in there" I might say. So then they are opening the mail with the support of their therapist in the moment. They get the opportunity to see that the feared task is not as scary as they believed it to be, increase their confidence in their ability to complete uncomfortable tasks, and prove their faulty cognitions wrong (ex: It will take forever. I can't do it.). When clients come session after session discussing the tasks that they are avoiding and are not engaging in them in between sessions they feel hopeless and lose confidence in themselves and in therapy. To interrupt this cycle I get literal. So we do it together and they receive in the moment encouragement and reinforcement in the session.
Building a strong rapport with clients in therapeutic settings fosters open dialogue, allowing them to express their thoughts and feelings freely. This relationship enhances the therapeutic alliance, making clients feel safe and supported. Such connections promote belonging and validation, encouraging greater engagement in the process. For example, a client with anxiety may initially hesitate to share their fears but may open up with genuine support from their therapist, leading to improved outcomes.