Can therapy give concrete help with social skills?
December 21, 2010 8:44 PM   Subscribe

Unbearable loneliness is making me consider trying therapy again. I'd like to work with someone who can give me concrete help on improving my social skills. Do such therapists exist, and how can I find one?

I'm in my late twenties and have struggled my entire adult life with socializing. Few of my friends live nearby and I struggle to make new ones. I have very little dating or sexual experience. And it's taken a toll on my mood and self-confidence. Sometimes the loneliness is almost unbearable and I feel powerless to overcome my situation.

This summer I finally started seeing a psychologist. He was professional and considerate, and also helped me explore some more general anxiety issues I didn't realize I had. But it didn't feel like a good fit, especially since he was unwilling to give concrete suggestions. He specifically said that it wasn't his place to say what thoughts and behaviors were "correct" or "normal". He did admit that some other therapists took a more…judgmental approach but that clearly wasn't his philosophy.

I really like the kind of help AskMe provides on matters of social etiquette. Providing suggestions of what to do or say in a given situation. I was hoping to get that sort of feedback as I try to build my intuition about how to interact with people.

I'm not as far along the autistic spectrum as that sounds. I'm fine with small talk, but terrible with taking things further to start and maintain relationships, platonic or otherwise. I don't take initiative because I'm terrified of revealing how clueless I am. Of course I need not follow society's norms, but how can I know the impression I make without knowing what those norms are?

So is there really an approach to therapy that deals with stuff on a small-scale level like one sees on AskMe? If so, what should I be looking for or asking to find such a person? And is this considered a mental health thing that I could use insurance for, or just some sort of "life coaching"? Certainly on bad days it seems indistinguishable from depression, and my previous therapist felt fine diagnosing me with generalized anxiety.
posted by anonymous to Human Relations (12 answers total) 21 users marked this as a favorite
Have you ever considered group therapy? It might be good for you to talk this issue through with some other people who can give you a laboratory in which to work on concrete skills.
posted by decathecting at 9:03 PM on December 21, 2010 [9 favorites]

Try calling therapists on the phone. Ask them a very general question: say, "what's your approach to therapy?" Anyone who is interested in tackling specific problems will be your best bet.

Once you decide on someone you feel you can be comfortable with, go in to your first session with the express goal that you just outlined above. That will get written down on a clipboard or in a notebook, and that's probably what you'll talk about for the next few sessions (at least).

Be aware that you'll have to do all the work here, though. Your shrink can facilitate, but it's your job to actually make the decisions and the changes.

Best of luck to you.
posted by Gilbert at 9:05 PM on December 21, 2010

For something you can do on your own while you figure out therapy, there are a bunch of books on developing better people skills. You could consciously work on developing and applying techniques one-at-a-time until they become habit. Then start on another one, etc. Over the past few years I've witnessed an acquaintance of mine very obviously take this approach to developing her people skills and she has made huge progress.

Something important to keep in mind is that social/people skills are skills. As in, you have to practice, practice, practice to develop them, including making mistakes and learning from them. So even if it makes you feel uncomfortable to socialize in your current unskilled state, you have to force yourself to do it. But again, try taking a deliberate, planned approach to developing your skills instead of just bumbling out there into the world.

One of the best ways to make new friends and take your mind off your own problems is to volunteer. Make sure you choose a volunteer opportunity that includes a lot of interaction with other people. This will also help get you over your insecurity about interacting with people because you'll know that even if you occasionally do something socially inappropriate, you're still providing a net positive to the people around you through your volunteer work. (I have certainly worked with and supervised many volunteers who were annoying but helpful, and I'd tolerate gaffes and quirks that might have been too annoying to deal with in a purely fun-oriented social situation.)
posted by Jacqueline at 9:07 PM on December 21, 2010

Yes! There are lots of therapists who help single adults figure out relationships. In states where there are marriage and family therapists, that might be a good place to start--MFTs know a lot about many types of relationships and systems, not just marriages/couples/parents-children type stuff. Or you could try to find someone who advertises themselves as working on relationships generally. I don't know how much actual searching you've done already, but this is not a needle-in-a-haystack sort of thing, you just need to do some legwork figuring out people's specialty areas--and therapists who like to get new clients make their specialties known on their websites, PsychologyToday profiles, etc.

Here's another thing to consider: a lot of therapists who work with social skills have things like social skills groups for kids, but they also may have a thriving interest in adults who are looking for social skills support. You might look up centers in your area meant to concentrate on children with autism spectrum disorders, and it's possible you could find a therapist there you could work with pretty happily. I'd call and ask if any of the staff therapists are also in private practice (or provide services for adults there at that office), or if you can find names, just google them.

A therapy group for adults, focused on relationships and social interactions, is going to be an ideal find for your situation, so I encourage you to google like crazy. A lot of bigger cities might have organizations that run lots of different types of groups, it's just a matter of finding the info.
posted by so_gracefully at 9:11 PM on December 21, 2010 [3 favorites]

Another question that you could ask potential therapists is how long they like clients to keep seeing them for. I have had therapists who seem to believe that therapy is very open-ended and long-term, and I have also had one who said she thought most people only needed five or six sessions and should have "worked through" their problem by then. Someone who prefers a short-term approach is probably going to be more goal-oriented and open to working on a very specific problem, which is what you are looking for.
posted by lollusc at 9:43 PM on December 21, 2010

Sometimes a psychological social worker is good for this. I have worked with two on issues similar to yours, they were more willing to give concrete suggestions.
posted by wandering_not_lost at 9:43 PM on December 21, 2010 [1 favorite]

I'd like to work with someone who can give me concrete help on improving my social skills.

You might want to investigate Rational-Emotive Behavior Therapy. It's a form of cognitive behavioral therapy, which as I understand it is more focused on concrete help, as you put it, than are the other forms of talk therapy--the stereotypical kind that goes on and on endlessly. There are plenty of books and reading material online about these if you choose not to go the therapy route just yet.
posted by scratch at 9:48 PM on December 21, 2010 [1 favorite]

You're probably looking for Interpersonal Therapy. I've never done it, but I've heard it's really good in addressing deficits in basic social skills. It's similar to CBT in that it's intense and focused, requiring comparatively few sessions.
posted by saveyoursanity at 10:11 PM on December 21, 2010 [1 favorite]

"Put Your Best Foot Forward" by Jo-ellan Dimitrius and Mark Mazzarella. Not just about first impressions. An absolutely invaluable book.
posted by uans at 7:48 AM on December 22, 2010

In the UK, I know that people with various levels of learning difficulties sometimes get exactly this kind of help through the health service.

Maybe you could find people who work in that context and ask them for recommendations.
posted by emilyw at 7:57 AM on December 22, 2010

What your describing is just the way some therapists were trained. In this model, giving advice is seen as the sort of thing that friends and family and advice columnists do, not what a therapist does, which is supposed to be more like helping people discover things about themselves, rather than telling them what to do. This often went along with a "long-term" approach to therapy.

I myself was trained in this way, and I've become much more flexible. Giving advice can be tricky, but it can also be so helpful.

Therapists who have been trained in short-term or brief therapy are typically pretty comfortable giving practical advice, because it can help move things along much faster. Also, therapists who do behavioral or exposure type approaches typically give homework to help clients work on particular problems. These approaches aren't for everyone, but if you can define what you're looking for, this kind of therapist should be able to work with you to map out a strategy that will involve gradually practicing new skills in situations that make you anxious.

You can suss out therapists over the phone pretty simply. Just explain that you're struggling with some social anxiety and you'd like to work with someone who can help you in a practical way, such as with strategies and homework, rather than just talking about the problem within the therapy session. Chances are the therapist will want to mostly talk for the first session or two, in the service of assessing you, and trying to figure out if there are underlying factors to be concerned about, such as trauma history. But make sure that the therapist remembers that you are looking for concrete guidance and approaches that you want to try out in vivo.
posted by jasper411 at 10:16 AM on December 22, 2010

I think you've articulated your concerns really clearly here. Saying "I want to explore my issues, but I also want coaching with specific strategies" should elicit either "That sounds like what I do" or "That doesn't sound like what I do" from most good therapists.

Best of luck.
posted by Sidhedevil at 11:02 AM on December 22, 2010

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