The Last Stop Theory

In over twenty years of being a psychotherapist I have been privy to more secrets than I could ever remember, more pain than my heart could bear in one helping, and the sufferings of countless human beings. Some days are wonderful. Some days are difficult. Some days are relentlessly heart wrenching.

Many years of education by professors who never worked as a therapist in private practice taught me to reflect feelings, content, and behavior. I was also taught the theories and art of dozens of famous clinicians like Rogers, Jung, Skinner, and Perls. I memorized the theories. I passed the tests. I was on the President’s List for having an exceptional grade point average. I graduated.

I went through the long internship and supervision period. I passed the state board. I got a license. These hoops I jumped through did not make me a therapist. My greatest teachers, my most knowledgeable trainers, and the people whom I owe my understanding of human nature are the clients who have honored me by sitting across from me on a well-worn couch in my office, or through a computer monitor. They taught me to be a therapist.

For over thirty years I have been licensed. And over the past twenty-five I have provided an average of 1,000 therapy sessions per year.

I am asked by friends and acquaintances, “What is the most difficult issue that you encounter?” I have pondered this question for many years. And I have come to one conclusion. The most difficult issue I face as a therapist is the death of a client. It is gut-wrenching. It is awful. I have no words to describe it.

The first client in my practice who died was a delightful teenaged boy whom I liked very much. I saw him for two years. We grew very close. He relapsed on drugs and was sent to a treatment facility. And he died there. My office was his last stop. The last place he had sat and worked through life changing issues, beliefs and pain. I hope it was meaningful for him. He changed my life.

I also like to think about the most joyful part of my career. The many times when people can make the life changing decisions to change their marriages, their families, and their lives.

I think of those who call me or email me years, and years after our sessions have ended and say thank you. And of course, the clients I see who remind me that therapy is making a difference in their lives.

When a person sits across from me, I assume that this is their last stop, their last chance to get help. I assume it is my last chance to get this right. I realize that each of us is only in this moment—this moment in therapy, this moment in life—so it must count. This may be our last stop.

In the evolving landscape of mental health care, telehealth has become a pivotal tool, especially in Texas. Offering online therapy sessions has allowed me to reach clients across vast distances, ensuring they receive the support they need without the constraints of location. Telehealth in Texas has revolutionized the way we connect, providing a flexible and accessible platform for clients who may not have otherwise sought help. This online approach has proven invaluable, enabling continuous care and support, whether in the comforting presence of my office or through a digital screen.

Telehealth is not just a convenience; it is a necessity. It allows individuals to access therapy in a way that fits into their lives, breaking down barriers of geography and time. The state of Texas has embraced this digital transformation, recognizing the importance of mental health care and the role of online platforms in providing it.

In conclusion, my journey as a therapist has been deeply enriched by the advent of telehealth. Texas, with its vast landscape and diverse population, has shown that online therapy is not just a temporary solution but a sustainable, effective way to offer mental health care. As we move forward, I am committed to continuing this path, ensuring that every client, no matter where they are, can have their “last stop” for help, whether it is in person or online.