We need to understand the current diagnostic criteria so we can have shared conversations. We also need to remember a group of people made them up, and didn’t agree on everything before the criteria were published. They are approximations and aggregates that were informed by an understanding that will continue to change.

We need to learn evidence-based interventions so that we’re not just winging it with other people’s lives and vulnerabilities. We also need to be mindful that other people made these interventions up, hoping to improve on what has gone before and the interventions will very likely be improved on again.

We know better than to repeat the mistakes of 50, 200 or 1,000 years ago. And we are making the mistakes they will not want to repeat in 50, 200 or 1,000 years time. And very likely making them sincerely and with the best of intentions.

Best practice is only best practice until something better comes along. And if we wait long enough, the next better thing may well be a reworking of a past better thing. We need to learn our craft but also know its place in the bigger history and the way it evolves over time.

So we can work hard to hone our skills while leaving room for a dash of skepticism. We can care about the frameworks that guide us while also learning to hold them lightly. And that just might be the most evidence-based thing we can do.

Wouldn’t it be nice if we all came with the equivalent of washing instructions – what conditions will allow us to produce the best results? Some of us might be able to tolerate high temperatures and a strong spin cycle, others may require a gentler wash and dry in the shade.

In reality we work these variables out with experience, and they may evolve as we go through our career. What we could tackle in the early days might become too much in time, while things we could never even dream of doing at the beginning of our career might become second nature later on.

You may not have full freedom to set up work the way you would prefer, but we can still learn what works best for us as we go and look for opportunities to adjust as we go. So what might be some of the variables we could consider?

Number of total clients: How many people can we have on our books before the details and edges between people starts to disintegrate?

Total number of clients in a week: How many appointments can we offer and still remain present and give people our full attention?

Spread of appointments across a week: How can be best manage our energy? Some may prefer fewer clients each day across the whole week, while other may do better with a more intense schedule on some days to get another day without any appointments.

Kind of presentations: What kind of challenges do we most enjoy working with and where do we feel we offer the most value? This may be to do with specific presenting issues, degree of complexity, and how broad or narrow the range is.

Format of sessions: Do we prefer one-one, couples, families, groups, communities or a mix? Many brief encounters or fewer intensive sessions? In person, by phone, by video, or multimedia?

Setting of sessions: Do we work best in outpatient, inpatient, home visits, residential, out on the community or right out in nature? We may also think about how contained the settings are (e.g. a 50 minute appointment in a dedicated counselling room) or a more informal contact (e.g. across the day in a residential program).

Variety: What kind of work mix offers you the best balance? Some people want to just focus on direct client contact, others prefer a mix of counselling and co-ordination, or a split between offering therapy, projects and offering training.

These are just a few, and there is no right or wrong about what pattern works best for us. It’s more a curiosity of how we find the best way to sustain doing work we care about. Because in the many times I tried to ignore my washing instructions, I often came out the worse for wear like a mangled jumper that was now two sizes too small.

There’s a lot of ideas out there about the best way to help people, hey. Like a LOT. Some of these ideas become camps, rallying points that bond some people together. Some of these camps become forts, defending themselves and sometimes going on the attack. At their extreme they become cults, denying the right of differing ideas to exist.

There’s an irony in the way people in some camps treat people in others, particularly when it is unhelpful or even hurtful. I get it, we get attached to our approaches, we’ve invested a great deal of time and passion into learning them, they may even become part of our identity. But still. It can feel incongruent to say the least.

At the other extreme, embracing too many ideas risks becoming an undiscerning soup of fragments. A lot of energy can get lost in the many possibilities and decisions may be less considered than is ideal.

Somewhere between the two, we can look for ground. A place where we remain clear that frameworks are not facts. They are tools, a way of understanding the work so that we can free up more attention and curiosity for the person in front of us.

Instead of certainty, finding our ground offers guidance. Roadmaps rather than prescriptions. It’s where we stand, the foundation of our practice. But like any good foundation, it’s not in itself enough. We can make the most of other approaches when they have a firm base to rest on. And we have a place that is familiar and safe enough to refresh and catch our breath before venturing out again.

Helping professionals are employed to facilitate change, otherwise we don’t have a job. The more straightforward version is when the person paying for the service is the person who wants the change. There may still be challenges but the basic transaction is clear.

It becomes more complicated when the funding has been provided to produce a change in a third party – someone who has been referred or mandated to attend. Some service models are softer where there is a hope, but no expectation, that change will happen.

But some roles have the expectation built in with targets workers need to achieve. Sometimes goals are set at the beginning of the work, sometimes they are set by the referrer before the person even turns up.

The irony is that if we approach this work with the expectation or need for someone else to make a change, it might be less likely to happen. People can smell an agenda a mile off and try to protect their autonomy by defending or withdrawing.

Pushing for outcomes means we take less time to discover what the person really needs and how to find a way forward together. And moving too fast towards a solution may just end up with the person arguing against a change that, under less pressured circumstances, they might even be open to.

It can feel like going to work in a unicorn factory, where the expectations are high but our confidence of success may be low. So what can we do? We can’t force change to happen. But if we can hold the hope for change more lightly and meet people with curiosity, we may be able to create a very real, shared sense of possibility together. Because that is how unicorns are really made.

The idea of self care matters. We need to look after ourselves – our bodies, minds, and hearts – in order to truly look after someone else. When we work supporting others we sometimes need to take a step back and disentangle our self from theirs. And it helps to be given permission – even outright encouragement – to do so when the work is never done and there is always more that we could do.

That said, I’m not a massive fan of the term ‘self care’. For a start it’s an awkward phrase, it feels constructed. If you swapped ‘self’ with ‘car’ and tacked on the word ‘package’ at the end, it would comfortably belong as a tick box on a form at the car dealership so they could sell you more stuff.

And language matters. The way we describe things frames how we think about them. When I think of the term self care, I think about me, my self, and my focus goes inwards. Yet we know that an outward focus that creates connection can be profoundly nourishing, whether it’s connecting with loved ones, nature, meaning or community.

More, self care implies that it’s my responsibility, something I should do in my own time, out of sight, like fixing my own car or some kind of DIY for the soul. But it can be deeply healing to feel not just connected, but how interconnected we are. Our shared humanity. Our shared flow of energy. That we are a living, breathing part of our community, ecosystems, universe.

While self care can include connection and interconnection, it doesn’t naturally point to them. It’s also just kind of… vague. An umbrella term, regardless of whether it’s raining or not.

So perhaps we can choose our own words that more accurately describe what we need. When I think of self care what I usually need is to refresh – to top up my well of energy and meaning. Sometimes I need to recover – to catch my breath after a period of intensity. And sometimes I need to repair – to heal something that feels hurt or damaged.

We can also think about the qualities we would like to rebalance. Perhaps we need more gentleness or lightness. Or something more tangible, like space or movement. Specific strategies may more naturally emerge when we are clear what we need. So when we talk about self care, let’s be curious about what language both expresses our needs and strengthens our connection.

If you are in the helping professions, you need support. Hopefully you have good managers and supervision. Ideally these roles are built into the work. Sometimes you need to find them for yourselves. When you get the right fit, external supervision is a worthwhile investment in your skills, professional self-care and career.

There is also value in less formal mentoring. Not your manager. Not your supervisor. People who can give you a refreshingly honest and grounded take on the work from one step back.

It’s hard to find your way when the support offered is mostly aligned with performance targets or organisational objectives. Or with a narrowly defined professional identity that doesn’t seek to question itself. You also need support that makes room for you – who you are, your values, your strengths and how you could make your way within in the bigger picture.

There’s a role for aunties and uncles. Someone who can talk authentically about the reality of the work, it’s limitations and messiness, as well as the opportunities. Someone who can talk straight with you, not via the funding models.

Maybe there’s a dash of healthy cynicism and almost always a generous dose of pragmatism. There’s a willingness to say “I don’t know” and mean it when they say “I believe in you”. Someone who will always bring you back to the fundamental purpose of the work and the people you are trying to support.

When we think of therapy, it’s hard not to imagine a therapist’s office. Armchairs, set on an angle to each other, box of tissues on a coffee table between. Maybe a sofa. Very likely a calming print on the wall, possibly of an impressionist painting or forest scene.

If you work in the public sector, you may need to swap out the cosier features for more utilitarian ones. The armchairs might be washable vinyl, or have less fabric and more plastic. The print might be more generic, sun faded or replaced by public health posters tacked to the wall.

Either way, the idea of the counselling room is embedded in our minds – a safe space for vulnerable conversations.

And yet… Youth workers often find young people are more likely to open up when they are being driven somewhere, eco therapists work on trauma in nature. Some people feel actively anxious in closed spaces, others are just more comfortable in motion. And sometimes profound connection can emerge in the space created by a shared, practical activity.

The counselling room is there for good reason, offering containment, confidentiality and predictability to many clients. It’s valuable to have spaces that are just for the purpose of therapeutic work, where a door can be closed when the conversation ends. A dedicated space also allows therapists and organisations to develop consistent procedures to offer services and respond to risk.

But it’s always worth asking if this our only option. We don’t want to mistake convenience with necessity, convention with quality. There may be times when we need to think outside of the box, with its armchairs, coffee table and print on the wall.

When we learn our craft we learn a lot about what to do – what to say, when to say it and, sometimes, how to say it. In terms of what not to do, we get the big ones – don’t cause harm, don’t breach trust, don’t violate the code of ethics.

There is less focus on how not to take action in the moment. How to become more comfortable with silence. How to hold back useful information at a not so useful time. How to refrain from giving opinions or advice when the other person’s ideas need to be brought forth. How to just sit, hold the space and allow what is happening right now to be felt and experienced.

Far from passive or indifferent, non action is a state of active awareness. An intentional redirection of energy from doing to being. Anyone who knows me will know this one is dear to my heart because I’m really not very good at it. I’ve had to work for it. I’m still working on it. I’ve got a mind like a box of bees and there’s always something I’m wanting to say.

Just as we build a repertoire of useful questions or strategies, we can build our capacity to hold our urges. Like strengthening a muscle at the gym, there is no wrong place to be when we start and each repetition helps.

We can ground ourselves with why it matters so much – holding space invites something to meaningful to emerge, rather than try to make something less substantial happen. We can build stamina – five seconds may become thirty, one minute may become five. And we can give our full attention to what the other person is saying and try to understand more deeply what has already been said.

And we can be gentle with ourselves when, once again, we lose our focus. The autopilot kicked in. The urge offer thoughts got too strong. Or we just reacted and joined a conversation as our less filtered selves. Perhaps we are able to reset in the moment. Sometimes we need to give ourselves space to refresh and return another time.

It’s tempting to think things will get easier when… we know more, the funding models are improved, more resources are made available, we’ve done that workshop, we get more staff, the roadworks are finished, the IT system is upgraded or we go to a four day week. And possibly it will. We can always try to improve what we have.

We can also waste a lot of energy resisting reality. Complaining about the limitations. Reserving our best for when the conditions are the best. But those things haven’t happened yet, and we’re here, right now, with things just the way they are.

The messiness isn’t just the reality of the work. It is reality. Life is messy. Relationships are messy. Change is wildly, unpredictably messy. When we fight reality we risk sending a subtle message that the people we support need unrealistically ideal circumstances in order to thrive.

We may worry about saying the wrong thing but their lives are full of people who say unhelpful or out of sync things. It’s more important to be on alert for when we inevitably miss the mark and repair any friction than to think we will can avoid such moments.

We may not have all the resources we would like, but we can model being adaptable, tolerating discomfort, and making do, and be alert for the ways that they also demonstrate their own resiliency.

If we offer the perfect therapeutic relationship, we haven’t helped the person to prepare for dealing with anyone else. If we offer perfect solutions, we’ve done nothing to help them discover their own wisdom. And if we offer seamless, generously funded services we might just have helped everything else to seem a little bit more disappointing.

So yes, absolutely, let’s keep improving ourselves, our skills, our systems. There is a gift in offering another human a thoughtful and carefully delivered service. But let’s also, equally, embrace the messiness of the reality we are in now.

This work is complex, multi-layered, nuanced, with multiple presenting concerns being the norm not the exception. Wouldn’t it be nice if there was a secret to unlocking the potential of therapeutic conversations?

We’ve all seen our fair share of confident experts promising that they have the answer. That the truth is simple once you know it. It sounds reassuring. Seductive even.

But what if I told you it’s true? There really is a basic hack to have better engaged, more productive conversations.

Get a good night’s sleep.

Like a really good, bone-deep, at-peace-with-the-world, refreshing, restorative sleep. And do it again. And again. And again.

Ah.

Damn.

There are so many reasons we might not get the quality of sleep that we need, and it’s not a simple thing to address. Listen to sleep experts on how the modern world, our diets, our habits, our hormones, our lives mess with our sleep and it’s amazing we get as much as we do.

Yet it’s also worth being curious about the things we do to try to become a better helper that might get in the way of being a truly rested one. Where might we be striving, straining, stressing? Cutting corners on self-care in the name of supporting others? Short-changing the present moment because we’re chasing the future or dwelling on the past? Undervaluing what we, the person, might have to offer, separate to what we know?

So yeah. I’m not saying it’s easy. And if you’re anything like me, it’s a work in progress. But it just might be one of the most fundamental areas of professional development that we could invest in.