Niches: Buck Black on Therapy with Truckers

Following his WTCI Interview, Buck Black, LCSW writes about doing therapy with truckers—what’s different, what’s the same, and how it works.

Truckers have their own community.  The average person probably doesn’t think about this community or even know it exists.  However, its important to remember that truckers are responsible for bring us practically everything we own, as well as making our economy move. However, there is little support for truck drivers and their families (see my recent article).

Given the nature of the life of the trucker, I see depression and family problems as the two most common issues truckers address in their coaching sessions with me.  Just think, you sit in isolation all day long (not just 8 hours, but all day long).  Then you repeat this procedure for several consecutive days, if not weeks.  Eventually, you are able to return home and spend just a few days with your family.

There are many disagreements between truckers and their spouses.  This is often caused as a result of the trucker essentially being an absent parent and doing his/her best to help parent from hundred or thousands of miles away.  Also, given that the trucker has contact with friends and family over the phone and occasionally Skype, there are often plenty of instances of miscommunication that result in arguments.  This type of long distance relationship is often prone to miscommunication because the phone and even Skype often does not convey true feelings and body language.

Truckers have a lot of time to think.  If you ask them, most will tell you that they have too much time to think.  If something at home is not going well, they have hours on end to dwell on it while driving.  This is one of the bigger dangers of the job the average person does not recognize.  I often help drivers with simple CBT techniques for thought stopping and distraction.  Given all the opportunity for rumination, there are many drivers that let their thoughts turn into worry and anger.  Again, I often help them use CBT techniques to address these issues.

How it works:  Clients typically find me via facebook, twitter, OOIDA, and word of mouth.  If you search “Therapy for Truckers,” you will find my website.  However, truckers often do not think of doing this.

The screening process is a must given that I work with clients at a distance.  I rely on the assessment form clients initially fill out.  This explains to the client that this service is not for them if they are homicidal or suicidal and that emergency services are not provided.  If there is a need for this service, then face to face therapy is required.  Of course, I will help a client if they happen to have an emergency.  However, I will not enter into a relationship with a client if I feel they will likely have emergencies.  Also, if I have the feeling that I will worry about the person’s wellbeing after I hang up, I will advise them that they need more intensive face-to-face therapy.  Ultimately, the telephone or Skype is the tool I use to screen the client to see if they are appropriate for distant services.

Amazingly, I have found that building rapport on Skype is about the same as in the office.  I think rapport happens so easily because clients come to me wanting to use the technology.  I am not trying to talk someone into using Skype.  If the person were not comfortable with the technology, then there would probably be more difficulty building rapport.  I must point out there are drivers who do not trust that I am a legitimate therapist.  I’ve had a driver call me up and say, “I don’t trust you people,” and continue to tell me his problems.  I listened to him for 20 minutes; he told me that it really helped to get his problems off his chest.  When I asked him to become a client, he said, “No offense, but I don’t believe in your profession.”  I invited him to call back and become a client if he ever felt the need.  So far, I’m still waiting!  There continues to be a great deal of stigma in the mental health field in general and even more specifically with truckers.

The successes that stand out on my mind are couples coaching sessions with a trucker.  I do this via conference call.  Other than using the telephone, it turns into a standard couples session. This is the time that issues can be addressed and I can help the couple with communication skills that will allow them to become much closer and limit their arguing.  This is often an opportunity for the couple to express feelings that they have never shared with one another.  It is this type of work that makes me feel that I really am helping.

Find Buck Black, LCSW online at TruckerTherapy.com and BuckBlack.com.

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