Clinician's Quandary

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November Quandary: How Do I Bring Up My Client’s Rigid Perfectionism?

Five Clinicians Weigh In

Chris Lyford

By Chris Lyford - A client sees his perfectionism as an advantage, even though it ramps up his anxiety, exacerbates his sense of shame, and keeps him living a very rigid life. He brushes off his therapist every time she brings it up. Five therapists weigh in with how they'd respond.

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October Quandary: Addressing the Idea of Meds with a Depressed Client

Five Clinicians Weigh In

Chris Lyford

Sandra has been struggling with depression for many years. A psychiatrist has prescribed her an antidepressant, but she’s told her therapist she doesn’t like the “idea” of meds and doesn’t take them regularly. He's not sure how best to explore the issue with her. Five clinicians share how they'd proceed.

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September Quandary: Will a No-Suicide Contract Help My Client Stay Safe?

Four Clinicians Weigh In

Chris Lyford

A new clinician is working with a client who’s expressed some suicidality at times. She's worried about him and thinks it might be a good idea to have him sign a no-suicide contract, but she's heard mixed things about them and isn't sure what to do. Here, four therapists offer their advice.

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August Quandary: How Do I Get Clients to Engage in Work Between Sessions?

Five Clinicians Weigh In

Chris Lyford

By Chris Lyford - A therapist recommends exercises like journaling prompts and guided mediations that she feels would benefit her clients between sessions. Although they seem interested when she introduces the idea, they always “forget” or can’t find the time to follow through. She's unsure how to proceed. Here, five therapists share what they'd do.

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July Quandary: I’m Feeling Burned Out!

Five Clinicians Give Their Advice

Chris Lyford

By Chris Lyford - Recently, a therapist has found herself losing steam. She mentally checks out when clients are talking, and constantly feels exhausted. She worries this burnout could be affecting her work, and is looking for some good, realistic forms of self-care beyond just taking a vacation or going to the spa. Here, five therapists offer their advice.

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June Quandary: My Client Ghosted Me!

Five Clinicians Give Their Take

Chris Lyford

By Chris Lyford - Sara, 26, had been attending weekly therapy three months, and had developed concrete strategies with her therapist to help her manage her depression and anxiety. He thought they'd developed a strong bond, but Sara has missed her last two sessions. Her therapist texted her after the first missed session to ask if everything was okay, but still hasn’t heard anything. He keeps worrying he might've done something wrong. Should he reach out again? Here, five therapists weigh in.

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May Quandary: Is It Ever Okay to Break Confidentially If I Know My Client Is Dating an Abuser?

Five Clinicians Give Their Take

Chris Lyford

By Chris Lyford - Diedre was widowed about three years ago, but was excited to tell her therapist about a man she's started dating. She's very happy. As her therapist heard more, he realized this is the same man another client used to date, who slowly became controlling and abusive. Should Diedre's therapist share this info? Five therapists weigh in.

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April Quandary: My Teenage Client’s Parents Say He’s Depressed, But He Disagrees!

Five Clinicians Give Their Take

Chris Lyford

By Chris Lyford - Fourteen-year-old client Tyler’s parents brought him to therapy because they say he rarely engages with classmates or teachers, isn’t interested in extracurriculars, and heads straight to his room after school to play video games. They worry he’s depressed, but he’s mostly responsive in therapy and insists he’s happy. Here's how five therapists say they'd proceed.

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Let Us Know How YOU Would Tackle This Sticky Situation in Your Practice...

Psychotherapy Networker

Even the best therapists rely on advice from peers. In the spirit of building community, we're introducing Clinician's Quandary, a new forum where you can weigh in on how you'd handle a particular clinical quagmire. Here's this month's Quandary.

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March Quandary: My Client is Being Bullied and Her School Won’t Help!

Five Clinicians Give Their Take

Chris Lyford

By Chris Lyford - Raisa is a sophomore in high school, and tells her therapist that the girls in her class are bullying her with insults like “slut” and “whore.” Her mother has been in touch with her school, but administrators say there’s not much they can do. Raisa is incredibly distressed. Here's how five therapists say they'd proceed.

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