What to Do When Therapy Stalls

Bill Doherty on Handling the Issue of Progress Before it's a Crisis

Rich Simon

After seeing a client session after session, week after week, it's a good possibility that the therapy will come to a point where it feels like progress has stalled. It's not necessarily the fault of the therapist or the client, but it is a situation that isn't doing either of them any good. So what's to be done?

According to Bill Doherty, the solution is to address the therapy's progress before it becomes an issue. Don’t wait until you get bored, and don’t wait until drastic action seems to be the only option; act as soon as you sense that a client’s progress is leveling off or slipping backwards.

In this video clip, Bill talks about a proactive approach that can lead to positive developments when therapy starts to stall.


William Doherty, Ph.D., is a professor and director of the Citizen Professional Center at the University of Minnesota. He's the author or coauthor of 12 books on families and family therapy, including Take Back Your Marriage, Take Back Your Kids, and Family Therapy, with Susan McDaniel. This clip is taken from his session in our challenging cases video course:

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Topic: Professional Development | Challenging Clients & Treatment Populations

Tags: attachment disorder | attachment disorders | challenging clients | Clifton Mitchell | families | families and family therapy | family | family therapy | Janina Fisher | John Norcross | kids | relationships | stalled therapy | therapist | therapy | tough customers | William Doherty

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2 Comments

Thursday, April 10, 2014 5:40:18 PM | posted by CliffB
I found this video clip surprising. In my years of doing therapy and now life coaching, I've always planned "process" sessions in which we review the client's goals, look at ways the goals may have changed, and learn what he's feeling about me and our work together. In groups, this is even more important since participants are all forming projections about one another.

This does not change the basic "work" that I've been doing with a client. I need to hear their criticism and their projections, whose unraveling is always central to the problem that brought them to see me in the first place. (Yeah, I'm in part echoing Freud's comments on counter-transference, of course.)

Why in the world would you wait to do this until you feel stalled, assuming that it's not necessary if you think the client is benefiting? I often tell the client a week before that I'd like to take time for process at the next session. I've never had a client dispute its importance. They usually welcome the opportunity. On the other hand, it seems to feel threatening to a lot of therapists.

Of course, one's perspective toward this depends on whether you view your work as collaborative or follow the medical model.

Thursday, April 10, 2014 3:03:25 PM | posted by elliotf
Boy, this was almost completely non-helpful. Except for the suggestion that the therapist bring up the issue of non-progress at the beginning, all he's suggesting is that you ask the client to see if he/she feels they're stuck too. I would think much of the time this would be obvious to both.