Topic - Challenging Clients & Treatment Populations

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We've gathered Psychotherapy Networkers most popular posts and arranged them here by topic.

The Trigger Warning Controversy

Are We Promoting a Culture of Avoidance?

Chris Lyford

By Chris Lyford - According to some critics, an overly protective approach to presenting college course materials deemed too triggering—in books, lessons, and lectures—could soon be coming to a university near you. Are they a boon to student mental health, or just promoting a culture of avoidance?

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Breaking Through Therapeutic Gridlock

How to Respond When Clients Resist Your Advice

Jay Lappin

By Jay Lappin - As therapists, we need to be open to feedback, even criticism, as a means of deepening the therapeutic relationship. Establishing trust by moving beyond the reflex action of offering a solution and creating a context in which the possibility for transformation is greater than the pull of old patterns is hard work both for clients and for therapists.

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The Silver Lining in Failure

Not Every Teachable Moment Has to Be a Successful One

Cloe Madanes

By Cloe Madanes - The problem with a failure is that one doesn't really understand why one failed. If one did, it wouldn't have been a failure. But I'm not giving up on my toughest client, Bob. There's one strategy I still haven't used.

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The Liberating Power of Honesty

What People Don't Know Can Hurt Them. What They Don't Reveal Can Hurt Even More

Frank Pittman

By Frank Pittman - When we therapists believe a secret's revelations would be dangerous, the client receives a frightening message about him- or herself and about the world. We may accept our patients and make psychodynamic, systemic or sociological excuses for them, while still conveying that their secret is unacceptable. Thus, while explicitly "supporting" them, we implicitly undermine their sense that they are fundamentally decent, acceptable people.

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Therapy in Post-Harvey Houston

What Takes to Do Psychological First Aid Well

Chris Lyford

By Chris Lyford - Disaster work is anything but therapy as usual. In the aftermath of August's Hurricane Harvey, clinicians at ground zero explain why the medical model of traditional therapy as most know it becomes irrelevant, and the simple but important components of effective psychological first aid.

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The Perils of Paying Too Much Attention

A Guide for Attending to Clients Without Getting Burned Out

Christine Caldwell

By Christine Caldwell - We've all experienced what happens when get tied up in our clients' knotted lives. But how do we attune to our clients' experiences and not get knotted up ourselves? In essence, self-care becomes more than just taking enough time off, balancing our practice, and getting good supervision. It involves getting our bodies back.

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When Therapy Takes a Personal Toll

A Therapist Working with Abusers Reaches a Crossroads

Michelle Cacho-Negrette

By Michelle Cacho-Negrette - I made my first appointment with Gloria one autumn afternoon. I needed a still point, a peaceful promontory in the ocean of loud, unrepentant excuses I heard daily from the men I treated in a batterer-intervention program, men who committed unspeakable violence against those they claimed to love.

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The Case for the Older Therapist

Five Therapeutic Lessons That Only Come with Age and Practice

Walter Lowe

By Walter Lowe - Time and practice, practice, practice count as much or more than formal instruction in becoming an expert at therapy or just about anything else—medicine, law, carpentry, fire-fighting, or violin-playing. The longer you've been at it, the more deeply knowledgeable and skilled at the work you're likely to be.

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How to Develop a Safety Plan with Suicidal Clients

A Process of Inquiry That Promotes Empathic Connection

Douglas Flemons

By Douglas Flemons - Suicide assessment is a high-stakes process infused with uncertainty. However, even the best scales can be unreliable when they’re completed in the midst of an emotional crisis. Rather than outsourcing your decision-making to an instrument, it's important that therapists learn how to conduct a conversational evaluation that builds on their therapeutic skills.

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Coping and Learning After a Client's Suicide

A Therapist Reflects on What He Might Have Done Differently

Frank Pittman

By Frank Pittman - I've been in full-time private practice for almost 30 years. In that time, three patients in my practice killed themselves. Each suicide has left me shell-shocked and questioning my therapeutic attitudes and methods. I did not expect Adam to be one of my casualties.

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