Topic - Challenging Clients & Treatment Populations

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

Why Are Narcissists So Hard to Treat?

How and When to Push Back

Wendy Behary

By Wendy Behary - Narcissists are notoriously difficult clients. The key to working with them is being direct about the roiling emotions they trigger in us, and remembering that their self-aggrandizement almost always covers up painful longings for true connection, intimacy, and a sense that they’re "good enough."

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What Comedians Can Teach Us About Therapy

A Comic-Turned-Therapist's Guide to Dealing with Unruly Clients

Kirsten Lind Seal

By Kirsten Lind Seal - Before I became a therapist, I spent 20 years as a professional performer, during which time I was a regular at standup comedy clubs. Many of the skills I learned as a performer have proven readily transferable to therapy, namely the skill of using humor to defuse tension, create alliance, and challenge what we often call resistance in difficult clients.

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July Quandary: My Client Uses Me in Inappropriate Hypothetical Examples!

Six Clinicians Give Their Take on This Tricky Clinical Scenario

Chris Lyford

By Chris Lyford - A male client uses his therapist in hypothetical examples, which the therapist finds inappropriate. Recently, when they were discussing healthy dating habits, he said, “So if you and I went to a movie, would it be okay to hold your hand afterwards?” The therapist wants to bring it up in their next session but is unsure how to do so. Here's how six clinicians say they'd tackle the situation.

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Stop Treating Eating Disorders Like Just Bad Habits

How to Empower Clients to Heal with Parts Work

Lisa Ferentz

By Lisa Ferentz - It's unproductive to deal with an eating disorder as though it were simply a bad habit. Therapy has the greatest impact when I step away from the temptation to get into a power struggle and empower clients to do a large part of the healing work themselves.

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Learning to Let Go

Sometimes, Too Much Investment in a Client's Recovery Keeps Everyone Stuck

Daphne de Marneffe

By Daphne de Marneffe - After decades in practice, I still find myself blindsided by certain clients in ways that both humble and mystify me. I’ve learned that if I’m going to be helpful to these clients, I have to work through something difficult in myself. Our ability to inhabit our clients' experiences is part of what makes us good therapists, but there’s always a delicate balancing act in not getting too involved.

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Myths and Realities of the Asperger's Experience

Normalizing and Mobilizing Clients and Their Families

Richard Howlin

By Richard Howlin - Adults with Asperger's syndrome often behave as if they were confused actors walking onto a stage and being the only ones who don't know the lines or the plot. One of my initial goals in therapy is to help them realize the role their brain plays in their everyday practical and social understanding. Then, we embark on a step-by-step process of skill training, life planning, and helping clients integrate their unusual and obsessive talents into a productive life.

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When Victims Victimize Others

Using Empathy to Help Abusers Make Amends

Noel Larson

By Noel Larson - Throughout my career, countless people have asked me how I can work with clients who’ve committed sexual abuse, murdered their wives, or broken their children’s bones and spirits. My answer has always been the same: all I have to do is remember and feel in my heart the traumatized children my clients once were.

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The Hearing

A Therapist Shares Her Most Transformative Session

Kirsten Lind Seal

In our own small way, the Networker has tried to revive the ancient, tribal practice of storytelling. At our third annual Symposium storytelling event, Kirsten Lind Seal shared the story of her attempt to rescue an immigrant client in a desperate situation.

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The Art of Not Trying Too Hard

For Some Clients, Our Best Efforts Might Be Having the Opposite Effect

Steven Shapiro

By Steven Shapiro - What stands in the way of connecting effectively? Sometimes difficulty stems, paradoxically enough, from trying too hard! Many clients, even if they're highly motivated, have only limited tolerance for emotional connection, interpersonal closeness, and sympathetic concern. Here are three guidelines that may help you form a solid alliance with your hard-to-reach clients.

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Meeting Teen Clients Where They Are

Here's What They Respond To

Janet Sasson Edgette

By Janet Sasson Edgette - Most of us were never trained to talk to adolescents, and they often find most standard, shrink-wrapped attempts to "engage" them infuriating. Here's what they respond to best.

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