Topic - Challenging Clients & Treatment Populations

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

When Your Client Won't Commit to Change

How to Accept Opposition and Still Get Results

David Johnson

By David Johnson - In my several decades of practice, one skill that’s served me well in this field is my ability to leave work at the office. But every once in a while, I see clients whose situation intrigues, moves, or confounds me in a way that keeps them in my thoughts in between sessions, even if I’m often not sure what it is about them that continues to haunt me. Such was the case with Matthew.

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What to Say When Clients Push Your Buttons

How to Spot, Confront, and Correct Self-Defeating Patterns

Wendy Behary

By Wendy Behary - There are ways to deliver profoundly effective, on-the-spot responses during difficult encounters—ways that can mobilize you and restore the receptive, flexible, and empathically attuned you. I've chosen a small sample of a long list of examples that colleagues and trainees have shared with me over the years, including my own personal favorites.

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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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My Nightmare Client, My Greatest Gift

Sometimes Our "Worst" Clients Are Our Best Teachers

Martha Straus

By Martha Straus - My young client, Brian, can reduce even confident mid-life adults to an infantile puddle, one provocative comment at a time. He's a therapist's nightmare. But he’s also the universe's gift to me. He measures my commitment to the work, to him, to my ideas about therapy, to my best self.

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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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