Topic - Challenging Clients & Treatment Populations

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

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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VIDEO: Ron Potter-Efron on Helping Clients with Anger Problems

"Building a Bridge" from the Old Brain to the New Brain

Ron Potter-Efron

Is it possible to overcome the typical oppositional response of a client with anger issues? According to Ron Potter-Efron, the key to working effectively with anger is first defusing reactivity by building a bridge from the response of the "old brain" to the "new brain." In this video clip, he explains how it’s done.

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Shoplifting: An Important (and Neglected) Clinical Issue

The Seven Types of People Who Shoplift and Why They Do It

Terrence Daryl Shulman

By Terrence Daryl Shulman - The American Society of Employers reports that 20 percent of every dollar earned by an American company is lost to employee theft, to the tune of $53 billion per year. Most shoplifters steal out of feelings of anger, loss, disempowerment, and entitlement, and many become addicted. So why is this an important—and neglected—issue for clinicians and others in the mental health fields?

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How to Engage an Angry Teen

A Paradoxical Approach to Creating a Therapeutic Alliance

Victor Shklyarevsky

By Victor Shklyarevsky - "Making nice" is doomed to failure when working with too many troubled teens who might otherwise be helped. From the very first moments of the initial session, our goal is to match the teens' negative intensity: to take what such rude and dismissive clients so readily dish out and give back the same. This kind of mirroring allows them to experience the therapist as someone who can meet them where they are emotionally.

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So Your Client Doesn't Want to Connect?

The Paradoxical Effect of Trying Too Hard

Steven Shapiro

By Steven Shapiro - What stands in the way of connecting effectively? I've found that the major difficulty stems, paradoxically enough, from trying too hard. Even if they're highly motivated to get into therapy, many clients 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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The Case for Alcoholics Anonymous

What Attendees Want You to Know

Mark Schenker

By Mark Schenker - Several features of AA make it ideal as an adjunct to therapy. No therapist alone can provide the kind of group support that AA makes available 24 hours a day. The process of change that occurs in AA can open up a tremendous amount of relevant clinical material, and the clinician, when properly oriented, can help resolve roadblocks and resistance that the patient encounters in pursuit of recovery.

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Diagnosing and Treating Subtle Bipolar II

A Perspective on "Depression Plus"

James Phelps

By James Phelps - Treatment for bipolar disorders used to focus on medication, but like many other mood specialists, I’ve found that most clients don’t get the help they need with medication alone, or even with established therapy approaches in combination with medication. Instead, a combination of new, lesser-known therapies plus medications has been shown to produce substantial gains in mood stabilization and daily functioning.

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On the Front Lines of Crisis Work

What Keeps a Clinician Going in High-Stakes Therapy?

Gary Weinstein

By Gary Weinstein - I've been doing crisis work for nearly 30 years. I've confronted a number of forks in my professional road, opportunities to take a less demanding route. But I've chosen to continue on this path, accompanying others who've been suddenly, often brutally, cast out of life's safety zones. The reasons I stay aren't simple, and they continue to shift and surprise me.

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