Topic - Challenging Clients & Treatment Populations

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

When Stagnation Sets In

Getting Off the Therapeutic Plateau

William Doherty

By William Doherty - Why do we get stuck in "Groundhog Day therapy"—cases in which we spin our wheels from session to session? Before lurching on to alternative treatment strategies, the key to progress is recognizing the need to shift the therapist–client relationship.

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The Resurgence of Patriarchy

Why We Need to Leave Neutrality Behind

Terry Real

By Terry Real - Factions of men and women these days are feeling a powerful pull toward many of the notions of traditional masculinity. What we’re witnessing is a reassertion of its most difficult and harmful traits. And yet we psychotherapists, as a field, have remained largely silent about this resurgence. Is neutrality in these times really in our clients’ best interests?

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August Quandary, Part Two: My Client Keeps Checking His Phone!

Five More Clinicians Give Their Take

Psychotherapy Networker

Our last Clinician’s Quandary received an overwhelming number of responses. Here are a few more that didn’t make it into Part One but offer other useful perspectives on addressing this tricky clinical scenario.

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August Quandary: My Client Keeps Checking His Phone During Sessions

Five Clinicians Give Their Take on This Tricky Clinical Scenario

Psychotherapy Networker

Jonathan is in his 30s and struggles with intimacy, which is why he came to therapy. Sometimes during sessions, he checks his phone for emails or updates, even though his therapist has asked him not to. She suspects Jonathan's phone use may be affecting his “real life” relationships, but he insists it’s not a problem. Here's how five therapists say they'd tackle the situation.

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VIDEO: What to Do When Your Client Cries

Making Tears Your Therapeutic Ally

Jay Efran

Many times, when clients cry, clinicians feel an urge to rush in and “fix things” that aren’t broken, which can actually make things worse. Watch as Jay Efran explains his strategy for working with a crying client.

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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

Psychotherapy Networker

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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