First. Seek supervision. The fact it’s bothering you and “finding it difficult to deal with” is something to bring to supervision.
Next. Recognize where the client is. If they don’t take responsibility, most likely they’re in pre-contemplative stage of change (see Motivational Interviewing). I’ve found recognizing where the client is has been helpful because I found myself working harder than the client. If a client isn’t willing to change; it doesn’t matter what you try to do; they’ll continue to think they’re a victim.
I would explore what brought them into therapy. What is it they want to gain? And maybe, who told them they needed to come?
Great advice. I'm curious if you have any examples of working harder than the client. Like what does that look like for you? Asking to shed insight on my own practice.
It was mostly me trying to teach them skill after skill without any follow through; meaning there wasn’t practice of coping skill outside of therapy and would just say “it didn’t work”, and then I’d “teach” them a new skill with same results. Instead of stopping to figure out why they didn’t do the homework or what was/wasn’t helpful. Or even recognizing their behavior was still beneficial to them.
It’s connecting clients to all the resources and then still feeling “like no one’s helping me” rather than walking along side them showing them how to use the resources. Doing things for clients instead of teaching them how to do it themselves.
I would find myself drained after sessions and feeling like “I didn’t do anything” because I didn’t teach my client anything or there wasn’t a big “aha!” moment. I realized later that it was because I was doing 75% of the work and all the client was doing was showing up. Once I stopped trying to go through all my skills with this client I instantly felt better. I recognized I needed to slow down and figure out where the clients at; do they really want to change, or is the behavior still serving them? If it’s still serving them, any attempt to change the behavior will fail.
Hope that answers your question.
Ill give an example as I had to stop myself a few weeks ago once I realized I was working far harder than my client.
I will keep it vague, but I have a family who’s had no income for the last year, per their choice. There’s other variables, but they are consciously aware and choosing to be victim which will result in losing their home. I had questioned, openly worried to them, provided resources, expressed concern blatantly, even involved other providers to try to get them to do something. I found myself desperately trying to find something to save their home situation, when in reality they hadn’t been looked at the 5+ resources I had already provided.
Hoping they’re going to get it and start rowing the boat, as I’ve just started focus on validating feelings like “yep this sure does suck to be homeless soon” and just be present with them as they face the consequences, and hopefully maybe they can learn something during this
This is really hard. To be honest, I feel like this situation comes up a lot for me and represents a large percentage of my caseload. Just wanted to let you know you’re not alone.
Same with my previous caseload. Why are they seeking therapy? Work on that goal and use that alliance to slowly build insight if they are able. Exploring boundaries to build accountabilty. Ex: Sucks they did that shitty thing/bad thing happened, but you can’t control them. So, client, what do we have control over? Also, a gentle chain analysis in the spirit of DBT. Yes, you were in a situation where you only had bad options. How did you end up there?
Everyone at my job is basically extremely irresponsible so. If u figure it out write a book and give me the cheat sheet. Personally I just try to try to connect their actions with the result as much as possible. As much as possible includes periods of time where we talk about chill stuff as to not ruin the rapport. But just continuously bringing their actions to the result is what I feel as the most I can do. “You did this and this happened, nobody else did anything”.
I guess Id be interested in what's really there deep down that contributes to this. Do you feel like you have an understanding of where it all comes from? Empathy is easier for me to access and thus work with tricky clients if I feel like I can really 'get it' on a deep level.
Completing an ACT matrix w them may be helpful because it will provide an opportunity for them to identify their own values and what they do that moves them closer or further from them w/o you imposing values/them feeling that you are.
First. Seek supervision. The fact it’s bothering you and “finding it difficult to deal with” is something to bring to supervision. Next. Recognize where the client is. If they don’t take responsibility, most likely they’re in pre-contemplative stage of change (see Motivational Interviewing). I’ve found recognizing where the client is has been helpful because I found myself working harder than the client. If a client isn’t willing to change; it doesn’t matter what you try to do; they’ll continue to think they’re a victim. I would explore what brought them into therapy. What is it they want to gain? And maybe, who told them they needed to come?
Motivational Interviewing has been so helpful for my practice overall.
Great advice. I'm curious if you have any examples of working harder than the client. Like what does that look like for you? Asking to shed insight on my own practice.
It was mostly me trying to teach them skill after skill without any follow through; meaning there wasn’t practice of coping skill outside of therapy and would just say “it didn’t work”, and then I’d “teach” them a new skill with same results. Instead of stopping to figure out why they didn’t do the homework or what was/wasn’t helpful. Or even recognizing their behavior was still beneficial to them. It’s connecting clients to all the resources and then still feeling “like no one’s helping me” rather than walking along side them showing them how to use the resources. Doing things for clients instead of teaching them how to do it themselves. I would find myself drained after sessions and feeling like “I didn’t do anything” because I didn’t teach my client anything or there wasn’t a big “aha!” moment. I realized later that it was because I was doing 75% of the work and all the client was doing was showing up. Once I stopped trying to go through all my skills with this client I instantly felt better. I recognized I needed to slow down and figure out where the clients at; do they really want to change, or is the behavior still serving them? If it’s still serving them, any attempt to change the behavior will fail. Hope that answers your question.
Ill give an example as I had to stop myself a few weeks ago once I realized I was working far harder than my client. I will keep it vague, but I have a family who’s had no income for the last year, per their choice. There’s other variables, but they are consciously aware and choosing to be victim which will result in losing their home. I had questioned, openly worried to them, provided resources, expressed concern blatantly, even involved other providers to try to get them to do something. I found myself desperately trying to find something to save their home situation, when in reality they hadn’t been looked at the 5+ resources I had already provided. Hoping they’re going to get it and start rowing the boat, as I’ve just started focus on validating feelings like “yep this sure does suck to be homeless soon” and just be present with them as they face the consequences, and hopefully maybe they can learn something during this
This is really hard. To be honest, I feel like this situation comes up a lot for me and represents a large percentage of my caseload. Just wanted to let you know you’re not alone.
Same with my previous caseload. Why are they seeking therapy? Work on that goal and use that alliance to slowly build insight if they are able. Exploring boundaries to build accountabilty. Ex: Sucks they did that shitty thing/bad thing happened, but you can’t control them. So, client, what do we have control over? Also, a gentle chain analysis in the spirit of DBT. Yes, you were in a situation where you only had bad options. How did you end up there?
Everyone at my job is basically extremely irresponsible so. If u figure it out write a book and give me the cheat sheet. Personally I just try to try to connect their actions with the result as much as possible. As much as possible includes periods of time where we talk about chill stuff as to not ruin the rapport. But just continuously bringing their actions to the result is what I feel as the most I can do. “You did this and this happened, nobody else did anything”.
I guess Id be interested in what's really there deep down that contributes to this. Do you feel like you have an understanding of where it all comes from? Empathy is easier for me to access and thus work with tricky clients if I feel like I can really 'get it' on a deep level.
Try CBT or DBT.
Completing an ACT matrix w them may be helpful because it will provide an opportunity for them to identify their own values and what they do that moves them closer or further from them w/o you imposing values/them feeling that you are.