When you’re working with clients, how do you know when you are stuck? What is your first reaction when you realize you are stuck? What do you do?
The answer to these three questions should NOT be attributed to your client. When stuck, there are four areas about you and your therapy process to examine: theory, attitude, process, and outcome.
Theory. First, examine if your theory about therapy is creating a positive change barrier. If you are more focused on your theory than your client, you are probably not listening well and looking to prove your theory.
Attitude. Is your attitude pathologically or strength based? A pathological attitude can understandably create resistance from clients. An outcome of pathological attitude can be historical intimidation, which can overwhelm you as a therapist. In these situations, ask yourself what is triggering this negative attitude towards your client(s). Then, try to engage in a session devoted to assessing strengths, resilience, and includes future-oriented talk. If you are challenged by historical intimidation and cannot engage in future talk, consider at least peer consultation. Often, therapists claim clients will not engage in strength-based talk. Simply, that’s blaming the client for your stuckness.
Process. Are you spending too much or too little time in process talk? It is also possible that your process talk is not what the client wants processed. The outcome of this dynamic is clients not feeling heard, or feeling hopeless because of little change. If process is a stuck point, then monitor and evaluate your in-session talking points. Process talk is oriented towards feelings, history, and thoughts about the presented problem.
Outcome. Outcome talk is oriented toward actions, change, and tasks. Too much or too little outcome talk can lead to clients not feeling heard or not gaining positive therapy momentum. It is possible that outcome talk is missing the target and clients will be understandably confused or resistant.
As you can see, before labeling clients as resistant or unmotivated, there are many steps to take.
- Asses if your theory or attitudes towards your client(s) are barriers
- Assess if you are too focused on process or outcome in therapy
- Continuously monitor your internal processes and external actions to evaluate what heightens client receptivity
- Use this matrix/flow chart as a reminder (click to enlarge)
A healthy therapist should possess excellent insight about their own contributions to a stuck therapy situation. As you learn what increases receptivity, do more of it and you will experience fewer stuck cases.
Tracy Todd, Executive Director