Common Concerns

1
Common Concerns

• Focus Questions - Groups of 3
• How can you avoid bringing home the problems of
  clients?
• What client behaviors do you think will be
  problematic?
• How do you view resistance in the helping
  relationship?

2
Exploring Your Own Self-Doubts and Fears as a
Helper

• Complete T-F survey on page 101.
• Do You see a pattern of concern?
• Begin to challenge your assumptions!!!

3
Transference Countertransference

• Transference -
• Essential to understand where the client
  behavior or reaction is coming from.
• Cannot take it personal!! (Stand In)
• Most client feelings / reactions to helper
  result from past issues, biases, relationships,
  assumptions.
• Examples -
• Super person - see you as perfect all-knowing.
• Replacement - of father, mother, spouse. Can be
  positive or negative.

4
Transference Contd

• Unrealistic Demands - frequently call between
  sessions. Run over allotted time. Expect not to
  be challenged.
• No Boundaries - similar to above. Try to
  befriend helper. May develop an attraction
  toward helper.
• Displaced Anger - Taking out frustration on
• helper. CAUTION - Sometimes client really is
  mad a helper!!
• What to do -
• Gain insight to why. Check your own emotions.
• When appropriate, disclose the issue to the
  client.
• Keep it positive!! Chance for client to have
  deeper understanding.

5
Countertransference

• It will happen - trick is knowing how to manage
  it.
• Are you taking it personal??
• Is it your issue or the clients issue?
• Are you working with the person across from you??
• Some subtle signs -
• Encourage client dependency
• Overprotective
• Avoid certain topics
• Lecture or debate with client
• Want to solve problem for client
• Become extremely irritated with certain clients.

6
Dealing With Difficult Clients

• Attitude Questionnaire
• Pg. 110
• Notice any perceptions about resistance in your
  responses??

7
Resistance From A Client

• Points To Ponder -
• Natural part of therapeutic process.
• Not all resistance is bad!! (common coping
  mechanism for some / self preservation / survival
  during crisis).
• Learn to respect client resistance and
  understand its meaning.
• Look at resistance as a coping strategy that has
  outlived its purpose!!
• It is important to practice patience and monitor
  your reactions toward client.
• Avoid using resistant word with client -
  (scared, over whelmed, cautious).

8
Common Forms Of Resistance

• Client / helper incompatibility
• Personality conflict
• Helper moralistic attitude toward client
• Out of comfort zone
• Secondary gain (Complainer vs. client for change)
• Feelings of hopelessness
• Chance of failure / disapproval
• Fear of success / expectations

9
Types Of Difficult Clients

• Involuntary clients - court ordered, intervention
• May lack motivation, reason to change.
• Setting stipulations on use of time and
  exploring resistance with client is acceptable.
• Withdrawn clients - say very little, use sarcasm
  as a defense mechanism.
• Silence has a meaning. Open questioning is
  important skill.
• The Talker - Gets lost telling stories.
• May be attempting to keep helper off balance.
• Work to clarify and focus on one or two issues.
  Focus questions are important.

10
Types contd

• Overwhelmed client - Endless number of problems.
  Seem to thrive on it!!
• Get client to focus on most pressing issue.
• The exception client - Ready with the yes but
  response.
• Know when your working harder than the client -
  have client reevaluate wht he/she wants from
  therapy.
• The Blamer - Portrays the victim or martyr role.
• Help client gain insight over what he/she
  controls.
• Challenge irrational thoughts - utilize
  reframing.

11
Types contd

• Dependent client - Escape from change by making
  you responsible for them.
• No choice is better than wrong choice.
• What is your role in fostering or maintaining
  the dependence?
• Passive-aggressive client - Very evasive, use
  sarcasm, hostility, non-verbal behaviors to avoid
  change.
• Make client aware of his/her behavior - how it
  is affecting you. Have them explain what it
  means.
• The Intellectual - Evade feelings by thinking
  outside themselves or in third person. Can
  theorize in abstract terms. (Think Green
  personality).
• Have patience!!!

12
Dealing Effectively With Resistance Difficult
Clients

• Some guidelines
• Be respectful.
• Avoid sarcasm.
• Encourage exploration.
• Do not judge client.
• Be sensitive to cultural differences.
• Monitor your countertransference.
• Do not take things personal.