One of the more difficult experiences as a therapist is watching your clients struggle. Clients come to us because they want things to be different– they are striving for change. Struggle is a part of the process for most, though when change eludes our folks it can be hard for you as well.
Unfortunately, some training programs and approaches expect for steady and sometimes even quick change. This can set us up to believe that if progress isn’t constantly being made, something is wrong. We worry our approach is wrong or maybe even we are the wrong therapist for them.
When change isn’t happening for clients, there are some important things to consider before you jump to suggesting a transfer.
Your Goals are Not Your Client’s Goals
A client-centered approach to therapy is often the best, however, sometimes this only applies to a written treatment plan and not necessarily the one we envision in our head. As you work with clients, it is natural to start identifying goals for them.
Common goals include decreasing intrusive symptoms, increasing functioning, making friends, being successful, and reaching all the goals WE find to be important. This may sound a little ridiculous as you read it, but you are only human and this type of thinking is likely to happen.
As a human you have your own goals and values. Sometimes we assume that others have similar ones. This isn’t always the case.
If you feel like your client isn’t making the progress you feel they “should” be, this can be a helpful place to begin to reflect. Explore whether the goals you feel your client isn’t making progress toward are actually their goals.
If the goal is theirs, it can be helpful to revisit what is important to them. Treatment plans aren’t written in stone and can always be updated.
If the goal is one of theirs, you can address this with them. Lack of progress isn’t a secret. Addressing this openly and honestly in sessions can make a huge difference. This can allow your client to process what is standing in their way and make a more realistic plan to overcome and continue their growth.
Change Looks Different for Everyone
Making changes looks different for everyone. We may have preconceived notions of what growth and recovery look like. If a client’s process doesn’t look like we expect, we may worry that they aren’t responding well to therapy. This isn’t always the case.
Change is difficult. It can be hard to admit that things aren’t as you’d like and even harder to take steps to make things different. This difficulty can make the process complicated for clients.
We know that change looks different for everyone, though sometimes we have to remind ourselves of this.
Much like I mentioned above, talking about this in sessions can help. Asking clients what change looks like for them can be productive. We set goals, though we don’t always dig deeper and ask what that means or what it would look like.
You remember the magic wand question, right? Most of us learn all about this in school, so much so it feels cliché to use in actual practice. I like to ask clients if they woke up tomorrow and their anxiety was gone, how would they know?
Of course, “anxiety” can be changed to fit what your client is facing. This approach can be really eye opening. Give it a try and see what happens!
The Downside to Solution Focused Thinking
Solution-Focused Therapy can be remarkable and it can also cause some complications. Not all problems, diagnoses, or challenges respond to this approach.
Focusing too much on solutions can leave clients feeling unheard. When we feel unheard we can dig in deeper, defending our right to feel a certain way or to convince others things are as bad as we say. This can also make any solution sound impossible no matter how helpful it may be.
Focusing too much on solutions can derail progress in treatment. This doesn’t mean we should avoid solution-focused treatment altogether, it simply means we may need to try something different if this is impacting progress.
I am willing to bet that you are skilled in validation, so try out some of those skills and back off of solutions if you think this may be part of the problem.
To Sum It Up
If your clients aren’t making the progress you feel they should be, it doesn’t mean you are “doing it wrong.” If you tend to be a bit hard on yourself, that may be your first thought. Take a step back and get curious.
Explore whether treatment is geared toward your client’s real goals. Take a look at whether you have a singular view of what change would look like and take stock of whether there is a balance with solution-focused approaches.
There are, of course, times that we are not the right therapist for our clients, and that is also okay. No one can be the right fit for everyone– that isn’t possible. Though this does not have to be your first conclusion you jump to.
In many cases, discussing a lack of progress honestly with your clients can yield amazing results. This can also build trust with your clients and spur on change. Don’t be afraid to be honest in a direct and supportive way.
Practice what you preach, my therapist friend. See you next time.
*If you are interested in becoming an independent contractor with CCS and you are a licensed therapist in North Carolina, send your cover letter and resume to the following email: Applicants@CarolinaCounselingServices.com
