What to do When Therapy Clients Don't Improve

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  • เผยแพร่เมื่อ 12 ม.ค. 2025

ความคิดเห็น • 55

  • @keyrosellc
    @keyrosellc 3 ปีที่แล้ว +63

    I also like to provide these clients with a blurb similar to “therapy like everything else we do, there’s a beginning, middle, and end…where do you feel you are in the process?”

    • @PrivatePracticeSkills
      @PrivatePracticeSkills  3 ปีที่แล้ว +1

      I love that tip!

    • @temmyvdh
      @temmyvdh 2 ปีที่แล้ว

      -5

    • @andrewcooper9339
      @andrewcooper9339 2 ปีที่แล้ว +2

      but what if there is no "end" what if they need more of a continuous solution

    • @jefesalsero
      @jefesalsero ปีที่แล้ว

      ​@@andrewcooper9339Many clients with severe mental illness fit this description. They often receive services from a local community behavioral health agency where the focus is on supportive therapy interventions.

    • @lpellum8809
      @lpellum8809 11 หลายเดือนก่อน

      @@andrewcooper9339 then they are NOT using the interaction as therapy but as a "paid friendship".

  • @Enchanteralle
    @Enchanteralle 3 ปีที่แล้ว +20

    What a great topic! All therapists have experienced this before. In the beginning of my career, I get so fixated on judging myself and questioning my capability. But fast forward a decade later, I've come to accept that there will always be clients who don't progress at the pace we want or they are either resistant or maybe not a good match for the reasons you mentioned. I am better at telling myself that I shouldn't work harder than the client. I have clients who might not understand what their role is in therapy and they just sit back and expect me to pull out interventions and hw out of the hat every time, but they come back telling me they don't think it works, it's not effective, or just simply not do them at all. I currently have one who I'm seeing for a couple sessions and it already feels a bit off because she repeatedly tells me nothing works and I'm implementing motivational interviewing, but let's see where it goes. If all else fails, I'm sure some other therapist can maybe make a break through with her. Thanks for sharing!

    • @cjmarren86
      @cjmarren86 ปีที่แล้ว

      ​@@shahilagh Why do you feel the therapist above is narcissistic?

    • @lamentate07
      @lamentate07 ปีที่แล้ว

      What is the client's role in therapy? And how would they know if they haven't been told? I think that is very presumptuous. Some of us are very motivated, take notes in between sessions etc, but it still doesn't work.
      The simple fact is that therapy has a relatively high failure rate.

  • @hunnybSue
    @hunnybSue หลายเดือนก่อน

    I was told by my last therapist that out of all her clients I was making very slow progress, and I was a very difficult client to work with. It really upset me hearing this. I have self esteem issues and this didn't help. I have always struggled to open up this made things so much worse. I started to feel that my sessions were coming to an end. I lasted another 6 months and I finally sent a text saying I felt I wasn't making any progress. I feel like I weight has been lifted.

  • @psichologelina
    @psichologelina 3 ปีที่แล้ว +9

    As F.Perls says, the dead end is before something important: you may not get out of it (the client may not be prepared or able to do it), or you may experience transformation.

  • @Malin0908
    @Malin0908 หลายเดือนก่อน

    Some people might never be able do change. But some people is in so much pain and frustration that having someone steady and stable listening and help them explore their feelings and toughts in a safe place with someone, keeps them alive. After being in therapy since I was very young, I do see some improvements in my life, but that is because I feel I have some support that I know is there, this makes me feel more stable. Not everyone can rely only on themselves due to things they have experienced by multiple people troughout their childhood. I wish therapist saw the value in just being that person for someone. Who was safe.

  • @rachelh-j5006
    @rachelh-j5006 3 ปีที่แล้ว +8

    I think where I've struggled is how to let the client know they are out of my scope of practice (or, that they do not fit my niche) in that initial phone call. Appreciate the encouragement to "go with my gut". I def feel it in the first sessh. Thanks, I feel more empowered to be authentic with my clients, and to figure out what is the best option for them in their journeys at the get-go.

  • @Rebeccabecc
    @Rebeccabecc 3 หลายเดือนก่อน +1

    I feel like the worst thing you can do is blame the client when expressing themselves when they've never had a voice, by saying your not improving,because your not showing on paper progress emotionally but take into account new traumas, maybe need a different style or understanding but if you notice signs of distress something is going on with this person whether its new trauma new understanding, misunderstanding situations.

  • @healingasmr4986
    @healingasmr4986 3 ปีที่แล้ว +3

    Something that needs to be mentioned and it happens more than we would like to admit is that therapists DO ghost their clients and that is unprofessional and cold. If a therapist doesn’t think they’re a good fit for their client, they should try to talk to them and send them to someone who might be a better fit. I see too much ghosting nowadays.

  • @teddybotana001
    @teddybotana001 3 ปีที่แล้ว +7

    I definetly see some of my kiddos regress in progress. Naturally I think it's my fault as a therapist but there really is a lot more going on then just my impact. Loved the video!

    • @PrivatePracticeSkills
      @PrivatePracticeSkills  3 ปีที่แล้ว +3

      That's such a good point! Sometimes regression is part of the process (for adults too! 😉)

  • @beverlyondera9558
    @beverlyondera9558 3 ปีที่แล้ว +1

    Thank you, it’s so nice to hear you describe the conversation needed. I appreciate you.

  • @esjoc
    @esjoc 3 ปีที่แล้ว +2

    Thank youuu so much I’m not a therapist yet but I know this will help me so much when I start. I’m barely a year in 😅

  • @wealthyasamindframe1946
    @wealthyasamindframe1946 3 ปีที่แล้ว +10

    Some clients come to therapy and often have unrealistic expectations and culturally the stigma of therapy affects the client's perspective. I also noticed the particarly therapy plateau with borderline clients who burn through therapist.

    • @radivojevasiljevic3145
      @radivojevasiljevic3145 ปีที่แล้ว

      Most of "unrealistic expectations" come from therapists. In most cases therapy is wonderful, life transforming and all good jazz, and the only important question is: a) finding "right" therapist; b) doing hard work (hard, not smart or productive).

  • @alfrednewman2234
    @alfrednewman2234 ปีที่แล้ว +4

    When clients don't improve, that's called job security. Just ask my neighbor, 30 yrs, same therapist.

    • @TheJ0k0r50
      @TheJ0k0r50 10 หลายเดือนก่อน +1

      Are you implying a therapist forces a client to stay? Maybe your neighbor has found the relationship with their therapist to be helpful for 30 years. What you would do in that situation might be different than what your neighbor feels like they need

  • @efiorkopoulou500
    @efiorkopoulou500 8 หลายเดือนก่อน

    Thank you for normalizing that. That was incredibly helpful and validating!! 😊

  • @enatp6448
    @enatp6448 2 ปีที่แล้ว

    One of my fav videos. Very helpful right now in particular!

  • @Ry-iz9bc
    @Ry-iz9bc 2 ปีที่แล้ว

    A friend of mine shared an experience of seeing a counselor and was traumatized from the session and reached out to the counselor for help and did not get any assistance and has since struggled with depression.

    • @cakesinthecity
      @cakesinthecity ปีที่แล้ว +2

      Are you open to sharing more details? I’m curious how they were traumatized? I understand if not though.

  • @baja1988_Texas
    @baja1988_Texas 6 หลายเดือนก่อน

    As Rick Dees used to say, "Call back when you're feeling better."

  • @jessman8597
    @jessman8597 9 หลายเดือนก่อน

    I'm just a client, so my opinion may not count. But don't terminate before you talk to the client first. I had a therapist terminate because I wasn't making progress. But I finally felt like I was on a roll. My wife just told me she finally had her husband back. It was awesome for me to see my goals being accomplished. Then my therapist terminated because it was "unethical" to continue seeing me since I wasn't making enough progress. I didn't just lose confidence in her, but I no longer trust therapists in general.
    Termination may mean the client may never seek help with anyone because you broke their trust with any therapist.

  • @stringedassassin
    @stringedassassin 3 หลายเดือนก่อน

    I'm finding that there are more shady therapists than I ever thought.

  • @justinjohnson9627
    @justinjohnson9627 3 ปีที่แล้ว +5

    Mine get better, but then don't seem to have the confidence to move on without seeing me anymore.

    • @lpellum8809
      @lpellum8809 11 หลายเดือนก่อน

      sometimes adult children are very competent earners but as adults they still live at home with their parents..... why is that?

  • @cheshtaarora6499
    @cheshtaarora6499 ปีที่แล้ว

    Hi.. I love your videos… Pls make a video on how you keep records for your clients…

  • @shawncrawford1777
    @shawncrawford1777 3 ปีที่แล้ว +5

    I recommend that therapists incorporate formal Feedback Informed Treatment methodology into their practice if they’re truly interested in responding to concerns about lack of client progress. The easy way out is to blame the client in one way or another. The more challenging and ultimately productive way is to own some responsibility as a therapist by asking questions about what we’re not delivering that would be more helpful and investigating the client’s experience of what may be lacking or they feel impedes progress. This requires us to shift from focusing on applying techniques to doing a deeper and more purposeful listening (aided by incorporating brief session and progress assessment tools). I feel a cogent question is something like “how is it that I’m not being the ideal therapist for this specific client at this particular point in time?” They’re paying and trusting me- I’m beholden to hold some responsibility. And BTW, I don't disagree with anything you've said here Marie - you have lots of good tips!

    • @radivojevasiljevic3145
      @radivojevasiljevic3145 ปีที่แล้ว

      @@shahilaghtherapy is not like any other business. There is no responsibility ad accountability in therapy. Resistance, secondary gains, "personality organization", list of therapists' excuses is endless. And what is their response? "Nobody forced you to come". That applies to food and all kinds of electronic gadgets and still there are regulation instead "free market".

    • @radivojevasiljevic3145
      @radivojevasiljevic3145 ปีที่แล้ว

      @@shahilagh therapists can have very successful career while not being successful therapists. You can find a lot excuses in professional literature (both books and journal papers) in form of all kinds of pseudoscientific writings, or to be blunt, psycho fantasy.
      Why next to zero therapists accept "pay for results" model or at least "money back" (with compensation for lost time of course)? Maybe because significant number (majority?) wouldn't survive financially under such "harsh conditions" having to actually deliver results? Instead, they can provide their grandiose egos as transitional objects or whatever nonsense one picks.
      Some people have even less pleasant description of therapists and what they really provide.

    • @shahilagh
      @shahilagh ปีที่แล้ว

      @@radivojevasiljevic3145 i wouldn’t go too far to ask for results because performance in anything between two ppl depends on both ppl….. but what I see in some ppl is far from taking responsibility

    • @shahilagh
      @shahilagh ปีที่แล้ว

      @@radivojevasiljevic3145 i wouldn’t go too far to ask for results because performance in anything between two ppl depends on both ppl….. but what I see in some ppl is far from taking responsibility

  • @magdaliny62
    @magdaliny62 2 ปีที่แล้ว

    Great video!! Very helpful!

  • @Halveig
    @Halveig 2 ปีที่แล้ว +1

    Hi, I subscribed to get a free guide to start private practise, but still haven't get anything.

  • @artnelson3360
    @artnelson3360 3 ปีที่แล้ว +1

    Do you think Telehealth created some of the ‘getting comfy’ dynamic?
    Part of it is human nature, of course. Just like pendulation is necessary when working through trauma, it also seems to be necessary in general as therapy progresses.

    • @ellenblasi3118
      @ellenblasi3118 2 ปีที่แล้ว +1

      As a client I have decided that teletherapy is inferior to face to face therapy. The past two years have felt stagnant and has brought on depression because of isolation. The need for human connection is vital.

  • @jaybirdful
    @jaybirdful ปีที่แล้ว

    Having difficulty motivating clients to gaining employment or momentum toward this goal. All other things go excellent…depression, anxiety etc, I’m adept at improving but can someone tell me a way to motivate clients as to getting work ? 🙏🏻 Any ideas sincerely appreciated

  • @Winngee
    @Winngee 2 ปีที่แล้ว +3

    Some clients do not progress . Some clients don’t even have goals . Some clients are in their depression as baseline . In reality , it takes real strength. They have to want change. Therapists are not to magically make problems disappear I can’t stand this misconception.

    • @colbyboucher6391
      @colbyboucher6391 11 หลายเดือนก่อน

      K, not paying you then.

    • @Winngee
      @Winngee 11 หลายเดือนก่อน

      @@colbyboucher6391 They pay before the appointment. Their progress is up to them. Their choice . We give the tools and they gotta use it.

  • @Ionut-lm9cj
    @Ionut-lm9cj ปีที่แล้ว

    Abcd

  • @liam.4454
    @liam.4454 ปีที่แล้ว

    I must admit I found therapy to do more harm than good, therapists can be toxic as they have big egos and won't help or pass onto a better therapist
    With this woman you can see she isn't straightforward and a she's a bit manipulative because she won't tell the client at the beginning that she's not comfortable with them,

    • @lamentate07
      @lamentate07 ปีที่แล้ว

      I had a similar experience and reported my therapist to the board. If they are dragging sessions out and taking your money without delivering, just report them.

    • @glory8065
      @glory8065 5 หลายเดือนก่อน

      Why would she tell the client that on the first meeting? Therapy is about the client not them. Also, it takes months for both of you to know you're a good fit. Remember they're human too; and at the end of day most therapists have 30 clients with different mental health issues, etc. So bad vibes/bad days are expected. Especially in the beginning.

    • @liam.4454
      @liam.4454 5 หลายเดือนก่อน

      @@glory8065 Because i'm paying £80 an hour and my health and life is at stake, i'm not interested if she's having an off day.
      If there's a clash or a dislike I want to know the same day.