What to do When Therapy Clients Don't Improve

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Күн бұрын

What to do When Therapy Clients Don't Improve
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Even the very best of therapists have situations when therapy clients just don’t seem to improve. For some therapists, there might be a pattern of clients not improving.
Before you jump to questioning whether you chose the wrong profession or start thinking you’re a bad therapist, there are a few things to assess first.
So in this video, I go over an assessment to run through when you notice that your therapy clients don’t seem to be improving so that you hopefully don’t have to find this pattern repeating in your practice.
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This video is geared for therapists of all kinds, including psychologists, MFTs, LPCCs, social workers, and others in the clinical counseling field.
Welcome to Private Practice Skills! I’m Dr. Marie Fang, psychologist in private practice. I post videos offering tools I learned the hard way about starting and growing private practice so that you don’t have to.
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Пікірлер: 50

@keyrosellc 2 жыл бұрын

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 2 жыл бұрын

I love that tip!

@temmyvdh Жыл бұрын

-5

@andrewcooper9339 Жыл бұрын

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

@jefesalsero 9 ай бұрын

@@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 5 ай бұрын

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

@Enchanteralle 2 жыл бұрын

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 Жыл бұрын

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

@lamentate07 8 ай бұрын

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.

@psichologelina 2 жыл бұрын

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.

@rachelh-j5006 2 жыл бұрын

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.

@baja1988_Texas 11 күн бұрын

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

@beverlyondera9558 2 жыл бұрын

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

@enatp6448 2 жыл бұрын

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

@teddybotana001 2 жыл бұрын

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 2 жыл бұрын

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

@magdaliny62 Жыл бұрын

Great video!! Very helpful!

@alfrednewman2234 Жыл бұрын

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

@TheJ0k0r50 3 ай бұрын

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

@healingasmr4986 2 жыл бұрын

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.

@esjoc 2 жыл бұрын

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 😅

@efiorkopoulou500 Ай бұрын

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

@cheshtaarora6499 11 ай бұрын

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

@jessman8597 2 ай бұрын

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.

@wealthyasamindframe1946 2 жыл бұрын

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 8 ай бұрын

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).

@Halveig Жыл бұрын

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

@jaybirdful Жыл бұрын

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

@shawncrawford1777 2 жыл бұрын

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 8 ай бұрын

@@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 8 ай бұрын

@@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 8 ай бұрын

@@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 8 ай бұрын

@justinjohnson9627 2 жыл бұрын

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

@lpellum8809 5 ай бұрын

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

@artnelson3360 2 жыл бұрын

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 Жыл бұрын

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.

@Ry-iz9bc Жыл бұрын

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 8 ай бұрын

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

@Ionut-lm9cj Жыл бұрын

Abcd

@Winngee Жыл бұрын

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 4 ай бұрын

K, not paying you then.

@Winngee 4 ай бұрын

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

@liam.4454 9 ай бұрын

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 8 ай бұрын

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.