NP0021 The 6 Most Challenging Issues in Therapy

This blog focuses on discussion regarding the course NP0021 The 6 Most Challenging Issues in Therapy... and How Therapists Can Overcome Them.

When Therapy Stalls with William Doherty


The 6 Most Challenging Issues in Therapy: NP0021 - Session 1

Welcome to “The 6 Most Challenging Issues in Therapy…And How Therapists Can Overcome Them.” In this series, leading innovators in the field will explore specific kinds of cases and clients that can stump even veteran therapists—narcissists, resistant clients, individuals with borderline personality disorder, and more. Each session will focus on concrete, practical strategies that’ll help you when facing these kinds of difficult cases.

In this first session, marriage and family therapist William Doherty highlights some techniques to follow when a client isn’t following the treatment plan, continues to follow a self-destructive path, or simply isn’t making progress. Learn how to avoid sounding like a disappointed parent or threatening to abandon the client when therapy stalls.

After you hear this presentation, please take a few minutes to comment about what you found most interesting or relevant, to ask any questions you have of the presenter or your colleagues, or to share any experiences. If you ever have any technical questions, please feel free to email support@psychotherapynetworker.org and our Support Team will help you.

06.21.2012   Posted In: NP0021 The 6 Most Challenging Issues in Therapy   By Psychotherapy Networker
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  • 0 avatar Catherine White 06.21.2012 13:29
    Thanks, Drs Simon and Doherty for a helpful discussion. I will definitely share this information with my consultation group I especially appreciate the respect for the people who come to us for healing and consultation, and the limits of our power and control in their lives. The place where I have the most difficulty with this personally is when it concerns teenagers. This is where I find it most challenging to find the line between their autonomy, and my responsibiity as an adult in their lives. How do you handle teens differently, if at all?
  • Not available avatar Renee Segal 06.22.2012 18:08
    Certainly the issue of the client making poor choices is a common one. I have used the "I am worried for you", comment previously. Sometimes it works, but mostly it doesn't. I believe it is because there are other deeper things going on. Such as the client's low self esteem or need to be needed in the relationship or feeling the only way to be loved is through giving. I try to get at those self concepts. When I am fearful for the clients safety, I usually comment on that. I worked with a lot of rape victims who tended to put themselves in similar situations over and over again. I believe this wasn't due to circumstances but through the choices they made and the people that the client chooses to associate with. It was an interesting session but I wish Bill would have gone slightly deeper. Renee Segal
  • Not available avatar Carolyn Spencer 06.22.2012 23:52
    Thank you so much Drs Simon and Doherty. This was extremely helpful to me. I took a lot of notes. I really struck with the being a healing and a lifestyle consultant. It really brought home for me how quickly we need to remain aligned to our real work in those 50 minutes. I am also going to begin using the worksheets that you had mentioned. I think it will be a great tool to keep the therapist present and current and the client clear. Thank you. If you can leave some suggestions where we can find some examples of worksheets to have clients fill out that would be great-
    Thanks again
  • 0 avatar Diane Perris 06.23.2012 14:36
    How did you all find this to listen to? I'm registered but can't find it!!
    • 0 avatar Psychotherapy Networker 06.25.2012 13:35
      Hi Diane,

      You should be receiving email announcements with the links. Try checking your Spam folder to see if it's in there, but you can also email support@psychotherapynetworker.org and they'll help you.

      The Networker Team
    • 0 avatar Jan Pierce 06.25.2012 17:09
      Your Purchased Items then New Web Perspectives
  • Not available avatar Bertha Alicia Alcocer 06.23.2012 20:17
    Thank you very much. It was useful and interesting.
  • Not available avatar Lynda Schoenbeck 06.24.2012 13:51
    Thank you for a very instructive hour. A question: I agree with your position that we should avoid "getting parental" with our clients, but there are some populations that I believe getting parental with is often appropriate, such as men who batter or others involved with the criminal justice system. Other opinions? Responses?
  • Not available avatar Sneha Nikam 06.25.2012 13:14
    Thanks a lot for this interesting series. Liked the conversation, very much educative.
  • 0 avatar Diane Perris 06.25.2012 15:51
    Thanks so much for this enlightening hour! I've been feeling boggged down with several clients for a while who are in the first form (pleasant hour but nothing's happening)and this gives me both a road map and a way to not project my own concerns or inadequacies.
  • 0 avatar Constance Kehrer 06.27.2012 12:47
    My comments echo those of Renee Segal's. Sometimes the "I'm worried about you" works, but often it seems I don't get anywhere with it. A particular frustration for me is working with insurance companies which, after a period of working with the client (say a year or more), want you to start a "step down" process of reducing session frequency. This is all well and good IF the client has made significant improvement. But with a few clients I've worked with, they are not nearly ready to start "stepping down". I need a strategy for instigating positive change in a timely manner when under the gun to do so by insurance reimbursement policies.
  • 0 avatar Hanusia Tkaczyk 07.05.2012 14:43
    I really appreciate the importance of supporting client autonomy, including their choices and pace of work. In my setting, we are getting pressures to serve more and more clients. Managers ask whether our time is spent well with people not making progress and, frankly, I ask that question, too.
    If, after various unsuccessful attempts to name and address the stall, how might the therapist carefully and respectfully decide that it's time to end? Maybe that's mostly about the therapist owning his/her own frustration or limitations (as in someone else may be able to help better or differently). Would love to hear about managing that.
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