Have you ever felt at a loss for how to help stuck clients in therapy?
We’ve all been there! We implement a tried and true strategy to help with a particular presenting issue and it just doesn’t seem to be working. And now we’re just going in circles trying to help our clients with the same tools but nothing seems to change.
It’s not a good feeling.
Personally, I’ve found that there is a specific approach that almost universally is useful. This is regardless of who I’m working with and what is making them feel stuck. I want to share that approach with you.
Preface
Before I dive in, I want to start with a disclaimer. Firstly, I’m not an expert, and there’s evidence to support different approaches for different presenting issues.
What works for your clients may differ from mine. I encourage you to consider the specific needs of the population you work with when implementing any therapeutic approach. Please consult as needed.
How Do We Help Stuck Clients In Therapy?
In my experience, often therapists go one of two directions when their client is stuck.
- We believe there’s something we’re missing or that it’s our fault.
- We put the blame on our clients, thinking they aren’t trying hard enough or aren’t invested enough in therapy.
Both of these might potentially explain why we find our clients are stuck. But, the approach of “I’m doing something wrong” or “my client is doing something wrong” tends to create an unhelpful power dynamic.
Of course I always bring up clients who seem stuck in a consulting group to try and problem solve. But, in practice, I tend to take a third approach with my clients.
With my clients, I focus on identifying that regardless of how we got here, we are now stuck in it together.
A “We” Problem
This idea that we are doing the work together, is an essential tenet of collaborative therapy. Collaborative therapy believes that therapists and clients are equals that are co-journeying together.
Curious about collaborative therapy? I would recommend the book: Collaborative Therapy: Relationships And Conversations That Make a Difference by Harlene Anderson.
The main takeaway I want you to have is: clients are more likely to get “unstuck” if you emphasize that it’s a “we” problem.
Not a “me” problem or a “them” problem.
The Trap Of Power Hierarchies
Think about it. If you see the issue as: your client is stuck and you’re not, there are so many ways that trying to help them will just reinforce a power hierarchy.
The image that comes to mind is of a client stuck in a pit of mud who cannot get out by themselves. The therapist is standing on the edge of the pit, peering in, offering a bunch of tools to help.
When you are in this scenario, no matter how helpful your tools may be, you’re free of the mud while your client is firmly stuck. You are both in really different places.
You may be incredibly gracious, and have an abundance of kindness. But, if you approach your client with the attitude of: “you’re stuck and I’m not” then it is going to create a dynamic where it makes them feel like we are on the outside looking in at them. Like a fish in a fish bowl.
Or you might be seeing the situation in reverse. You may be feeling like you’re the one causing the issue. So you might imagine yourself in the mud pit while your client peers down at you saying, “Hey, you okay doc? I was kinda hoping you could help me out.”
I find it much more helpful to take another approach. That is that regardless of how we got here, we are both stuck in the mud together. We’re in the same predicament together. We’re on the same team and we have the same goals together.
When I take this approach, it starts to sound more like: “Huh, we are pretty stuck in the mud here together. What a dilemma! I wonder what we should do?” And now, my client and I can collaborate and do something together.
Focusing On “We” When Stuck
In practice, this is what this approach often sounds like for me:
“I notice that we’ve been working at this for a bit and we haven’t made as much progress together as we might have hoped. I wonder what we might be missing here?”
Notice that there is an emphasis on we. We are not progressing, we are stuck, we are missing something.
When we think the client is not invested in the work, we might instead be tempted to say to them: “You are not progressing. You’re not ready to do the work…etc.” Which naturally turns up anyone’s defenses.
However, if we feel like we’re at fault, we might say more “I” focused statements like: “I’m not sure I’m helping.” Or “Am I being helpful?” This might lead our clients to assume that their problems are too great and we’re not equipped to help them.
When we use “we” in our conversations about how the work is progressing, then it creates an open, curious invitation to wonder together.
It gives us each ownership over what’s happening. It allows us to consider pivoting the therapeutic approach. Or maybe we uncover that the client might have something to gain by not fully investing in the work.
The Broader Benefits of “We”
This is part of my ethos for all of my therapy work. Not just in the moments when things feel a bit stuck.
So from the initial phone call and assessments all the way through graduation, I refer to the work we’re doing as a collaborative team effort.
That way, if a day comes when things feel stuck, it doesn’t feel like I’m suddenly using this “we” language out of nowhere. It’s part of the inherent approach to therapy as a whole.
Using “we” language in therapy has other benefits as well. We are modeling for clients that a lot of what happens in life is a “we”. Not always a “me” or a “them”.
It encourages our clients to be an agent of change as well. If they see that we’re missing the mark somehow, hopefully this approach creates enough sense of safety for them to say something. “I’m wondering if we can try something different.”
Need More Practical Therapy Tips?
I hope this has helped you think through how to help stuck clients in therapy.
I have an article with 4 approaches to try when your clients are stuck. This will help you explore some other strategies when you find yourself with a stuck client.
Also, if you are interested in other tips on the clinical side of what we do as therapists, I have a couple videos that might interest you. One is on how to start a therapy session as a therapist.
And, another is how to end a therapy session as a therapist.
So, until next time, from one therapist to another: I wish you well!
-Marie
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