How to Engage Difficult Clients as a Counsellor
Every counsellor is likely to find themselves counselling difficult clients at sometime or other.
Engaging a resistant client means understanding what the barriers are for the client before looking for a solution. Counselling difficult clients effectively takes a carful balance of theory, self care and understanding the process.
In this article we look at:
- What the theory tells us about counselling difficult clients
- Is the client suitable for counselling?
- Types of difficult clients
- Setting expectations
- Solutions on how to engage challenging clients
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Possible barriers to helping clients include their history, beliefs, behaviour and social relationships – including resistance to change or to engage in therapy.
Sometimes, the therapist may inadvertently contribute to this situation. It’s important to be up-front about what is achievable, and to be willing to explore with prospective clients whether counselling really is right for them at this time.
Theory related to counselling difficult clients
In 1961, Carl Rogers, in his book On Becoming a Person, identified seven stages of process – representing the stages of personal growth.
Those who are currently at stage 1 or 2 will rarely present voluntarily for therapy, instead believing that their problems are other people’s or the world’s fault instead.
Client suitability for counselling
Clients who present because they have been sent – perhaps by a partner, relative or the court system – are generally not good candidates for counselling because they have not come through autonomously.
Often, if they do agree to keep coming, they don’t complete many sessions as essentially they don’t really want to be there.
In existential terms, philosopher Jean-Paul Sartre used the term ‘bad faith’ to describe a phenomenon whereby humans disown their innate freedom under pressure from social forces, and adopt false values.
This can sometimes be experienced by clients who have a false sense of what can be achieved in therapy or are attending to please others.
It’s important to be up-front about what is achievable, and to be willing to explore with prospective clients whether counselling really is right for them at this time.
Why clients are challenging
When you find yourself counselling difficult clients, it is worth exploring the client’s history to give us clues about where we might encounter any resistance.
If we have a client who has had a history of help-seeking and has faced protracted criticism in the past, we may be looking at issues of attachment – and hence some level of distrust.
Clients who have had a difficult, neglectful or abusive past may find trusting others very difficult and have issues around attachment. The therapist may need to offer a reparative (or re-parenting) relationship, as described by Petruska Clarkson as part of her five-relationship model.
Carl Rogers’ core conditions are fundamental to this, as we show the adult side of being a parent – neither an over-protective nor a critical parent one.
It’s about showing our genuineness and compassion, listening, setting boundaries (as clients may test us in this way), normalising emotions (as they may have been dismissed, discounted or ignored), being fully present for them, and being consistent (in both our availability for sessions and our responses during them).
If a client builds trust and feels safe within the therapy room and the relationship, that can have a huge effect on how they view themselves in the world, so beginning that reparative development of self-trust and self-love.
Setting client expectations
Some clients believe they can’t be helped, and so come in expecting to fail, especially if previous therapy has not worked for them, or other professionals have let them down in some way.
In this case, they may come with a preconceived idea that we’re not there to help them or that they can’t trust us enough to build a relationship.
We may wish to ask them more about what they perceive as having gone wrong in previous therapeutic relationships. For example, it might be that the client and therapist were mismatched, or that the modality wasn’t the right one for the client or their issues.
Sometimes, when clients describe their behaviour, they may feel that we’re going to judge and/or reject them, discounting them as other people may have done. Some clients may be overly compliant, demanding or both.
If a client is excessively demanding (beyond the scope of good service on our part) – e.g. wanting to change appointments at very short notice, demanding more appointments, expecting us to work in a certain way or strongly criticising us – explore what this is about, rather than ignoring it. This gives us the opportunity to co-create the therapeutic relationship.
Other clients may have idealistic and unrealistic expectations, expecting super-fast results from therapy.
If they mention fearing therapy ‘failing’, explore what they mean by this: what would success look like to them?
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Hard-to-Help Clients
Client History
Be attuned to loss in the client’s history (e.g. around death, or of health or status), and to messages they may have received from others (in the sense of introjected values and conditions of worth).
Part of our work is to establish a place where clients can be accepted and not be judged.
Manipulative Clients
Beware of games. We need to use helicopter skills to see any such patterns, so we can ‘hover above’ the interaction and take a view on what’s going on, while still remaining too in the client’s frame of reference.
Don’t underestimate the power of the therapist just being themselves as a way of helping the client regulate themselves and become calmer.
Karpman’s drama triangle can be a useful model to look at in this respect. This describes a psychological game that we may unconsciously play because of dysfunctional patterns we’ve learned growing up as part of our families and society. Roles include victim, persecutor and rescuer.
It’s really important for the therapist to avoid entering the triangle, instead remaining a compassionate adult, within what Martin Buber called the ‘I–Thou’ relationship.
Don’t underestimate the power of the therapist just being themselves as a way of helping the client regulate themselves and become calmer.
Barriers to client engagement
Working with trauma can put up barriers to therapy being successful.
For example, the client might feel the traumatic incident was their fault in some way, or that they have feelings for an abuser.
The latter phenomenon is sometimes known as Stockholm syndrome or trauma bonding.
A client who has been sexually attacked may be confused because they experienced sexual pleasure during the abuse.
Here, it’s important to explain that the human body naturally responds the way it’s been programmed to do, but this doesn’t mean that the person somehow ‘asked for it’.
Psycho-education is essential in this situation, providing factual information on how the human body and brain react in different circumstances.
Similarly, it can be invaluable to explain about trauma responses (fight, flight or freeze), which are simply outside our conscious control.
Other Types of Psych-Education
Another issue for psycho-education could be sexuality, letting a client know that their sexuality or gender is not ‘incorrect’ in some way.
In loss and bereavement too, people are often told how they ‘should’ grieve, perhaps being criticised for crying ‘too much’ or ‘not enough’ – or for struggling after six months, a year etc.
Giving them factual information can be really liberating.
Social Relationships
Social relationships can also be a barrier in counselling, with some clients feeling isolated.
This may relate to language barriers, learning difficulties, neurodiversity (e.g. autism or Asperger’s), self-concept, attachment style, class, political standpoint, gender or sexuality.
Solutions to engage difficult clients
There are various adjustments we can make to how we work to support hard-to-help clients.
For example, we could:
- offer shorter sessions
- use drawing and other creative/expressive ways of working
- rearrange the seating (e.g. people with autism may prefer to sit back to back, to avoid the pressure of eye contact)
- provide the client with a card that says ‘I want to end the session’ – so they can just hold this up if they feel this way, removing the pressure of having to explain this verbally.
The Counsellor's part in creating engagement
Sometimes barriers to counselling can come from the client, but sometimes they might be within ourselves as therapists. Transference and countertransference may be present. Clinical supervision is vital here.
If we have experienced something similar to what a client is describing, this is sometimes referred to as ‘parallel process’.
A competent supervisor will guide us through what’s ‘our stuff’ and what’s the ‘client’s stuff’, supporting us with the appropriate use of challenge and helping clarify what is really going on in the therapeutic space. Good clinical supervision is invaluable in this respect.
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Hard-to-Help Clients