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How to Deal With 7 Types of Difficult Clients in Therapy?

Types of Difficult Clients in Therapy
Written by:

Rabia Khaliq

MSc in Applied Psychology


The primary mission of a therapist is to guide your clients in reaching a treatment goal. The only way to reach this goal is through progress.

This process can sometimes be frustrating if there is no or little progress achieved, or if clients bring difficulties into the sessions.

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Therapy is always more challenging when dealing with different types of difficult clients. Typically these clients are not ready to make a change in their life and have been forced into your session. How to deal with the difficult clients can sometimes come down to making ethical, legal, clinical, or risk-management choices. However, no matter how difficult your clients in therapy may be, there are several strategies [1*] to manage them effectively.

Types of Difficult Clients in Therapy

Clients are individuals and each should be treated as such. This roadmap of the seven types of difficult clients in therapy can help you know how to deal with the difficult clients.

1. The Unmotivated Clients

Unmotivated clients typically go to therapy against their choice. They are with you to please a loved one, or because they have been court-ordered to attend.

Unmotivated clients are going to make it obvious they do not want to be with you.

Dealing with unmotivated clients [2*] will be difficult as they often only provide vague answers. You may find there are long silences during your sessions, and they may change the topic to irrelevant points.

You may find there are long silences during your sessions, and they may change the topic to irrelevant points.

Pushing the different types of difficult clients in therapy, especially the unmotivated ones, will only cause more resistance.

Your best action is to embrace how they want to use the session and talk about the topic they choose.

Don’t worry about the conversation not being related to what you want to discuss just give your client what they want.

Deal With Difficult Clients

2. The Bigoted Clients

One of the hardest types of difficult clients in therapy to deal with is the bigoted clients. These types of difficult clients will insist on expressing homophobic, misogynistic, or racist beliefs. While it may be challenging to deal with these types of difficult clients, you must follow the ACA Code of Ethics and not force your beliefs on them.

As a therapist, you have to work within your client’s worldview. When your client makes discriminatory comments, you don’t want to ignore them as it then appears it’s OK for them to talk this way. To address these comments it would be best to ask them why they feel that way, and not refer to the comments as discriminatory or offensive.

Addressing a prejudiced comment [3*] without labeling your client, can create an open-minded talk. This open-minded talk can help you understand your client, and allow you to work with bigoted clients without becoming resentful or offended as a therapist.

3. The Clients Who Self-Sabotage

The self-sabotage clients are no less challenging than those who resist a therapist’s help. These clients will appear to be making progress, however, they return to destructive behaviors in their daily lives.

Of all the different types of difficult clients in therapy, the clients who self-sabotage make many therapists feel responsible for them relapsing.

Rather than pushing them harder, which is a normal response, allow them to lead the sessions. This response will dissolve their resistance and allow you to address their core issues.

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4. The Hostile Clients

The types of difficult clients in therapy include hostile clients. Anyone, including therapists, will find it challenging to work with people who act aggressively, yell at you, or make threats to your well-being.

The first step in how to deal with difficult clients who are hostile is to remain calm.

Even if you are feeling self-doubt or anxiety working with someone who is hostile, remember that showing these feelings or mirroring their actions, could possibly escalate a situation.

Remaining calm and trying to understand the reasoning behind their anger can help to de-escalate them and get treatment back on track.

Set boundaries with these types of clients, but also empathize with their feelings. If they cross or ignore the boundaries you’ve set, the session should be ended.

5. The Clients Who You Don’t Like For Whatever Reason

While it is taboo in the mental health field, you can run into clients who don’t like for whatever reason [4*] . You are a human, and these types of difficult clients in therapy will come to you sometime in your career. Your best course of action is to understand why you don’t like them, and then get yourself to look past the issue.

You do not have to like every single client, but you do need to show empathy and want the desired goal for all clients. If you try and are unable to get past your dislike, you should refer the client to another therapist.

Types of Difficult Clients

6. The Client Who Cannot Listen

There are many types of difficult clients in therapy and one of the more challenging ones is the client who cannot listen. These are the clients who are so talkative, you do not get a chance to outlay possible solutions to their issues. They are like this because they are possibly starved for attention.

Sometimes a client is going to need time to vent before they are ready to listen. You will have to help them find time outside of sessions for their venting and offloading, so you can work together during sessions to reach their goals.

7. The Contrary Client

Another of the types of difficult clients in therapy includes the contrary client. The contrary client is going to want to do or say the opposite of everything you present. This tendency for them to be so completely contrary is ingrained in their personality and will present itself automatically. A contrary client is much more than just simple or honest disagreements with your suggestions.

How to deal with the difficult clients who are constantly opposing you involves finding out what makes them the contrary client [5*] ? It may be a control issue or that they need to derive a sense of status in all interactions, or they may just have a habit of arguing. Learn the reason, and try to get them to see it and perhaps control it so sessions can be successful.

In Conclusion

As a therapist you will meet all kinds of different personalities. The types of difficult clients in therapy are also going to vary.

No matter who your client is, or which category they fall under, listening respectfully will go a long way towards building rapport.

When you can build rapport with your clients, you can turn the different types of difficult clients into someone who can work with to meet their goal.

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5 sources
  1. Strategies for Managing Difficult Clinical Situations in Between Sessions
    Source link
  2. Motivating the unmotivated: how can health behavior be changed in those unwilling to change?
    Source link
  3. Addressing clients' racism and racial prejudice in individual psychotherapy: Therapeutic considerations
    Source link
  4. Dislikable Clients or Countertransference: A Clinician’s Perspective
    Source link
  5. Managing Transference and Countertransference in Cognitive Behavioral Supervision: Theoretical Framework and Clinical Application
    Source link
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Written by:

Rabia Khaliq

MSc in Applied Psychology


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This article contains scientific references. The numbers
in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.