Help! I'm stuck with a client who won't change!....and the Stages of Change model isn't working!"

  • Friday, August 19, 2016
  • Shona Innes Psychology

 

You can walk into just about any community welfare of counselling space and see images of the Stage of Change model hung proudly on the walls – sometimes in multiple languages or in indigenous art in an attempt to make it more responsive to those who might be stuck. You probably know it off by heart – precontemplation, contemplation, preparation, action, maintenance. But sometimes the Stages of Change model just doesn’t seem to be working for you. It’s not enough. Indeed, sometimes, it’s just a reminder of how stuck you feel with a client.

So.... your client is not progressing as fast as you would like!

You open your calendar for the day and see the name of the client who is stuck and keeps avoiding appointments, coming late, being rude and challenging to those who attempt to reach out to help.

Your body reacts with a massive slump in energy and a feeling of helplessness. You feel ineffective and stuck, the young person (or the client of any age, really) just doesn’t seem to be moving towards any change for the better.

If you stay in this stuck space, the client or even you and your service may end up giving up on change. The client may disengage and you may be tempted to find reasons or excuses to pass them on to another agency or service because their lack of change is draining you.

The Stages of Change model helps us see that the client is not resistant or purposely staying stuck, but it doesn’t really allow us to understand all of the complexities associated for a client or in the system the client is living in nor the problems with the system of procedures and protocols that you and your client have to work in. You may have mapped through that complexity and you are ready to proceed with your well crafted intervention, but your client is not ready.

In my experience, when you find that after all of your hard work to understand their complexity your client is difficult to engage, it is worth considering spending more time on your alliance with the client. Of course, this does not mean making your interpersonal and professional boundaries sloppy. But, it does mean considering whether your goal for the client is anywhere close to the client’s goal for accessing your service. It can help to consider modifying your goals for the client to be closer to their goals to promote earlier engagement. This can be an investment in getting closer to the goals you would like as the intervention progresses.

If your client feels like they are nowhere near taking action towards change, then perhaps you should consider taking action.

Use your next supervision or peer consultation session to discuss how to modify your goals for the client without losing sight of the big picture or of important ethical and interpersonal boundaries. Get some support to meet your client closer to where they would like to be.

While Shona is regularly engaged to develop formulation and treatment plans for troubled children and young people, she is also available for consulting, speaking and workshops. Call Shona Innes Psychology on 0400 150 106 or email admin@shonainnes.com