I saw that someone found my website by searching the phrase “how to help a client who doesn’t want to be helped”. I could tell immediately that this is a therapist, possibly a relatively new one, who is having trouble getting through to their client. We’ve all been there. I remember in the early years of my practice just staying up all night worrying about how I was going to get through to a client. Wondering how I could help someone who doesn’t want to be helped. Of course, client resistance is not something that goes away once you’ve gained more experience. It’s always there. It’s the bane of all therapists. The difference is how you deal with it after you’ve been in the profession for a while.
The fact of the matter is, if a client doesn’t want to be helped, you can’t help them. Sure, more clients are hesitant about therapy at first, but if that resistance doesn’t go away after a few sessions, generally there is nothing you can do about it. My way of dealing with client resistance is I try to prevent it as much as possible. People are generally their most resistant when therapy wasn’t “their idea”. Examples of this include DSS referrals, hospital discharges, court ordered counseling, coercion from a spouse, etc. Due to this, I don’t take any referrals from the courts, DSS, or hospital discharges. When people call to schedule an appointment for someone else, I tell them to please have that person call me to make the appointment themselves. If they don’t make the call, clearly they were not committed. When people call to set up an appointment for couples counseling, I make it a point to ask if the other person is committed to the couples counseling and explain why trying to coerce their partner is not going to work.
Now some therapists would say that by screening people I’m leaving out a whole group of people that need help. This is how I look at it. They may need help, but if they don’t want help, you’re just torturing that person. It also goes back to that old saying “You can lead a horse to water but you can’t make it drink”. You can be there for your clients, but you can’t make them do anything outside of the session. And what the client does outside of the session is the most important part. The counseling centers in my area have wait lists that are months long. Is it fair to fill your caseload with people that ultimately aren’t going to benefit from therapy while leaving motivated clients to wait months just to get an appointment? I don’t think it is.
After I’ve screened my clients, I give them a “client agreement”. It’s a piece of paper that explains what they can expect from me as their therapist and what I expect from them as my client. Some of those things I expect from them include: Being engaged in sessions, having an agenda of things they want to work on in session, doing the homework, attending every session, etc. The client then signs it. Now, even after all this, I still get clients that don’t want to be helped. I can tell this because they come to sessions unengaged and unprepared, they don’t do their homework, and they cancel and reschedule frequently. I will explain to them the importance of being engaged, etc, but if they still won’t get with the program, at some point you have to let the client go and make room for someone that does want your help.
At some point every therapist comes to the realization that “helping” isn’t enough. Ultimately, the client has to be willing to help themselves.