A time to nurture & a time to confront: Knowing the difference is crucial for success as a therapist

shutterstock_820953341Have you ever had a prospective client or even just a random person ask you “What exactly is counseling?”  It’s a surprisingly difficult question to answer.  Counseling is such a complicated profession, full of nuances and subtleties.  One way to think of counseling though is that it’s a balance between nurturing and confrontation.  And walking that line is key for having successful outcomes with your clients.

Nurturing is obvious.  It’s reassurance, empathy, understanding, and validation.  Confrontation in counseling though is different from what we usually think of when we think of confrontation.  It’s not like when your parents confronted you as a teenager or when you get called into your boss’ office.  Confrontation in counseling is not harsh or condescending.  Confrontation can simply be the counselor bringing notice to a behavior and asking questions about it, such as “Do you think there were other ways you could have responded to that?” or “Why do you think you responded that way?”  Not harsh at all, but client’s still tend to not like it if used at inopportune moments.

When a client comes in for counseling, it’s very rare that I am the first therapist they have ever seen.  As part of my intake process, I ask them about the previous therapists and why they quit.  This is when it becomes obvious the importance of having a balance of confrontation and nurturing.

“The therapist yessed me too much”  Too nurturing

“I just didn’t like the therapist.  I didn’t feel a connection.  I don’t really know why.”  Probably too confrontational

Clients need nurturing because it’s a primary need to feel understood by other people, especially if you are telling that person your deepest darkest secrets.  Too much confrontation and the client will feel that the therapist doesn’t “get” them and it wont feel like a safe environment to talk.  If there’s too much nurturing, the client wont make any changes and there wont be any progress.  Clearly there needs to be a balance, and what that balance is varies from client to client.  The client often wont tell you what their balance is, and if they do, that doesn’t necessarily means that what they’re telling you is entirely accurate.

Surprisingly I have found that the clients that come in the first session and tell you that what they are looking for is tough love, honesty, and to get called out on their bullshit, are actually the clients that need the most nurturing and validation in counseling.  Likewise I have also found that some of the most fragile-seeming clients can benefit the most from regular confrontation.  But we also know that nurturing when you should have confronted and vice versa can cause a client to very quickly drop out of therapy.  Knowing the difference is key, but how do you know?

I think where a lot of beginner therapists go wrong is that they try to “force” therapy, and they think that by doing so they are doing a good job and doing so much better than the therapist that doesn’t force therapy.  “Looking at how hard I’m working for this client!” they say to themselves.  They coerce the client to talk about things that they don’t want to talk about and see this as a good thing.  They shove self esteem and positive thinking down the client’s throat.  They lead the client towards the goals that the therapist has for the client, but not what the client wants for themselves.  Then when the client suddenly stops showing up for sessions, the therapist can’t understand why.

I subscribe to the Rogerian principles that the client will naturally move in a positive direction if they are receiving support and unconditional acceptance from the therapist.  When you try to force things in therapy, you are sending the message to the client that they are unacceptable.  When you work towards your own goals for the client, you aren’t supporting their goals.  When you focus on supporting the client and stop trying so hard to force things in therapy, suddenly it becomes a lot easier to figure out what the client really needs from you.

And that’s really it.  When you chill out a little and stop putting your own needs for validation and self esteem on the client, suddenly you get a lot less drop outs in counseling.  The client talks about the things they need to talk about in therapy without feeling pressure from the therapist.  Progress happens a lot faster when you sit back and give the time and space needed for progress to happen.

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About

My name is Marina Williams and I am a licensed mental health counselor with a private practice in Jamaica Plain, MA. This website is my professional website devoted to my activities as a therapist. If you are interested in finding out more about my private practice, please visit my other website JPcounseling.com

Contact

Do you want to make an appointment for counseling or supervision? Interested in having me speak at your event? Have any questions or concerns? Feel free to contact me at 774-240-5550 or info@jpcounseling.com