What Can Therapists Do When Clients Don’t Getting Better?

Curt and Katie chat about what modern therapists can do when their clients don’t (or can’t) get better. We explore what “getting better" looks like in therapy, what can get in the way of clients improving, how we can support clients who are unable to reach traditional treatment goals, and how clinicians can take care of ourselves while doing this longer-term work.

Transcripts for this episode will be available at mtsgpodcast.com!

In this podcast episode we talk about how therapists can happen when clients aren’t improving

At a recent talk, we got the question – what if my clients aren’t getting better? We decided it was time to look at how goals are set, what “getting better” actually looks like, and how therapists can cope with clients whose treatment goals are "not getting worse."

What does “getting better” look like in therapy?

·      Treatment goals are often set based on functionality, independence, and productivity

·      Outcome measures can be used to track improvement on mood, anxiety, etc.

·      Goals of “not getting worse” or prevention of future concerns are often hard to quantify or are unsatisfying for therapists (and potentially for their clients)

What can get in the way of clients improving in therapy?

·      Situational concerns that are not changed

·      Longer-standing diagnoses that don’t go away, but can be stabilized

·      When improvement is defined as reaching goals, rather than avoiding relapse

How can therapists support clients who are unable to reach traditional treatment goals?

·      Collaborative treatment goal setting

·      Identifying appropriate expectations

·      Quality of Life goals

·      Showing ongoing medical necessity and documenting appropriate need for ongoing care

·      Higher acuity and relevant diagnoses documented

How can clinicians take care of ourselves when we have longer term clients who don’t show dramatic improvement?

·      Getting clear on client’s capacity for growth

·      Be clear on your own skills and capacity as a therapist

·      On-going conversations with the client to determine whether other help is needed

·      Exploring quality of life goals

·      Identifying incremental gains and reframing to build hope

·      Deepening the therapeutic relationship, focusing on the attachment

·      Redefining success and understanding the pieces that are still uncomfortable

·      Making sure that therapists do not define their own success based on client outcomes

·      Destigmatizing long-term weekly therapy as a coping strategy

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Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano https://groomsymusic.com/