It is easier to resist at the beginning than at the end.
Leonardo Da Vinci
Primary Skill Objectives
• Understand and be able to explain several reasons why some clients may struggle in starting.
• Understand and be ready to avoid mistakes that a counselor might make that can inhibit a client’s beginning use of counseling.
• Understand and be able to implement counselor actions that can help clients struggling in starting.
• Be able to explain the roles of empathy and UPR in helping clients begin to fully utilize therapeutic relationships.
• Understand how and what types of questions or topic suggestions might help clients who are struggling and what types would not. Be ready to implement this understanding.
• Understand and be able to differentiate and explain the parts of your clients’ struggles in starting that are within your influence, the parts that are not and how you may best respond to each.
Focus Activities Activity 1
Think of a variety of clients with situations in which they may struggle to begin to make use of their therapeutic relationship. Strive to understand the reasons why some clients might struggle in starting. Examples might include persons who are generally shy and rarely talk about themselves, persons who feel very anxious but have not realized that they are anxious, persons who usually spend their time helping and focused on others, or persons who were urged into counseling by others and do perhaps feel badly but have no idea why or how to start. Most clients do not need help getting started, but for
those who do, there are an infinite variety of reasons why. Try to put yourself in the situations of each person that you imagine need help getting started.
What might each person be thinking and feeling?
Contemplate how you might naturally feel, think, act, and be with clients who are struggling in starting. Then, imagine things you might do or say, as their counselor, or ways you might be with each person that you expect would be most helpful in their struggle. Journal and discuss your con -templations on these matters with your peers.
Activity 2
Imagine times in your life when it would have been difficult for you to get started in the counseling processes described in previous chapters. Why might it have been difficult for you? What parts of your self or situation might have gotten in the way? What might you have felt and thought, and how might you have been and acted? What might a counselor have done to help you through that time, if anything? Journal and discuss with peers your thoughts, feelings, and answers to these questions regarding such a time in your life.
Introduction
In this chapter, we focus on ways you can help clients who struggle to begin to make use of their therapeutic relationship with you. We find that when we and other counselors follow the skills of the core conditions as we have des -cribed them through the preceding chapters, most clients readily and rapidly begin their work. Yet, some struggle in starting for a variety of reasons. Some may be inhibited by negative preconceptions of counseling. Some may have internalized a perception, stated or implied by family, friends or society, that using counseling means there is something terribly wrong with them or that they are weak and not selfreliant. Or they may have internalized the per -ception that counseling is disempowering, that the counselor will break them down with analysis, expose their weaknesses and assume a long-term need for ongoing therapy. Others may fear that they have something to hide and that their counselor will see and critically judge this part of their self. Some may be shy and not at all used to relating closely to another person. Some may have anxieties that nag at them and that have driven them to counseling but that they avoid feeling fully and facing at any length. We humans are naturally taught to avoid anxiety because it is, at the very least, uncomfortable. Yet, in counseling, it will be hard to avoid facing painful anxiety. Some clients may have often been judged, have felt hurt by this, and greatly fear critical judgment from you. The reasons that some clients may struggle in starting seem infinite. We would like you to consider that while it is a minority of clients who struggle getting started, their struggle can be quite understandable.
When such slow-to-start situations occur, first review your ways of being for common mistakes that may be inhibiting your clients’ progress. Then,
after considering the possible effects of your ways of being, consider explana -tions that may help struggling clients understand how they can use counseling, and finally, consider use of questions that may help struggling clients get a stronger start.
Mistakes that Inhibit Clients’ Beginning Use of Counseling
Trying Too Hard or Worrying about Motivating Clients to Make Rapid Use of Counseling
Jeff’s grandfather once added to the old expression “You can lead a horse to water, but you can’t make him drink” the additional phrase, “but a goat will eat anything.” You see, with goats, the problem is not getting them to eat or drink but containing them and limiting them to eating and drinking the things that are healthy for them. Part of what he meant was that some people focus too much on the problems of motivating others and come to see those they wish to motivate as a horse that simply will not drink. Papaw was a good motivator of people, and one of his ways of doing this was to recognize when he could see them as goats, not horses; when he could and should give them good, but limited direction, then get out of their way, having provided an environment that is fertile and safe for their work. A therapeutic relationship is an optimally fertile and safe environment for your clients’ growth. So, while there are things you can do to help clients who struggle in starting, the first and most essential thing you must do to help your clients who are slow to start is to accept their pace as it is and trust the process of providing a therapeutic relationship.
Not Recognizing that Your Client Began to Use His or Her Therapeutic Relationship with You As Soon As You Began to Provide It
If your client is nervous beginning counseling, does not talk as much as you might expect, and has uncomfortable pauses in her early work with you, then rather than indicating that she is not using her therapeutic relationship with you, it means that working through those uncomfortable pauses is an important part of how she is using her therapeutic relationship with you. You might offer such a client help getting started in the form of explaining how counseling may work for her or even offering questions to suggest topics.
However, this guidance may not even be necessary when you provide empathy and acceptance for how your client is starting.
A Quiet Client
Imagine that your client seems quite uncomfortable with repeated pauses, and you feel just how hard and scary getting started is for him. In that case you might reflect your client’s process by saying something like, “You seem unsure of what to say and this leaves you very uncomfortable, apprehensive,
maybe even afraid of how this will go.” Because his experience is happening within the healing environment you are providing, working through this discomfort and fear in getting started is how he has already started and may be a very important part of his use of the therapeutic relationship. Working through to closeness may be a central part of his work in counseling. Your empathy can help him learn from his anxiety and your acceptance can help him be OK with experiencing it long enough to learn from it. This work can then build his confidence to face other challenges, and can help him see the things he fears of himself in a more realistic perspective.
A Talkative Client
Another client who seems slow to start may begin, not by talking less but by talking more, while seeming to express little that is important to her. Some clients who are anxious about starting counseling may try to fill the time with words that seem to express anything but heartfelt experience. Persons in this situation might talk about others in their life, their to-do list, or the weather.
Again, this is not really a problem. If it is coming to be how you see a client, after reflecting her content with warm acceptance, you might tentatively offer a process reflection like, “I get the idea that there are things you’d thought you might say or do here, but you seem to talk of anything but those things.”
If necessary, you could even add a structuring explanation for her use of counseling, such as “While I want you to use this time to discuss any of the things on your mind and heart, I think it may be most efficient if you consider what thoughts and feelings are most important to you and say those. While I don’t want you to focus on editing what you say, I also want to help you get to the core things that will be most helpful for you to say.” In most cases, nothing needs to be done to help such clients, except to focus yourself in therapeutic listening, especially emphasizing empathy, which will lead to the heart of the matter, and accept this as her start. Just the process reflection and following with therapeutic listening, deep empathy, and genuine UPR will usually suffice. Example dialog of how this might go, following the same process reflection from before, may clarify our guidance for such situations.
COUNSELOR: I get the idea that there are things you thought you might say or do here, but you seem to talk of anything but that.
CLIENT: [Responds with a slight giddiness that seems to be nervousness, and with an apologetic tone.] Oh gosh, I didn’t mean to waste your time, it’s just, I thought I was supposed to say anything.
COUNSELOR: Oh, you seem to have taken my statement like I was fussing at you. Yes, absolutely, you may say anything. [Counselor combined a quick reflection with a structuring explanation that seemed important to avoid misunderstanding.]
CLIENT: [Sounding slightly exasperated and picking up pace again.] It’s just, I’m so busy and have so much on my mind that I wouldn’t want to waste time here. I’m sorry.
COUNSELOR: Oh, so you were talking quickly through subjects in order not to waste a minute. I also get the idea that you worry slightly that I am critical of you. I see that you are working hard. [Counselor combined three brief, related reflections that each seemed important.]
CLIENT: [Sounding more emphatic.] I am working hard and no one seems to appreciate it. I am sick of it! [This was her strongest statement yet.]
COUNSELOR: [Responding with same emphatic tone.] You see that lots of people, maybe even me, are seeing you that way; and you’ve about had enough of people not valuing your hard work!
The conversation may then go to a trend in wanting appreciation and seeming to get criticism, or perhaps to lists and explanations of hard works, but our purpose in offering this example is to show how staying with such seemingly slowtostart clients can lead to strong starts and beginning expres -sions that are close to your client’s heart. In this example, the client did not respond to the parts of the counselor’s reflections that were about their relating in that moment. So, we would assume that those parts were too soon or just not the most pressing things on her mind, and so were not keys to her immediate experience. In fact, it may never be necessary for her to have direct conversations about her relationship with her counselor in order to make good use of that therapeutic relationship.
Lack of Acceptance
Sometimes counselors can care so much for their clients that their way of being communicates, “I will accept you when you show me that you are using our therapeutic relationship.” The behaviors of that mistaken way of being often include having a single picture in mind of what it will look like when clients are making efficient use of their counseling, then responding enthusiastically to client behaviors that fit this picture and responding with anxiety and disappointment to client behaviors that do not fit that picture. This beginner counselor error is sometimes exacerbated by counselors’ insecurity and belief that their clients must be making clear progress or it means that they are bad counselors, or by counselors seeing their clients as fragile and thus not acceptable as they presently are.
Pedantic Reflections
Another reason your clients may start slowly is that you probably have not yet become artful at therapeutic listening and therapeutic relationships. This is a set of tasks that sounds so simple but that we and many of our friends and peers expect to devote lifetimes to perfecting.