As we stated in Chapter Nine, therapy concludes when clients are confident they are on a solution track. This does not mean that the problem is totally resolved or that there is nothing more to do. A solution track merely means that clients now feel they can act (where before they may have felt stuck or powerless) and that the actions they are taking are working. In some cases, there may no longer be a problem. In any case, there is no longer any reason to meet and therapy discontinues.
Occasionally, therapy seems to be not working and we do not know what to do. In this, our final chapter, we would like to offer you our advice of what to do in those situations.
If therapy does not seem to be progressing, there are several procedures that we reconsider or check.
We want to check to make sure that the person we are working with is the person who wants a change. Sometimes, we have found that we assumed incorrectly that the person in our office is the client. Later, as we recheck and ask again what the client wants or how she or he decided to come to therapy, we find that attendance is not really the client’s idea. A husband, a wife, a parent, a boyfriend, or some referral source may have strongly suggested that the client make a change. However, the supposed client is not interested in a change. The client may have been interested in pleasing the relative or friend, but has no real goal for therapy.
If you are sure that the person in front of you is there because she or he wants to be there and wants something, then the next thing to check is what is the client’s goal.
Many times, when either one of us senses that our therapy is not moving along as we like, we use the other for consultation. The first question the one who is the consultant usually asks is, “So, what does the client want as the goal?” We often respond with an answer such as, “I think the clients want better communication. They are complaining of too many power struggles.” At this point, the consultant asks, “Is that what the clients say they want?” At that point, we may be embarrassed to find that we have inadvertently decided what the goal is for the clients. We do not know for sure that what we have assumed was the goal is what the clients would say is their goal. Make sure, then, that the goal is what the client wants and not what you want or someone else wants for the client.
Then, make sure the client wants the goal more than you do! Sometimes, we find that somehow we have slipped into wanting the goal for the client, maybe even more than the client does. In those situations, we have inadvertently slipped into pushing the client or working more than the client is on coming up with a solution.
The sign we look for to indicate that we may be pushing clients is when they seem to be on the defensive and saying “Yes, but,” or becoming very quiet. They can appear to be giving us reasons why change cannot happen or may have become quiet because they concluded that we are pushing, and are afraid to say anything more. These cues are our feedback that perhaps we need to do something different. We may need to back off and examine how we can cooperate more with the clients. We want to change our language or position so the clients know and perceive us as being behind them in a supportive fashion rather than pushing or pulling.
One sign that we are working too hard is when we find ourselves switching pronouns. We find that we have inadvertently switched to how are we going to solve this situation rather than how are you (the client) going to solve this situation—a sure sign that we need to back off and switch the pronouns back to the client.
Another sign that we are working too hard is when we catch ourselves sitting on the front edge of our chairs. We are talking much more than the client. At that point, we literally need to sit back in our chairs and allow the client the time and space to work toward solutions.
You may be working on a level involving only a complaint or wish and may not have moved to a goal that is within the client’s control. Ask yourself what the client is saying about what he or she wants to change in this situation. If the answer is a change of feeling or a change in someone else, then you need to literally ask the client again what he or she wants to change about the situation. Then use the questions for developing a well-defined goal, as well as the questions from Chapters Ten, Eleven, and Twelve on how to define a goal that is within the client’s control.
Try looking for smaller change. Use scaling on the goal or on the expectations for the pace of change. If clients appear to be cautious about change, you may want to advise them to take it slower.
You may need to only provide some feedback for them to think about, rather than an action-oriented task.
You may find in your zeal to be positive that you have slipped into trying to talk your client into recognizing progress while the client is saying, “Yes, but you do not understand.”
Since we may sometimes be too close to the trees to see the forest, we may not recognize a nonproductive pattern between us and the client. Sometimes, we are so involved with the session that we do not recognize a “Yes, but” pattern or we may not recognize how we have adopted the client’s worldview. At such times, a team or consultant can be helpful to provide a more detached frame of reference. Seek out a different frame of reference when you can. Two heads are better than one.