5 Types Of Difficult Clients In Therapy + Turnaround Strategies (2021)

5 min read

This guide will help you to work with five types of difficult clients in therapy.

As an experienced certified life coach, I have gained several useful insights that could help newer therapists ignite positive change within their clients. 

So, read on for advice based on my experience dealing with many different therapy clients.

Let’s dive right into it.

Types Of Difficult Clients In Therapy
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5 Types Of Difficult Clients In Therapy + How To Deal With Them

Although each client is an individual and should be treated as such, you can use this advice as a roadmap for dealing for these five archetypes. 

1. Clients Who Self-Sabotage

Therapists will be prepared to deal with client resistance during their training.

However, that doesn’t mean that self-sabotaging clients aren’t challenging to work with. 

These are the people who appear to be making real breakthroughs in your therapy session, only to (seemingly immediately) return to their destructive habits in their day-to-day life.

In this scenario, it’s easy to feel responsible for a client’s relapses. A therapist may feel the need to push their client harder, but this often only leads to more resistance.

A better approach is to let the client lead the session. Only they can control the pace of their progress. 

This approach will eventually dissolve the resistance, leaving you both free to tackle the core issues causing their self-sabotage. 

Difficult Clients In Therapy
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2. Unmotivated Clients

These are typically the people going to therapy against their will. Perhaps they’re doing it to placate a loved one, or because their therapy sessions are court-ordered. Either way, you can expect this person to make it obvious they don’t want to be there.

You can expect vague answers, long silences and the topic being changed to seemingly irrelevant points.  

As a new therapist especially, you may become frustrated at the lack of progress. Of course, you wish to provide value in your therapy session, and it may feel like these silences and ‘off-topic’ conversations are not working to improve a client’s experience.   

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Remember, it’s the client who leads the sessions and decides what is valuable.

Pushing them a certain direction will usually only serve to cause more resistance. It’s better to embrace however your client wants to use the session. Address how they feel during these silences. Talk about whatever topic they’d like to discuss

Stop judging your performace as a therapist during these moments. Don’t worry if a conversation isn’t related to what you want to discuss. Instead, get in the present moment with your client and give them what they want. 

With time, you’ll often find that this is exactly what they need. 

3. Hostile Clients 

Without doubt, it can be challenging for any therapist to deal with people who make threats, yell or act aggressively.

This can trigger anxiety, fear or self-doubt in even the most experienced professional. 

The first thing to do is stay calm. Mirroring their aggression will only escalate the situation.

Once you have calmed yourself, make an effort to understand why the client has become so angry. This can de-escalate the situation and get you back on track to providing treatment. 

In many cases, the therapist is not to blame for sparking the red mist within a client. They’re dealing with emotional topics and anger is a common form of resistance for a lot of people. 

While it’s important to empathise with a client, you must also set boundaries for how they are going to treat you. 

If a client breaks these boundaries too many times, feel free to end the therapeutic relationship with them. You have no obligation to accept repeated hostility.  

4. Bigoted Clients 

I know it can be challenging to deal with someone who insists on expressing racist, misogynistic or homophobic beliefs.

The ACA Code of Ethics states that therapists shouldn’t force their own beliefs on clients. In fact, therapists are trained to always work within the worldview of the client. At the same time, they have an ethical responsibility to work within an understanding of social justice and advocacy. 

It’s not in the best interests of the client to ignore a one-off discriminatory comment, even if they say something not directly related to the issues they’re experiencing. First things first, this signals that it’s OK to not talk about difficult topics. On top of that, it indirectly helps to keep the status quo of oppression alive. 

Such comments can also fester in a therapist’s mind, causing resentment and making it more difficult for them to deliver the best possible session.

Of course, a therapist should address a client’s prejudice with the intent of creating an open-minded talk, just like they would with any other potentially harmful bias they may be experiencing. 

This means questions like: “what makes you feel that way”, rather than throwing labels like “offensive” or “discriminatory” at them.   

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5. Clients Who You Don’t Like For Whatever Reason 

It’s possible that you might not like a client, even without them showing hostility or bigotry. 

This is a taboo topic in the mental health field. After all, therapists are trained to be professional and show unconditional positive regard at all times. 

However, you are also human. 

If you find yourself experiencing these negative feelings towards a client, the best treatment is a quick self-assessment. 

What do you dislike about this person? Is it their attitude to life? Is it how they are treating you? Do they remind you of someone in your personal life? 

Once you understand, ask yourself if you can look past this. 

It could be that the personality trait that’s annoying you is something they’re determined to change, with your help.

You’ll have a lot of clients in your career. You don’t have to like every single one. All you need is empathy and to desire an outcome that’s best for them. 

If you can’t manage that, refer them to another therapist. Don’t feel pressured to continue. Sometimes, that’s not what’s best for both of you. It’s perfectly normal for a therapeutic relationship to be a bad fit. 

My Final Thoughts On Dealing With ‘Difficult’ Clients

It’s inevitable that some clients will be more challenging to work with than others.

However, I’d invite you to answer this question: what good comes from labelling them as a ‘difficult client’? Will you work more effectively from this lens?

I see this label as unhelpful and perhaps even dangerous.  

In my practise, it has served me well to see every human as a person with huge potential and a bright light burning inside them. 

Of course, sometimes there may be large clouds blocking it, but if you can keep focusing on this bright light inside someone during treatment, it’ll be easier for them to see it too. This could be key for them to make that big change in their life.

Difficult sessions are unavoidable in this line of work. Instead of fearing them, see them as an opportunity to learn and grow as a mental health professional.

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Any Questions About Dealing With These Types Of Clients? 

I hope this article will help to improve your experience working with these types of clients. 

If you’d like to ask me some questions on this topic or get some feedback on your method of handling clients, feel free to use the comments section below. 

It would be good to hear what you have to say about this topic – and I’ll do what I can to get the answers for you.

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