Challenging Clients: Fostering Change

Rationale for Challenge Recognize maladaptive feelings, motives, and desire. Awareness of Ambivalent feelings Not taking responsibility for actions Reduce Denial, Displacement, Rationalization, Projection, Sublimation Understand self more deeply

Psychodynamic Approach Challenge before Interpretation: Defenses must be confronted and lowered for an interpretation to create an “Aha!” moment Why may that be? How do defenses get in the way of insight?

Gentle Challenge: Note Discrepancies Group Exercise: create a client scenario reflecting each type Contradictory Statement (say you enjoy your family and also state you can’t be around them very long) Actions contradict words (claim to have high self worth but engage in self- destructive behaviors) Contradictory feelings (Middle school girl states she hates a boy that she can’t stop following around) Values and Behaviors (greed is a moral sin, yet enjoy expensive hobbies) Self-view and Real Self (low self-worth yet thought of highly in community)

Challenging Thoughts Cognitive Theory: Irrational thoughts and beliefs source of maladaptation Challenge erroneous thoughts Challenge illogical thoughts Complication: Beware not to turn therapy session into a debate or argument. Why?

Challenge: Gestalt Approach Two Chair technique: clarifies inner conflict, contractor views and feelings Group Exercise: work through a discrepancy pattern noted in earlier exercise (In mock dyad session) Empty Chair technique: Express unspoken thoughts and feelings; clarity in process Group Exercise: Jeffery Case- address unspoken issue with Mom, and with Dad.

Responses to Challenges Client Denies challenge Use socratic approach No Reaction Assess reason for resistance to therapist (therapeutic relationship) Client accepts aspects of challenge Client responds with new awareness