I once had a potential client contact me because he wanted to pray more. He was praying 6 hours a day, and he wanted to pray 8. But that’s not what this post is about.
I didn’t take him on as a client, but I sometimes use the story as an example to point out to folks in the industry, that you don’t have to take every client that comes along.
Recently, I told this story and someone objected to my take on the situation. They said I shouldn’t have written this person off. “Maybe”, they said, “you could use the opportunity to open this person up to new ideas.”
Where Is The Line?
I think most of us would agree that 6 hours of praying a day means there’s something wrong here. And wanting to pray even more, is concerning. And on the surface, opening this person up to new ideas sounds good. And of course, you shouldn’t necessarily write people off!
However, there’s an insidious presupposition hidden in there that I believe we, as therapists, have a responsibility to combat.
I don’t know better than my clients. You don’t know better than yours. Well, maybe we do, but it’s not our place to put our world-view onto our clients!
When I take on a client, I take on the responsibility to help them reach their goals. If I can’t get behind their goals, I don’t take them on. My goal is to help clients into a resourceful state, that helps them make decisions in accordance with their own values — not with my own values.
When Do We Go After Belief Systems?
Now, in the process of doing that, you may find that beliefs shift. And if there’s a belief specific to a presenting problem, that’s getting in the way of the client’s stated goals, we may have to go after that one.
For instance, if a client wants to stop smoking, but believes it’s impossible to stop, we make seek to dissolve that belief. Or if a person wants to find a loving relationship, but believes that all relationships end badly, we may want to address that.
When Do You Not?
I once had a client who came to me with a fairly small presenting problem. Let’s say it was nail-biting. In short order, I found it was connected to some stuff with his mother. I started down that path and the client stopped me. “I don’t want to get into that”, he said. “I’ve been dealing with this stuff for 5 years with my regular therapist, and we’re not going to solve it in one session here. I just want help with my nail biting.”
I assured him that the stuff with his mother was quite possible to deal with quickly, and it might even be in one session. I asked him if he was open to working on that. He said no. Now, could I be sneaky, and try to work on it anyway? Could I use embedded suggestions, or talk in metaphor? Yes. But did I? No. Why? It’s the height of arrogance to act as if I know better. I work for the client. I go for what they tell me to do. If I can’t do that, or if I’m uncomfortable with their goal, I don’t do it.
I’m the expert in how to get it done. I’m the expert in what can be done. They are the experts in how they want their lives to be.
We have an agreement, tacit, or otherwise, with our clients. We work toward their best interests, according to them. Don’t violate that agreement!
The Grey Areas
Let’s suppose you have a client who comes to you because her husband yells at her, and she feels bad when he does. She wants to not feel so bad. You may think that this is not a good marriage and she should leave him. That’s not your place to say.
Alternately, let’s suppose you have a client who wants to have the strength to leave her abusive husband. You believe in the sanctity of marriage, and believe they should stay together, no matter what. That’s not your place to say. (Note: If you believe any person is in danger of harming themselves, harming others, or being harmed by others, you may be legally required to report it, aside from the moral questions.)
Here’s what I do.
What To Do?
When I get contacted by a potential client who wants to accomplish something that I don’t think is the right way to go, I ask myself if I would be comfortable doing what they asked. If the answer is no, I ask the potential client if they’re open to other avenues of working. If they say yes, we’ll keep talking, to see if we have common ground.
If they say no, I either try to find someone to refer them to, or I simply say I wouldn’t be a good fit to help them.
And when I do take on clients, we work out what the client wants to accomplish, together. Then all the techniques I use (covert, or overt), are aimed toward getting those goals. The only things I’ll work toward beyond that, are general suggestions of well-being.
During the therapeutic part of the sessions, there are no suggestions of them coming back for sessions for other issues (that would be my goal, not theirs), referring their friends to me (that would be my goal, not theirs), or telling everyone how great I am (that would be my goal, not theirs).
Keith
