Sunday, April 29, 2012

Client change


This chart comes from a book that was published in 1978. A basic transactional analysis text at the time. It is one of those things you find in a book that you notice for some reason and kind of never forget. It always struck me as an interesting chart.

Client change 2

It’s great when you get a client who is in the first and second groups and they attribute their change to you the therapist.
One of the reasons I noticed it was that it is based on the assumption that everybody is help-able. That all clients can be helped. It assumes that all people can be helped as long as the therapist’s skill is high and there is enough time and energy put into the client. I have my doubts that this is true at least at times. Some clients at some points in time can not be helped. That can and often does change over time for the same person. For instance a person who is in the 5th 20% is likely, over time to move up the list and therefore become more capable of being helped. I would add a 6th category - at this point in time no change will occur no matter what the therapist does or the amount of energy put in.

Another feature is that it is based only on the client and the therapist characteristics. I would add in a third criteria and that is the psychological condition being presented. Some things are easier to treat than others regardless of the client’s motivation. It is easier to treat a tightwad than a spendthrift. The tightwad does not have enough Free Child and the spendthrift has too much Free Child. People naturally do not like giving up their FC. The antisocial personality is too hedonistic whereas the OC personality is not hedonistic enough therefore the antisocial generally is harder to treat.

Woman smoker



Then of course value judgements also creep into what is considered abnormal. It was only 40 years ago that homosexuality was considered by mainstream psychology to be an abnormal psychological state. Some kinds of illicit drug use are considered abnormal behaviour whereas the reason why it is illicit is for political reasons not psychological reasons. Hence they are considered psychologically abnormal because of a political judgement not the natural state of the human psyche. In these types of conditions perhaps one needs to consider more than just the client and therapist qualities.
Graffiti

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