Saturday, July 18, 2009

The expert & novice client

Is it better to see a new client who has never been to counselling before or see someone who has been counselled before?


Initially with the novice client the out come is far more unpredictable. People go to counselling for a whole variety of reasons and thus one first assess which ego state has motivated the person to attend counselling. Is it a Parent reason or are they coming because the Child ego state is in pain and wants something different.


Its easier to work out the motives of

some clients than others


The person needs some ability and willingness for introspection. For instance some people enter counselling with a change others contract. “How can I make my husband love me”, is a change others contract and it can’t work because the husband is not there. The wife needs to be willing to look at herself and how she contributes to the presenting problem because she can do something about that. Thus she needs to be willing to be introspective. If they are not then the counselling probably will be short lived. It seems more likely that a person who has had counselling before will be willing to be introspective and thus will not leave after just one session.


The expert client will know what to expect at least to some degree and has a willingness to seek change of a psychological nature. This of course is a good thing but it can also be a bad thing. The client knows what to expect and will have played out in their mind what will happen in the session coming up. This is not a good thing and reduces the impact of the counselling.


Clients come in all shapes and sizes


As I have said before you need to keep the client on the left foot. If the session goes as the client expected then their Free Child is not being touched or shaken up. For more see this Video. The therapist needs to ‘touch’ the Free Child of the client at least once in every session. With the novice client this is easier to do because they don’t know what is going to happen.


At times I will ask an expert client after they have presented their contract, “What do you expect to happen now?”. At the end if a client reports that the session did not go as expected then that is a good sign. If it goes as expected they probably have done the therapy in Conforming Child which is by and large ineffectual.


Do it different


With the client discussed in the previous post she knew what clients are suppose to do and say because she had some considerable experience as a client before. This shows another problem for the experienced client where the therapy starts to become part of the problem. This is inevitable for the ongoing (expert) client and not for the novice client. If a client says something like, “And I think I suck at therapy, so it just confirms my feelings that I'm a loser”, the therapy is being used to support the feelings of not OKness.


As I said before this is inevitable and not a condemnation of the client. If I was a client I would be doing the same as well. With the expert client one needs to be doing therapy with them and making sure the therapy is not supporting the problem. Freud discovered this a hundred years ago and coined the term, “The transference neurosis” to describe it.


I had a client recently say to me, “I’m trying to work out why you gave me that homework”. To which I responded, “Stop trying to work why I am doing it and just do it”. I will tell him why next week. Unfortunately sometimes I have forgotten by then. He had been saying how he felt bad towards his ex-fiance who dumped him in bad circumstances. I told him to ring her up and just have a conversation with her. Not telling her off or expressing anger at her. Just a catch up call to find out what she had been doing in the last few years as she had played a major part of his life. He agreed to, so I will find out next week if he did.


Why?


Or I get bulimic clients to contract to throw up at least once this week. Or get clients who have panic attacks to have one in front of me right now. Or I get clients to do drive byes of those who have spurned their affections in the past. I don’t do this to be unexpected but to disempower the problem being presented but they are also contracts that the client is not usually expecting. This is more necessary for the expert than novice client. The problem is, the unexpected then becomes expected. But that is another post and I can’t let all my trade secrets out of the bag.


With experienced clients one can sometimes get the comment, “You are so much better than my previous therapist”. That immediately gets the alarm bells ringing because (yes you guessed it) how long will it be until they are saying that about me to their next therapist. Also, of course one never besmirches a previous therapist or therapy with a client. That is a most unwise thing to introduce into the therapeutic relationship.


However by far the main advantage that the expert client has over the novice client is the relational. As we know the main factor in psychological change comes from the relationship the client has with the therapist. The novice client obviously can’t benefit from this whereas the expert client can.


Graffiti

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