Counselling Strategies for Dealing with the Lonely Client

In part 1 of this 2-part series, we explored the symptoms, causes and effects of loneliness. In this continued article, we’ll discuss various counselling strategies for dealing with the lonely client and provide you with guidelines to maintaining appropriate professional boundaries.

Counselling strategies for dealing with the lonely client

The level of loneliness a client experiences can be changed. It is important for the counsellor to recognise this. It is also important for the counsellor to be aware that loneliness is a common human experience. Loneliness does not have to be a negative or permanent state. Rather, it should be viewed as an indicator that important needs of the client are not being met (Peplau, 1998). A client will engage in counselling when they become overtly aware that their needs aren’t being met. The counsellor can help the client to identify which needs are not being met in the client’s situation.

Their loneliness may result from a variety of needs or situations. It may involve the need to develop a social skills or a higher level of social competence to seek a circle of friends. It may involve learning to do things for themselves, without social interaction i.e. friends. Or it can involve learning to feel better or more content about themselves in general by working on their self-esteem and/or assertiveness skills (Peplau, 1998). Sometimes, clients become so afraid of being alone that they may hold onto unhealthy and/or circumstances rather than risk the consequence of becoming lonely if they were to let go.

Talking to a counsellor can allow the client to explore and understand their problems, and to find the courage and strength to face and change the circumstance that they feel so overwhelmed by. The counsellor can teach them how to gain a healthy, functioning self-esteem to achieve a positive sense self-acceptance, and find relating to others is both achievable and enjoyable (Murphy, 1992).

Teaching a client how to create their own happiness alone is a key part of building self-confidence and overcoming fears of rejection and loneliness. As long as they do not believe that they can create their own happiness and enjoy life alone, then the client will be less confident and more dependent on others creating their happiness.

The feelings associated with loneliness are a self-perpetuating cycle – the lonelier a client feels, the harder it is to take steps to break out of their loneliness, and the harder it is for them to commit to change. As with changing any patterns of behaviour, it takes effort and commitment for the client to begin to move out of feeling lonely.

From a counselling perspective, breaking the cycle of loneliness requires finding its cause, then identifying any existing dysfunctional ways the client deals with it (hiding away, drinking alcohol, sleeping).

The next steps usually include identifying the settings and conditions under which one feels willing to communicate with others, and finally encouragement to take the ‘risk’ of contacting new people or former acquaintances, which is facilitated by the counsellors ongoing encouragement and support (Warwick, 2006).

It should be remembered that feeling lonely is a common human emotion experienced by everyone at times (it is not a defect). Intimate friendships take time to develop, and sometimes it is useful to help deal with the loneliness by having clients share their experiences with someone else (Aspel, 2001).

Encourage the client to think of themselves as a whole person. Not to neglect their other needs just because their social (friendship and companionship) needs are not being met. Some points for counsellors to consider when working with the lonely client is to encourage the client to:

• Realise that everyone gets lonely at some stage in their life. It doesn’t mean there is anything wrong with you or that you have to stay lonely. Loneliness is especially common when transitions or change is occurring.
• Get together with the people they know, even if they aren’t who they want to be with right now. Human contact makes more contact easier. Take risks about revealing themself. Saying what’s in their mind, if it seems at all likely the other person will be receptive. Teach the client how to be assertive.
• Encourage the client to learn how to see their detachment. Notice the difference between loneliness and solitude.
• Do everything they would normally do with a partner or friend. Many times it isn’t the partner or friend you are missing, but the activities and hobbies you shared. Take themself out for a date.
• Encourage them to connect with anyone who they assess to be genuine, and who is around you. Following their instincts about people can be important here.
• Set up social activities when they’re not feeling lonely. Plan in advance if possible. (Warwick, 2006)

If a client panics when left alone, and constantly seeks others out in order to avoid inner loneliness, it might be worth spending some time teaching them how to feel relaxed in their own company. Spending time alone may involve facing the difficult feelings that relentless socialising keeps at bay. It may also enable them to focus on the kind of person they really are, and what they really want to do.

It can also be worth encouraging a client to spend time concentrating or participating in something that really interests them, which they can enjoy as an end in itself. Focus on the pleasure it gives them and the fact that periods of time spent alone can be rewarding.

Does your client feel uncomfortable in situations such as meeting new people, speaking in front of groups, and dealing with someone who is upset, having to tell someone about a mistake, or divulging your inner feelings?  Fear of rejection may underlie all of these situations. Work with the client on their self-esteem, confidence and possible self-image.

If your client experiences difficulty overcoming fear of rejection as means of overcoming their loneliness, the following can be considered:

• If you find that the client is lonely because they fear rejection, try to get them to look at themself objectively. For example, notice some of the qualities a friend might value in them, and try to remember that they have these things to offer.
• Try to find out what things they have in common with others. By doing this they may realise they are not so different from others after all.
• If they find that someone is indifferent to them, remember that they may have something on their mind that makes them seem self-absorbed and thus it is not necessarily personal. (Loneliness, 2006)

Small group counselling can be helpful in providing an opportunity for clients to fully realise that other people suffer difficulties which may be similar to their own. They can compare notes, offer each other support, and learn, in a safe context, something of how other people see them.  The counsellor could facilitate a self-help or psycho educational support group for example.

The prospect of joining a group can feel a bit intimidating for the lonely client initially, but it can be a positive morale booster to realise that they are not alone in your feelings; that they are not weird; that people can respond to them with warmth and understanding; and that you have things to offer other people.

Teaching the client assertiveness skills can also be an important tool. Discuss the difference between non-assertive behaviour (“I lose, you win” – passive, indirect, avoidance); aggressive behaviour. “I win, you lose” – dominating, controlling, selfish); and assertive (“win-win”- caring, calm, understanding, diplomatic, honest, but direct and firm behaviour). The most successful relationships are assertive-assertive ones (Murphy, 1992). Teach the client how to be both an understanding listener who can communicate their own feelings in a direct, empathetic, and assertive manner to others (Counselling loneliness, 2006).

In summary, teach and encourage your client to not define themself as a lonely person. No matter how bad they feel, loneliness will dissipate when they focus their attention on the needs they currently meet and how they can develop new ways to engage their unmet needs through the counselling process (Counselling loneliness, 2006).

Short Case Study

Mary is a 38 year old, single, professional woman. In her childhood Mary experienced rejection by her father when he walked out on her mother and was eventually bullied at school.

Mary tells you in counselling that she can only be happy if she marries and has children by the time she is 40. She fears becoming too old to have children and not having a loving partner forever being alone. She now has a desperate need to get married; she comes to you for counselling to learn how to avert her fears of loneliness coming true.

Maintaining appropriate professional boundaries

It is important for you as the counsellor to understand and apply professional boundaries and ethics when working with clients from any client group. However, it is more important when working with clients who are presenting with issues and/or concerns of loneliness as they are vulnerable in terms of looking to establish social networks and relationships as a tool to their recovery from loneliness.

The professional counsellor working with the lonely client needs to consider. The following are boundaries in order to maintain an appropriate relationship with the client:

The counsellor needs to be self-aware and understand their own vulnerabilities in terms of their social needs in order to not transfer the counsellor’s issue to the client.

Have sound psychological health.

Be open-minded and objective with what the client is disclosing regardless of any level of resistance. Sensitivity to any cultural racial or ethnic factors which may exist in the way the client seeks social contact i.e. not appropriate to teach Muslims to use eye contact to engage people as it’s not a positive communication strategy in this religion.

Apply a level of professional competence in order with the ethical standards of the profession (see Australian Counselling Association – www.theaca.net.au – for a copy of these).

Be trustworthy. Counsellors who exhibit qualities such as reliability, responsibility and predictability safeguard their client’s disclosures; respond with energy and dynamism with regard to the client’s problem.

Be interpersonally attractive to the client. This occurs when the client perceives the counsellor to seem similar to them. It is not appropriate to achieve this with self-disclosure by the counsellor building rapport, establishing and applying an empathic relationship with the client.

Keep your professional development and supervision up. Debrief. The lonely client’s problem will be multi-faceted with loneliness being both a cause and outcome. As such, it can be difficult for a counsellor who hasn’t directly worked with this client group to work professional supervision –peer, individual or group will assist the counsellor to overcome any ethical dilemmas opt treatment/process issues.

Ensure you as the counsellor understand what the client’s expectations and purpose (goals) of counselling are to ensure the therapeutic relationship is assisting the client appropriately and consistently with regards to their needs.

Be aware of and possibly revise the stages or steps in the counselling process. If the counsellor follows these steps, then appropriate boundaries are more likely to be maintained than if a counsellor has no structure:

1. Relationships building – establishment of rapport and therapeutic relationship
2. Problem assessment – assessing or defining of the presenting problem/ issues/ concern with the client.
3. Goal setting – Identifying and setting of client goals by also taking into account the clients expectations of the counselling process.
4. Counselling Intervention – The counsellor selecting and indicating the appropriate intervention i.e. CBT, SFT etc.
5. Evaluations, termination or referral – this step involves evaluating the process with respect to achievement of the clients goals negotiated in Step 3. Introducing termination of the process, follow-up of the client post-counselling termination. If counselling of the lonely client is not able to be undertaken by the counsellor then a referral should be made and facilitated for this client. (Hackney and Cormier, 2005)

References:

• Aspel, Melaine, Ann., (2001). Let’s talk about feeling lonely. New York; Rosen Publishing.
• Hackney, H., Cormier, S., (2005). The professional counsellor – a process guide to helping. Boston: Allyn & Bacon.
• Loneliness, (2007), retrieved on 25 October, 2007. Retrieved from http://www.uoregon.edu/~counsel.
• Murphy, P.M., Kupshik, G.A. (1992). Loneliness, stress and well-being: a helper’s guide. London; New York: Tavistock/Routledge.
• Peplau, Letitia Ann, Perlman, Daniel, (1982). Loneliness: a source of current theory, research and therapy. Ann Arbor, Mich.: U.M.I.
• Warwick, (2006), retrieved on 25 October, 2007. Retrieved from http://www2.warwick.ac.uk/services.