Managing Challenging Clients

Within a counselling environment, the need may arise for a counsellor to work with clients who appear resistant to change or unhappy with external assistance. Some clients, who are attending counselling due to a mandated requirement, may resent the fact that they feel coerced into attending. Such clients may cite benefits such as meeting parole conditions or court orders as their only motivation for attendance.

Consequently, many individuals can view a counsellor’s involvement in this process as an imposition of their rights and they take the view that what is happening to them is in some way the counsellor’s fault.

Similar to any interpersonal transaction, an individual’s behaviour can become challenging when they feel threatened, undervalued, judged, or simply if the counsellor they are dealing with appear to have differing goals or desired outcomes than they have for themselves (Roes, 2002).

Defining a Challenging Client

As a counsellor, not judging clients is crucial to the therapeutic interaction. So, defining a challenging client can be difficult in itself. There are many reasons for people becoming challenging clients. As counsellors, labelling them can interfere with the therapeutic relationship, build tension, stress and undermine the counselling dynamic.

Some clients may have a justifiable reason to feel angry or frustrated. Sometimes clients may present as being challenging because of negative life experiences and a reluctance to participate in counselling can be a defence mechanism (Norton, & McGaulry, 1998).

There are different types of challenging clients that a counsellor will encounter over the course of their work. They are described below:

Aggressive and Angry – This may be obvious to the counsellor as direct physical violence, or physical intimidation, which by its nature is destructive, and which is directed at harming or controlling other people.

Complainers – Clients who complain about their position but are unwilling to try anything new or do anything about their situation.

Unresponsive and Silent – Clients who are unwilling to engage in any type of conversation or divulge any information about themselves. They will usually only provide minimal responses.

Superficially agreeable – These clients are ‘yes’ people, in that they will agree with anything you say but rarely follow through with action.

Pessimists – These clients will always find a reason why your suggestions cannot be attempted and will not work (“yes but” players).

Know it all’s – There is nothing these clients do not know or have not done.

Illusionary – These clients do not acknowledge that they have any needs. They are ‘special’ and can’t understand why they are required to attend counselling.

Indecisive – These people are likely to put off a decision until it is made for them or no longer an issue.

Drug affected and intoxicated – This refers to clients who are under the influence or affected by alcohol or drugs.

It is important that a counsellor acknowledge each of these types of client challenges are of a behavioural nature and do not cover the unique problems associated with socio-economic or environmental issues (Norton et al, 1998).

Considering Basic Human Rights

When dealing with challenging clients we need to remember that each and every individual is entitled to a number of basic human rights.

As individuals, clients have a right to:

• have and express their own feelings and opinions
• refuse requests without having to feel guilty or selfish
• consider their own needs
• set their own priorities and make their own decisions
• change
• decide what to do with their own property, body, and time
• make mistakes – and be responsible for them
• ask for what they want
• ask for information
• choose not to assert themselves
• do anything, as long as it does not violate the rights of others
• be independent
• be successful
• have rights and stand up for themselves
• be left alone
• be treated with dignity and respect
• be listened to and taken seriously
• get what they paid for

(Kottler, 1992)

If you are in a position of counselling clients that are considered to be ‘at risk’ in terms of their risk of becoming or being challenging, then it is important that you as a counsellor have adequate strategies and risk management procedures in place either in your practice or workplace, in the case of a challenging situation occurring.

Please Note: If you work within an organisation it is imperative that you become aware of the established procedures and protocols that exist for dealing with complaints, risk and crisis.

It is important for you to review the security arrangements within your workplace or practice, by considering the following:

1. Consider the severity of situations requiring back-up assistance.

• Have the local police, mental health team and emergency phone numbers clearly displayed (or on speed dial) on your phone.
• Consider procedures for making another staff member aware if you have concerns regarding a client – be clear about what you expect them to do. If you are working on your own then it is best to only see the challenging client when another person can be in the office.
• If the counsellor anticipates problems, have a colleague in the room with you.
• If the counsellor is on his/her own and a client becomes challenging, excuse themselves and leave the room.
• Keep the office door open, unless you are visible to others through a glass partition.
• Position yourself closest to the door.
• Be conscious of your personal safety and the information you disclose about yourself as the counsellor.

2. Discuss the process of isolating an identified problem.

Where do you deal with a distressed or angry client? It is usually better to take the client to a more private area to resolve their concern, keeping safety issues in mind. Taking someone into an office and addressing the problem indicates they are being taken seriously and are being listened to.

3. Know the process for reporting an incident.

Who is responsible for dealing with complaints and what is the procedure?

4. Know the practical safety considerations of your counselling setting.

• Layout of the office – including placement of furniture, whether you offer glasses rather than plastic cups, not offering hot beverages to the challenging client etc.
• Leave doors open but ensure that you are maintaining the client’s privacy and confidentiality.
• Encourage staff to consider having unlisted phone numbers.  Do not give out personal or after hours numbers.
• Review the arrangements for travelling with clients (if applicable).

5. Debrief with other counsellors to share their own experiences.

• How did they cope?
• What was the situation?

6. Take personal responsibility for your actions

• DON’T respond with anger and aggression
• Take into consideration your client’s needs and be aware of situations and statements that may cause aggression eg. culture, gender and language
• Be respectful, friendly, helpful and attentive
• Be non-judgemental
• Be calm
• Be aware of the client’s behaviour
• Know your limits

(Hanna, 2001)

Developing an Internal Process for Recording and Reporting an Incident

As discussed earlier, all counselling staff should be aware that each and every individual is entitled to act upon, or be treated according to the principles of basic human rights. As such, our clients are entitled to make a complaint if and when they feel it is necessary for them to do so.

To ensure complete and accurate records are kept with respect to a client complaint, it is the responsibility of the counsellor to:

• LISTEN to the complaint. Listen Actively.
• ESTABLISH if the client wishes to make the complaint in writing. Attach to Non-conformance complaint form and forward to designated Supervisor.
• RECORD the contact details carefully i.e. name, phone contact.
• RECORD where, when and how the complaint was received.
• DOCUMENT the conversation/complaint.
• DOCUMENT the corrective action that you have taken, how it was dealt with and by whom
• In the event that the complaint or incident remains unresolved, advise the client that they will be contacted within 48 hours (2 working days).
• INFORM the client of the outcome/result of their complaint.
• If the client is unhappy with the outcome/result, advise of other avenues (if applicable) of resolution i.e. mediation
• RECORD actions in complaint register.
• INFORM the client of the result.
• FINALISE complaint
• Do not offer advice or make promises you are unable to keep.

References

• Hanna, F.J. (2005). Therapy with challenging clients using the precursors model to awaken change. Washington: APA.
• Kotter, J. (1992). Compassionate therapy: Working with challenging clients. Los Vegas: Jossey-Bass.
• Norton, K., & McGaulry, G. (1998). Professional skills for counsellor: Counselling challenging clients. London: Sage Publications.
• Roes, N. (2002). Solutions for the treatment resistant client: Therapeutic techniques for engaging challenging clients. New York: Howarth Press Inc.