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Read your clients’ information sources

Be aware of clients’ information sources in addition to your own. Newspapers, magazines and online forums vary widely in quality, but may contain information of use to you and your other clients. A client who I had advised on the control of panic attacks returned a...

Ensure that your client can say stop

Ensure that your client can tell you to stop or to go away. All but the most severely disabled clients should be able communicate these instructions and should be encouraged to do so. Professional codes of conduct require informed consent to treatment. Clients with...

My client won’t do as I say

One of the major challenges to the therapeutic alliance arises when the client fails to follow the therapist’s advice. Therapists can often be heard to complain that clients reject their instructions (sorry, “advice”) out of hand: Don’t they want to get better? Why...

Have stuck clients keep a prospective diary

Ask clients stuck awaiting change to keep a prospective diary. An explicit account of life after the hoped-for change can help clients unstick themselves and start changing now. Some clients (and some therapists) get stuck awaiting a single change which will solve all...

Prevent panic: keep your room cool

Prevent clients from panicking by keeping your room cool. Overheating clients can misinterpret a rise in room temperature as the onset of a panic attack. Panic occurs when benign physical sensations are interpreted as threatening, leading to a surge of adrenaline...

BPS Research Digest 3rd anniversary

In celebration of three years of continuous publication, first as an email newsletter and now as a weblog, the British Psychological Society’s Research Digest has published a special edition. The authors of seven psychology blogs have each provided an article...

Compensation cases and miraculous recoveries

Experience suggests that receiving compensation for physical or mental injury or distress is often followed by a significant improvement in the client’s symptoms. Many therapists decline to take on clients with ongoing compensation cases and some question the...

Leave deduction to Sherlock Holmes

Deductions impress clients, but incorrect deductions can be disastrous. Deductive reasoning has its place in therapy, but only as a means of generating hypotheses on which you can work with clients. A client who usually had bare arms arrived in a long-sleeved shirt on...

I have to breach confidentiality – part 2

Disclosures requiring that confidentiality be breached are rare. A little preparation should permit you to focus upon supporting your client through the process, preserving your therapeutic rapport. In part one, we considered how to react when a breach of...

Aim for reliability before availability

Reliability is more important than availability in the long run. Clients who know when you are not available can make informed choices regarding alternative sources of support. I once worked with a client who rang her GPs so frequently and insistently that they...