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Most clients have abnormal daily routines

We base our assumptions about normality on our own experience and risk mistaking the norms of our immediate social circle (or movies and TV) for demographic reality. I was asked to help stroke ward staff manage a patient who took his bed very early in the evening and...

You can always be misunderstood

There are two aims in any conversation: unambiguous expression of your own position and complete comprehension of the other person’s views. We should always remember that neither of these aims is a realistic goal. A client told me of an ante-natal appointment at which...

The Golden Rule is universal

Treat others as you’d like to be treated is a universal principle. Therapists who avoid working with other faiths and cultures can be assured that there is common ground to work from. Working with people with different beliefs can be challenging, especially for...

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...

Always ask when you don’t understand

Asking when you don’t understand benefits you and your clients. Pretending to understand can discourage disclosure and support poor decision making. When I began working with people with learning disabilities, I was told “don’t pretend that...