If you donâ€™t know your clientâ€™s strengths, how can you capitalise upon them? Client factors account for 40% of the variance in outcomes and a wise therapist will play to their clientâ€™s strengths.
Clients are often defined solely in terms of their difficulties. â€œIâ€™m seeing my obsessional woman this afternoon.â€ â€œWhen that guy with MS turns up, tell him Iâ€™m running late.â€ â€œCan someone attend to the broken leg in cubicle three?â€
Modern medicine has come to be construed as an interaction between a physician and a disease rather than between a physician and an ill person striving to get well. (Scovern, 1999)
From a rigidly biological standpoint, the efficacy of a medication or other treatment should not depend upon the personal history of the client, but upon the nature of their disease. I once heard an eminent psychiatrist and researcher argue that a disease has no narrative: if he had a broken arm, he wanted his arm splinted, not to have tell the story of his life; if he had depression, he wanted an antidepressant, not to have to tell the story of his life.
Even within this narrow perspective, there is a role for client factors. The client who can be relied upon to take medication as prescribed is more likely to benefit from antidepressants than one who can not. A therapist who does not think in terms of their clientâ€™s strengths may end up wasting costly resources, not least of these being their own time.
Focussing upon the problem and then considering how client factors might impact upon treatment is insufficient. Gassman & Grawe (2006) found that successful psychological therapists focussed upon their clientsâ€™ strengths from the outset. Unsuccessful therapists tended to focus upon the problems and consider the clientâ€™s strengths only at the end of the session (if at all).
What strengths are relevant to therapy? At the very least, any therapist should know something of their clientâ€™s home, family, work and leisure interests, all of which can be enlisted to facilitate therapy. Iâ€™ve found that a healthy curiosity about a client and their circumstances always seems to throw up something which can facilitate therapy, whether it is a religious conviction, a talent for mechanics, an interesting friend or a flair for poetry.
So how do you start focussing on the clientâ€™s strengths? Iâ€™ve tried to get into the habit of asking myself what is it about my client, their personality, circumstances and supports, that has prevented their problem (whatever it is) from being worse than its is. Bearing this question in mind gets the session off to a good start.