Not sure about the first question. I think if someone is open to the idea of being helped, then they can be. As to the second, I definitely think tailoring the approach is a good thing. My T had to shift her approach a bit after some stuff she was doing didn't work with me. And I don't seem to do well with CBT (cognitive-behavioral) type approaches--it's like part of my brain overrides it. She's also been a bit more flexible with out-of-session contact than she normally would be (though that led to a bit of a rupture when she thought I was expecting too much of her).

And I guess my marriage counselor could be said to be tailoring things for me, too, since he allows me to have some individual out-of-session contact with him, like through e-mails/texts/occasional phone calls (though we usually later discuss the content in session with my husband). This started when I revealed some transference for him, which led to some abandonment fears and stuff that was difficult to deal with in a joint session.

I know some people on the board have been helped by meeting outside the office, like going on walks, things like that. Actually, one time when I was having a panic attack in a marriage counseling session, MC suggested the three of us walk outside in the courtyard together. And that really helped, because it wasn't just all of us sitting and staring at each other. I haven't done this personally, but some others on here have talked about things like doing art, playing games, doing sand trays, etc. with their T's. I think sometimes it may need to be about building the relationship and trust first, so that could take different forms with different clients.

Totally rambling here, but hope that helps somehow!