and what do you think would be reasons that no therapist wants a certain client?

[ECHOES]

I don't think it is possible.

[jexa]

I agree, I don't think it is possible. I think some therapists don't work with some clients, but even perpetrators of horrible crimes can find a good therapist.

[BlueMoon6]

I think there is a T for everyone. My T works with perpetrators. It also makes her a good T for survivors. I think some ts may limit the number of high need clients they take on, but I dont think no one wants a certain client.

And I dont think you are that client that no T wants. Did something happen in therapy, Solar?

[rainbow8]

I agree with the others. Did you see your T again? If so, I hope you brought up your reactions to her talking about her family. If she's not right for you, another T is. You are not a client no one would want!!!

[kitten16]

Any therapist who wants only easy clients, or attractive clients, or articulate clients, or ones who dress well and smell good and would be ideal hip friends or whatever, shouldn't be in the field!

I agree, there's no client who's so intractable that no therapist would want them. It is hard to find good therapists, though (boy, is that clear from this board) -- but it doesn't mean they're not out there. (Or so I keep telling myself )

Lauren Slater is a psychologist and writer who writes incredibly movingly about these things. In one of her pieces (some are anthologized in the Best American Essays series) she talks about a breakthrough with a really tough case, a prison inmate who hated women and said so. As therapy progressed, each of them made inner discoveries, and ultimately he was weeping in her arms. Gosh, I need to read that again!

Anyway, if you're feeling rejected, that sucks! We expect acceptance from therapists more than from any other kind of person. They're sort of like priests. Their attitude should be: nothing human is foreign to me. They're supposed to be able to identify with their clients, no matter how the externals of the other person's life might differ. The need to be seen and heard and understood is universal, and that's partly what they're trained in.

Long way of saying -- if a therapist rejects you, it's not you. Not all of them are competent. Or their style of relating might be unhelpful. But it's not about you. You can be any way you want to be. It's their job to help you. You're presenting yourself, saying, Look, I know I'm damaged. If a therapist can't handle that, WTF?

That was a big problem for me in my own initial session with my current T. I kept apologizing and saying, I'm sorry I'm not very good at this! He said I didn't have to be!

Therapists have all kinds of standards for what they need to be. Clients don't.

[deliquesce]

that's a really lovely post, kitten. thank you .

[elliemay]

I would actually contend just the opposite. I do think there are clients that no therapist wants. That doesn't mean that therapists can't or won't objectively treat that client.

A client that only wants someone to listen to them complain or is wildly inappropriate I can't imagine would be wanted, treated yes, wanted - not necessarily.

I'm sure there are patients that no physician wants, but they provide care for them anyway.

[Perna]

I don't think one can know since a client can't work with more than one therapist at once and that takes time. I've not known of a therapist asking a client to leave unless, at the very beginning after the initial interview they say they don't think they're qualified to help that particular person. That's not a personal rejection, just an admission of not having tools to help that particular person.

[mobius]

Outside of the question itself, this sounds like a pretty painful position to be in - if it's what you're thinking about yourself. If that's the case, I wonder what leads you to think it. If it's just rhetorical, well never mind

[Kiya]

*sigh* seems that way.... i'm going from T#5 to potentially T#6... and so far no one wants to work with me

[pachyderm]

Originally Posted by kitten16

Any therapist who wants only easy clients, or attractive clients, or articulate clients, or ones who dress well and smell good and would be ideal hip friends or whatever, shouldn't be in the field!

I was told a number of years ago by the receptionist at one of the prestigious mental health clinics here, when I was asking for help (in a tongue-tied way), that this establishment wanted and needed and would only serve clients who were articulate and could serve the needs of the therapists training there. In other words (my words), we were there to serve them, and not the other way around.

It happens.

[pachyderm]

One more comment: I recently finished a book called Psychotherapy With "Impossible" Cases. Do mental health people use the term "impossible"? Yes, they do. Why otherwise would these people write a book with such a title?

"Impossible" means something cannot be done. The impossibility lies in objective reality, not in the particular circumstances of client A with therapy B. People use words carelessly, and that kind of use can have consequences. It can kill.

off.

[kitten16]

((((((((Kiya)))))))))

Originally Posted by Kiya

*sigh* seems that way.... i'm going from T#5 to potentially T#6... and so far no one wants to work with me

[BohemianPrincess]

Even if a condition is one that will cause problems for a client for their lifetime, a therapists job is to help the client learn how to manage life with the condition. A therapist went to school for 8 or so years to help people with the trivialist of problems to the most difficult problems to live with. If a therapist turns a client away because they are too difficult to work with, then that is on them not the client. They are either not trained in that area or too incompetent to help anything bigger then someones bad hair day. Like I said in another post, unfortunatly some therapists get into the field because they want to drive a bently and not because they want to help people. It takes time to find a therapist that you can connect with. Dont give up!

[deliquesce]

Originally Posted by pachyderm

I was told a number of years ago by the receptionist at one of the prestigious mental health clinics here, when I was asking for help (in a tongue-tied way), that this establishment wanted and needed and would only serve clients who were articulate and could serve the needs of the therapists training there. In other words (my words), we were there to serve them, and not the other way around.

It happens.

not quite. many uni/training clinics only accept certain clients because the trainee therapists do not have the skills to help clients with "harder" issues. it's as much to train the therapists (give them practice at basic skills) as it is to protect the clients (dont sign them up with a T who doesn't have the required experience).
my university clinic will only accept clients with mild depression (i.e., nothing requiring hospitalisation) or the "Easy" anxiety disorders. basically because CBT is meant to be good for these and they want us to have practice using CBT in the way it is "meant" to be used before they introduce us to more complex cases (e.g., dual diagnoses).
in this case it's not that the more complex clients aren't wanted, but that the centre does not provide those services because the therapists there do not yet have those skills.

[amandalouise]

Originally Posted by Solarwind

and what do you think would be reasons that no therapist wants a certain client?

Yes it is possible and happens a lot.

We get clients all the time that come in because they are court mandated. I hate working with those folks. they don't want to be there and they make it real hard to work with them. they dont think they have a problem, they dont want to talk they dont want to make any changes in their lives they are just there because the court said they have to be. We try to get them to open up and all we get for our efforts for ages is glares, sarcastic remarks and F this and F that. When I hear Im getting assigned a court case I cringe, Take a deep breath and say here we go again.

One type of client many of us here complain about is the ones that come in just because they have a friend who is in therapy so they want to be in therapy. What do they want to work on or change nothing, what do they talk about usually downgrading the friend that is in therapy. you just want to take them by the shirt and shake um and say you don't have to be here just because your friend comes to see us. If you don't have a problem and your life is hunky dory then you really don't need to be here. but of course we cant do that. We smile and let them ramble on or sit quietly for the hour then ask them if they want to come in again.

Another kind of client I get that I don't like is those that come in complain about problem, we work on ideas for solving that problem then they come in the next week with the same problem, didn't bother trying any of the suggestions, didn't bother trying to fix the problem their self. Week after week same problem with no attempts to do anything about it. Then they get upset when their insurance money runs out for the year and they are still stuck in the same problem that they started to see us for 8-10 months ago. I dont let it go for the whole year. if after two months the client hasn't put in any effort and hasn't accomplished any goals. I transfer them to another therapist in the agency, Some people just need more boundaries, and structure than others. I don't like to play the cold hearted strict type therapist but we do have a few therapists here that can pull that off and most times get results with these kind of clients. and if that doesn't work we just tell them sorry we cant help you if you don't want to help yourself come back when you are ready to get rid of this problem. Then we leave it up to them to call us. Usually they don't because they know if they do come in to see us we expect them to work on their problems. We did have one client that recently came back to us after seeing a few other therapists around the community. By this time they were ready to get rid of their problem.

[pachyderm]

Originally Posted by deliquesce

many uni/training clinics only accept certain clients because the trainee therapists do not have the skills to help clients with "harder" issues.

There was no indication that I ever knew about that this was the character of this establishment. And if this were the case, they made no effort to pass me on to someone better able to handle more "difficult" cases.

(((((((((((((((((solar))))))))))))))))

[mobius]

Amandalouise -

if after two months the client hasn't put in any effort and hasn't accomplished any goals. I transfer them to another therapist in the agency, Some people just need more boundaries, and structure than others.

How do you decide what qualifies as "effort" or having accomplished goals? Are these client-directed or therapist-directed goals? Just curious.

[BohemianPrincess]

I can see how a court mandated client might be a problem, but thats the job you signed up to do and having court mandated clients goes along with it. Also if a client comes in because they have a friend in therapy, then they must have some sort of problem if they are wanting to be that much like their friend. It just takes some digging. As for clients who dont try your suggestions, maybe ask what other kinds of suggestions they might like. Maybe your suggestions just arent any good.

[BohemianPrincess]

One more thing on that last type of client you mentioned, there is probably an underlying reason why the problem keeps coming back up and why they dont want to try anything.

[~firefly~]

Wow, the fact that any therapist would complain about any type of client makes me not want to go to therapy. What if a therapist thinks my problems are too trivial or judges me because it may take me awhile to talk about the more serious things of my life. It takes me awhile to admit parts of my life are hard even to a mental health professional. So thanks to the therapist who posted on here, its nice to know what therapists really think of their clients!!

Interesting post. I think so. But maybe that's only because I feel like I am one of those clients.

I've had 3 Ts get fed up with me because my depression won't improve - one T even told me that my reactions were "excessive" based on the context of the situation I grew up in!! Maybe so, but that doesn't help me now!! So much for being non-judgemental!! Grr! So I stopped with T for the time being. Tired of following their suggestions and doing my best to get nowhere and then be told off about it like I'm a child. I'm frustrated that after 3yrs of depression I'm nowhere near beating it - I don't need T to unload their frustration on me as well!!

Also, out of 6 Pdocs, 4 got fed up of me (inc my current Pdoc who is now just waiting for me to go back to Uni so she won't have to see me again), 1 was a mutual discontinuation (we both annoyed each other! lol), and the other I only saw once so didn't have time to get fed up of me.

The way I see it is that it is natural to get frustrated after time when you've tried your best and the patient has tried their best, and there is still no improvement. However, the patient should be directed to another professional instead of the T/Pdoc offloading all of their frustration onto the client!!

*Willow*

[Kiya]

Actually - same here with Pnurse. We both got mad at each other. She didn't want to take me from the start, saying I was "too complicated", but did anyway. Then she TOTALLY messed up, said it was my fault, i lost my temper and reported her and so we're not speaking to each other. Meh.

some people just aren't meant to work together. takes time to find the right one - sort of like dating relationships, i suppose.