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Is it how they act, or their problems?

[stopdog]

Sometimes I think it is simply the attitude or mindset of the therapist.

[Leah123]

It's the bad judgement of their therapist.

I don't think seeing a client as difficult helps anything, and I trust competent therapists to have tools to work with all kinds of clients or refer clients out.

One thing to have difficult moments in therapy, but I don't buy into the "difficult client" label really.... more like... mismatches perhaps in terms of client, therapist pairs that have troubles. That was true in my case.

I suppose that depends on the client.

I've never been called "difficult," but I was aware that both my pdoc and my T had great concerns about me at times and were at times challenged about exactly how best to help me. In my case it was about my problems: the rather unstable bipolar disorder that wasn't responding well to treatment was frustrating to two very skilled professionals who were doing their best to find me some relief. They weren't frustrated with me; they were frustrated by their inability to help me as quickly as they would have liked.

[stopdog]

The first one I see has said I am a challenge for her and the second one has said I am a delight. I am the same with both as far as I can see. I don't believe either of them, but it seems to be coming from them-not me.

[atisketatasket]

I agree with the point that it's the judgement of the therapist that may be the problem. Someone who's very troubled may not be the ideal client, but the difficulties they pose are not ones they actively try to pose.

That said, I think it would be fair to say there can be more objectively difficult clients - someone who can afford therapy, for instance, but always puts up a stink about paying the bill. Or who is deliberately rude - e.g., is always late but never apologizes and still expects the full hour. I don't think that's what you had in mind though.

Here is one opinion about what is a good client.
The link is to part one.
10 Qualities a Therapist Recognizes in a Good Client, part 1 | Discussing Dissociation

Here is part two

10 Qualities Therapists Recognize in Good Clients, part 2 | Discussing Dissociation

[Rive.]

I think it's more how they act, than their problems or what they came to T for. In the latter case, imo, it would be the T who is not specialised enough or experienced enough to help that particular client.

In terms of difficult client, a few instances come to mind: people who don't want to change and/or automatically shut down any suggestion without even giving a try (predicting it won't work anyway) but then complaining that nothing is changing or the T is not helping. Clients who are aggressive/violent... or those who don't take responsibility or who pass the buck on to T for their problems e.g. 'I am not making any progress, my T is not helping me and is thus rubbish' etc.

Ts can't do the work for us not live our lives. We are the ones who have to be - or act as - the agents of change. Obviously, Ts ought to be able to support, encourage + impart therapeutic tools etc. but ultimately, it is our journey.

[JustShakey]

I think a lot depends on how well matched the personalities are. A client who may be 'difficult' to one therapist may be, as Stopdog says, a 'delight' to another.
My previous T thought me difficult, T says he enjoys me.

I agree with the above and stopdog. Not all therapists are a match to every client.
I have experience in this! My first t called me difficult every week because I couldn't talk to her, instead of looking at what she was doing to cause this she projected onto me and blamed me. My therapist now says she doesn't find me difficult but if she did she would explore what was happening in the room and was she contributing to it.
I am a trainee t and in our class , half of us prefer silent type clients and the other half find them a nightmare so in my experience I am convinced that it is the dynamic between client and therapist.

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[CantExplain]

Originally Posted by Starry_Night

Here is one opinion about what is a good client.
The link is to part one.
10 Qualities a Therapist Recognizes in a Good Client, part 1 | Discussing Dissociation

Here is part two

10 Qualities Therapists Recognize in Good Clients, part 2 | Discussing Dissociation

Sounds like they want patients who don't need any help.

[PinkFlamingo99]

I feel likeva difficult client because I can't stop hurting myself.

[Lauliza]

If s client is considered difficult I've heard it in the context of being resistant to treatment. But I am in s hospital treatment setting where there is a clear treatment plan and " difficult" is a little different in his setting than outpatient therapy. Still I think the most common type of client labeled "difficult" is one who repeats the same behavior over and over again even though cognitively they know it's harmful to them. I think this says more about the disorder being challenging than it does about the client. So I think it's the therapist's own skill set and personality type that dictates what they consider a difficult client.

[LindaLu]

Originally Posted by Starry_Night

10 Qualities Therapists Recognize in Good Clients, part 2 | Discussing Dissociation

I like the entry about Loyalty. For the therapist evaluating a client, loyalty would be a good proxy measure for compliance and docility in the dyadic relationship...

[PinkFlamingo99]

Originally Posted by LindaLu

I like the entry about Loyalty. For the therapist evaluating a client, loyalty would be a good proxy measure for compliance and docility in the dyadic relationship...

As long as the therapist feels the same.

[LonesomeTonight]

My T recently said that I'm a good client because I'm interested in the therapy process and willing to do the work to help myself get better (most of the time, anyway!) She said, for her, the clients that are difficult expect the T to do all the work, want her to tell them what to do and make all their decisions for them. Like they expect the T to be able to magically solve their issues without putting in any work.

[JaneTennison1]

Me apparently/ IDK I did the work, showed up, paid on time, thought about what T said. I am reactive though I try not to be and I guess that made me too difficult.

[stopdog]

Originally Posted by CantExplain

Sounds like they want patients who don't need any help.

The comments were fun. If a therapist told me they expected loyalty from me - I would laugh (before leaving and never returning). I don't think therapy is a place for loyalty.
This therapist sounds like she has a lot of issues. Just the way it was written annoys me. And I have little desire to be a good anything to a therapist. Good is used as a weapon against people - often women - to keep them under control.

[CopperStar]

My personal opinion would be that clients who lie and manipulate a lot as a defense mechanism could prove to be the most difficult; it could take months before the client is even comfortable enough to start telling the whole truth and nothing but the truth, and then it could be back to square one after months of the therapist thinking they were getting somewhere.

But I see it as just an "is what it is" sort of thing. Different people have different problems, and some problems are more difficult/stressful/confusing/etc to some people than others. Just like how some therapy approaches work great for some people, and are worthless for others. It's a matter of matching up a person's problems with a therapeutic style that will work.

I would think only narcissistic therapists expect their technique/style/approach to work miracles for everyone. And I do think there are plenty of narcissists in that field of work, unfortunately.

[The_little_didgee]

I've been called a difficult client for a few reasons, mainly because I am not easy to talk to. It takes me a long time to open up and feel comfortable with people. I'm like this with everybody. My obsessive tendencies also interfere with therapy because I will talk about a topic over and over again. It is just the way I am. Another issue is my trouble with illustrative language. I'm much too concrete. Sometimes my therapist has to explain common sayings such as, "In a pickle". I also question everything.

My therapist puts up with me because she recognizes my cognitive style and sees my motivation and effort. Her openness really helps too.

What do people mean by difficult ?

[divine1966]

Well some clients are probably difficult same as some students are or some patients etc it comes with the territory. Some have difficult issues and some are just difficult people. It is a given. You work with people, you encounter tough cases.

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Originally Posted by divine1966

Well some clients are probably difficult same as some students are or some patients etc it comes with the territory. Some have difficult issues and some are just difficult people. It is a given. You work with people, you encounter tough cases.

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But, what precisely is meant by difficult?

I think that was what the OP was asking, so there are several takes on what that could mean.

I think there are mental defences. That doesn't equate to being 'difficult'.
I think some like to 'pride' themselves they're difficult. But that in itself is a defence.