[firecracker09]

Two questions, similar ideas...

Is there a type of person that therapy may just not work for? I'm not thinking with a certain history or diagnosis, but more overall personality traits and characteristic. (ie. inpatient, defensive, overly sensitive, can't articulate feelings...)

What specific ways can therapists help combat those issues? For example using art/play therapy for those of us who think more creatively, going on walks for people who like to be active, out-of-session contact for those who struggle with once a week, giving homework if you like having tangible assignments...)

Sorry if that doesn't make sense!

[mindwrench]

I think a T should change up whatever they can to help the client to receive benefit from the sessions. I know for me personally, if I think a T is trying textbook stuff on me I will lose interest and call a time out to rethink strategy. One size fits all is a big turn off, and will probably be the reason I abandon the mental health industry.

[Skeezyks]

Hello firecracker09: Thanks for asking these interesting questions. Unfortunately the Skeezyks doesn't really know the answers. What I can say is that I am a person for whom therapy will never work. The reason is there is so much in my history I could never talk about that any therapist I might see would get only half the picture at best... plus at this point there's simply so much of it! I believe full disclosure is essential to a successful therapeutic experience.

I imagine too that the older one gets, the less likely it is therapy is going to be helpful. I think youth is a real advantage when participating in therapy. As one ages, it just gets to the point where too much water has flowed under the bridge, so to speak. A lot of therapy nowadays seems geared toward helping people make changes in their current & future lives. There are no changes I can make in my life. It simply is what it is. As I said to one therapist I spoke with: I know what my options are. I just don't like any of them.

[LonesomeTonight]

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!

i think that therapy needs to meet i
each individual clients needs, not just some one size fits all kind of thing. my first t, we just talked. all thhe time. it wasnt too helpful. I have DID, and i have inside kids that dont want to sit and talk.
so she started play therapy for when they came to sessions. that helpped so much.
my current t does what works best for each of us (alters)- so e like to sit and talk. some like to go for walks. some can open up easier while shopping or going out for lunch. some just want to draw and not talk. etcetera. so t does all those different things.

[amandalouise]

yes its called WRAP (Wellness Recovery Action Plan) an assessment is done to find out what problem areas a person wants to work on, what mental and physical health issues needs to be worked on, what kinds of services a person needs to help them. then goals and services are set up, and a treatment team is added. in short a person has all these services, treatment providers and treatment options that best fits their needs.

suggestion if you would like this proactive client is hands on wrap around kind of treatment option contact your or a mental health treatment provider. they will help you set up your WRAP program tailored for you.

[kecanoe]

I thin there are some people who won't be helped by therapy but I don't know that they have a common trait. Attachment disorders are very difficult to treat, I believe. And I have heard that personality disorders are hard to treat, but I have found a t who is helping me with that.

I definitely believe that treatment should be individualized. I think for some, somatic type of treatments are the best. There are studies that show that EMDR is especially helpful for trauma. In my experience CBT is helpful for addicts. I also believe that out of session contact is sometimes helpful, but that seems to vary for different people. Internal Family Systems works for some people, but H hated it and sees a t who is more of a coach and he likes that.

I wouldn't see a t that thought there was only one way to treat.

[bounceback]

I don't think sociopaths or narcissists can be helped because they don't think they need help. Most people who are advoidant can't be helped because they usually avoid going to therapists. (I was avoidant but now I am more borderline personality disorder I guess) There are also people who are court ordered who have to be there who really don't want help. Then there are others who just want to vent but don't really don't want to change. That is my opinion

[ADeepSandbox]

Me, probably! Due to an absolute refusal to be willing to trust anyone a hairbreadth more than I have to, to survive. In my therapy I spent most of my time trying to guess the therapist's thoughts and predict what she would say and do, and why, and carefully curating my disclosures and keeping her away from me to protect myself from this threatening total stranger I was locked in a room with.

I was too scared, distrustful, and good at BSing for it to work. I don't know if I will ever try again. I was too busy protecting myself to do anything else. I have some healing to do alone before I can consider taking the plunge again. I would just be wasting time and money otherwise. I'm not ready or willing.

[kecanoe]

I am avoidant. Therapy is helping. But I probably would not be in therapy if I didn't have a meltdown due to DID and depression and anxiety.

[Sarmas]

I fell into this category. I think partially in my particular case it was because I've hurried my feelings for so long and I've been through so much that it becomes hard to verbalize and trust someone with my deepest thoughts. I was a definitely a difficult client. I think it takes more time and perhaps a different approach to try to "breakthrough" and stop the cycle of holding things in. I know in my case if my T was a little more proactive that would've helped and by proactive means that there are more questions thrown out. My son has a similar personality as well and he needs to be questioned in order to get out the "story". Certain therapists practice that the client leads the session which is great but if the client doesn't start or feels that they can't start then perhaps a different method should be used. I fell into this cycle with my T session after session. I know my youngest loved playing games with my T. He's at comfort and he just talks. That was more needed when in the beginning of therapy now he trusts his at and can verbalize well. Sometimes he needs my help to et things out. I've noticed that my kids T uses a different approach when needed instead of getting frustrated and defensive. I would bring things into the session to hold in my hand to make me feel more at comfort. That was a technique that I tried using. This doesn't involve having the T intact the client out of session and putting the T through a obstacle course to achieve things. Although there are many clients that would love that outside contact many Ts would disagree due to boundary issues. I believe that a good T will find multiple ways to communicate and help client without disturbing boundaries. In my case my best sessions was when my T challenged me with questions that I was totally avoiding. those sessions that she sat and looked at me as if she was bored or lost all hope were the worse.

[Cyllya]

Originally Posted by firecracker09

Tailoring treatment to each client's needs?

Different therapy techniques are used for treating different problems (and I don't mean the diagnostic label, but rather the contributing factors of the symptoms), so they have to tailor treatment.

For example, CBT is good for correcting cognitive distortions. If a therapist tries CBT when you don't have significant problems with cognitive distortions, they tend to end up stating the obvious, being needlessly argumentative, or just straight-up gaslighting you.

Originally Posted by firecracker09

Is there a type of person that therapy may just not work for? I'm not thinking with a certain history or diagnosis, but more overall personality traits and characteristic. (ie. inpatient, defensive, overly sensitive, can't articulate feelings...)

I haven't been able to get help from therapy yet, and it seems that the reason is... I don't have the right problems! The benefits therapy is supposed to confer are things I seem to already have without therapy. Obviously, having those benefits is a good things, but (a) I'd still like help with my actual problems, and (b) it's darn frustrating to repeatedly get advice to go to therapy for my diagnoses.