Working with Difficult Clients

Working with Clients: Reflections on the Process

According to the American Psychological Association (APA) dictionary definition of “Unconditional Positive Regard,” the concept reflects “an attitude of caring, acceptance, and prizing” that the therapist offers to a client “irrespective of his or her [client] behavior and without regard to the others’ personal standards” (“Unconditional Positive Regard,” 2021). For example, even when counseling a client exhibiting frustrating behaviors, such as engaging in continued drug abuse after treatment, the therapist tries to see the client’s world from the client’s perspective. The therapist must understand what types of stressors may be leading to the client’s behavior, such as a sense of emptiness, a desire to return to a familiar routine, and a lack of other pleasurable activities and hope in the future.

Only if people feel safe to be honest can they change and grow; the therapist’s asking people how they feel, rather than passing judgement, is essential (“The Surprising Benefits of Unconditional Positive Regard,” 2021). However, not all clients are in the necessary place in their lives to benefit from unconditional positive regard. If a client is in a very physically or emotionally insecure place, such as a woman who has just experienced a domestic violence situation, the client may not trust the unconditional positive regard being offered as valid.

Likewise, if the therapist is dealing with a client who is engaging in unacceptably violent or self-destructive behaviors, it can be difficult to extent such unconditional positive regard and empathy beyond a certain point. If a rupture occurs in the relationship due to this, healing may need to be contingent upon certain behaviors of the client. A therapeutic contract beforehand, which outlines the expectations of the client and the therapist, and sets some boundaries regarding acceptable and unacceptable behaviors and expectations, may be necessary (Sheperis, 2017).