Therapy With Difficult Clients: Using the Precursors Model to Awaken Change
Why is therapeutic change so difficult for some clients yet easy for others? What are the telltale signs that a client is ready to push ahead, and what remedy is there when the challenge of change seems threatening or insurmountable? For therapists, these questions are timeless.
In Therapy With Difficult Clients, Fred J. Hanna suggests that therapeutic change hinges on seven factors. If the client has hope that change is attainable, feels the necessity to change, is aware, is willing to experience anxiety or difficulty and willing to confront issues, if the client will exert will or effort and has social support, the prognosis will be positive, no matter what the therapist's theoretical orientation or techniques. On the other hand, if these change catalysts, or precursors, are absent or deficient, there will be roadblocks to therapeutic change no matter how skilled the therapist, how potent the theory, or how close the relationship. The good news for any therapist who has ever encountered a client who believes change is frightening, unattainable, or a waste of time, is that the obstacles are not insurmountable.
In this practical guide, Hanna offers a tool for assessing clients' readiness for change. He offers an abundance of strategies, examples, and insights for enhancing the precursors that are lacking and leveraging those that are present. This model offers invaluable guidance for the stalled client and therapist alike.
I. Understanding Difficult Clients, Therapeutic Change, and Resistance
- What Makes a Client Difficult?
- Toward a Model of Change for Difficult Clients
- The Precursors Model: Skills and Functions of Change
II. Assessing the Potential for Therapeutic Change
- Rating Client Change Potential: Using the Precursors Assessment Form
- Rating Therapist Precursors
III. Clinical Applications: First Steps
- Orienting the Relationship Around Change
- Reducing Therapist Interference and Increasing Therapeutic Wisdom
- Multicultural and Gender Considerations: A New Adaptation of Cognitive Therapy and a Framework for Empowerment
IV. Clinical Applications: Implementing and Enhancing the Precursor
- Instilling a Sense of Necessity
- Establishing the Willingness or Readiness to Experience Anxiety or Difficulty
- Cultivating Awareness
- Enhancing Confronting
- Increasing Effort or Will Toward Change
- Building Hope for Change
- Developing Social Support for Change
- At the Horizon of Change
Appendix: Characteristics of Wisdom
About the Author
At last! Here is a book that offers real insight and practical guidelines for working with all our clients, especially those we find most challenging…Detailed, sophisticated, meticulous, yet eminently readable and down-to-earth, this book may very well revolutionize the way we conceptualize the role of the therapist. Fred Hanna has provided a real service to the helping professions!
—Johns Hopkins University
This is a good book—a very good book…It is full of warmth and wisdom, not to mention a broad and balanced view of the conceptual and practical panorama.
—University of North Texas, Denton