After reading the title, your first guess might be “suicide” or “homicide,” but I don’t really mind that (anymore.) I know what to do with that – a lethality assessment and/or send them to the hospital (then do a bunch of paperwork to prove I did my job.)
Instead, I’ve learned (the hard way, of course) that it’s the subtle and seemingly-benign things that I should attend to because if I don’t, it has the potential to come back like a Raid-immune cockroach, who always brings his equally-nasty friends back with him.
Translation: burnout.
That said, here’s my Top 3 List of ”red flags”:
1) “You’re the best counselor I’ve ever had.”
Now, we were taught in counseling school about this, but a lot of times clients don’t actually say it in these words – or say it with words at all. Some variations I’ve experienced are:
- ”Now I understand. My last counselor said the same thing, but you explain it better.”
- A client walks in, looks at his/her watch and says: “Wow, I’m on time. I was always late with my last counselor.”
- “No one has ever understood me like you do.”
Is this pathology or “games” on the client’s part? Absolutely not (although it can seem like it sometimes.) Is the client lying? Probably not. Why they say or do it doesn’t truly matter, but the way you attend to it does.
When clients hold us up on that proverbial pedestal, making us higher than everybody else in their lives, there’s potential problems brewing for both us and the client. The danger isn’t really falling off the pedestal (because that’s bound to happen the first time we don’t return a phone call within 10 minutes.) Instead, it’s a possible sign that the client is starting to depend on us like a life raft…and we’re going to end up drowning if they ride on us for too long.
It’s our job to teach our clients to save themselves, which involves letting them float on our raft for a little while, but also to prepare them for when they fall off. A good technique I’ve found is to take inventory of the healthy coping skills they use, suggest more if needed, and remind them to use them.
Also, when clients hold us up higher than everybody else, they’re also holding us up higher than themselves. Deep down, they’re thinking that we are the ones that healed them, and they had nothing to do with it. A client that thinks like this isn’t going to get better. A few responses I’ve found to address this is:
- “I certainly appreciate the feedback, but remember you’re the one that’s done all the work here, I’ve just given you the tools.”
- “The fact you’re coming to your appts. on time now must mean you’ve reached the point where you’re ready to get better.”
2) “I’m fine.” “I’m okay”. “It’s all good.”
And maybe they are. But if this is their response a week after they were hospitalized or spent an entire session sobbing, you better probe around here. I like to ask:
- ”Tell me some of the good things happening in your life right now?”
- “Sounds like you’ve made some positive changes. Tell me about them.”
- “Sounds like you’ve been taking care of yourself. What have you been doing?”
We all know we ultimately can’t be held responsible for what our clients do. But if we take “I’m fine” at face value, we might end up in court explaining why our client did something bad 6 hours after our session. But you’re covered if you can write in your notes: “Client states she’s doing ‘fine,’ taking her meds, sleeping well, and going to A.A. 3x per wk on 2nd street.”
At the same time, it’s good for your clients when you probe around the I’m-fines. Many clients have been well-trained since childhood to be “good little boys & girls,” hide their feelings, not burden others with their problems, and/or believe no one really cares so why saying anything. Let them know you’re happy when they’re doing well, and you’re happy when they’re not doing well but willing to talk about it.
3) “What should I do about…”
Yikes! Advice-giving. Yep, we were all warned about this in counseling school, but I see counselors (myself included) doing it all the time. It’s hard not to, especially when you see the same client go off the rails several times in various ways.
But again, giving advice fosters the same type of dependence mentioned in #1, as well as reinforcing their core belief that they aren’t capable of doing anything themselves. Here’s one way I’ve found to handle this:
- Start with some variation of: “I can’t tell you what to do because I’m not you.” Then, depending on how that goes, you can try one or more of the following:
- “What has worked in the past when you’ve been in this type of situation?”
- “I know you can do <list their strengths>.” Then help them figure out how to use those strengths to solve the problem.
- Get pen and paper and say “Ok, let’s brainstorm. Give me some possible solutions, no matter how far-fetched you think they are, and let’s see if we can come up with something.”
- And what if you still get the I-don’t-knows or the I-cants? Then remind them, using whatever language fits the situation, that this is their problem, not yours…and you’re not going to do all the work to fix it.
Of course, these are just suggestions based on my own experiences. Most of the time they work. Sometimes they don’t. But I actually kind of like when they don’t, because then I get the opportunity to find more things that might work.
So if you’ve found something useful during your interaction with clients, feel free to add it in the comments section. We’d all be eternally grateful :)
