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Techniques for Dealing with Difficult Clients

Techniques for Dealing with Difficult Clients. Linda Swann, M Ed NAMI North Carolina August 30, 2010. difficult behavior - Is it … . Erratic? Accusatory? Uncooperative? Inflexible? Argumentative? Problematic? Highly emotional? . Our reactions to difficult clients.

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Techniques for Dealing with Difficult Clients

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  1. Techniques for Dealing with Difficult Clients Linda Swann, M Ed NAMI North Carolina August 30, 2010

  2. difficult behavior - Is it … • Erratic? • Accusatory? • Uncooperative? • Inflexible? • Argumentative? • Problematic? • Highly emotional? • ....

  3. Our reactions to difficult clients • “Fight or flight” mode • Culture of honor • Pushes my “buttons” • Makes it hard to think straight • Patience and empathy are at a premium

  4. Goals and objectives • What is goal of DTC? • What is the goal of the client? • Discuss how to keep goal and objectives “real.”

  5. Expectations Exercise • In small groups, list your (professional) expectations of the Drug Treatment Court (DTC) process:

  6. Expectations Exercise • In small groups, list what expectations of the process may be held by the client:

  7. Underlying mental health issues Is client • Hypersensitive to environment or emotions? • Over-reacting to what’s going on? • Struggling to stay in control (anxious)? • Unable to calm down and refocus? • Angry at system, self, or circumstances? • Poorly motivated to succeed?

  8. Reframing “difficult” behaviors – client may • Be confused • Be highly emotional • Taken by surprise • Have had a rough evening • Be used to no one believing him/her • Overwhelmed • Feel totally alone • Feel intimidated by professionals in room • Not feel safe

  9. Reframing in context of abuse – Client may • Feel very much alone • Be accustomed abandonment at some pivotal point • Expect no one to listen • Have difficulty trusting others • Be hyper-vigilant, always expecting danger, or at least, poor outcomes for self

  10. When feelings are intense … thinking is impaired!!

  11. Cognitive distortions at play • Concrete, very black and white, thinking • Unable to form reasonable generalizations of process or situation • Rationalizing why goals cannot be reached • Disastrous thinking

  12. Cognitive distortions at play • Mental filter - Accentuating the negative and discount the positive • Overgeneralization – one event seen as pattern of failure • Mind reading – assuming others are thinking badly of you • Fortune Telling – Predicting that things will turn out badly.

  13. Cognitive distortions at play • Magnification – Smallest mistake is projected into worst possible outcome. • Labeling and Mislabeling - Generalizing – “I am stupid.” “I am a loser.” • Personalizing– “If anything goes wrong, it must be my fault.” • Learned helplessness – “Nothing ever works for me anyway, so why try?”

  14. Techniques for dealing with challenging clients • Be prepared • Non-judgmental approach • Help client identify what he/she needs • What is the problem? • What do you need from me? • Respond to some “kernel of truth” • Demonstrate a genuine interest

  15. Techniques for dealing with challenging clients • Reflective listening • Acknowledge client’s lived experience, their reality • Direct your response to what he/she must be feeling (It must be difficult to ….) • Communicate that you understand • Do not correct or “disconfirm” other’s viewpoint until you have reflected his/her perception or feelings. • Your focus is on emotional content • Airport metaphor

  16. Techniques for dealing with challenging clients • “I” Statements used properly can help • Maintain your self-control • De-escalate an emotional situation • Put onus back onto the client. • Pause if necessary. • Walk away if it’s best. • Back-up plan • Be upfront about process • Tell them what you need. Repeat calmly as needed.

  17. Techniques for dealing with challenging clients • Focus on strengths • Begin with recognizing what client does/has done well • Help client to remain goal-oriented • Break tasks into smaller parts if necessary • Praise effort • Remember, client and DTC want same positive outcome • “Reframing” • Can a perceived negative be reframed into a positive?

  18. Brief reminder • System of Care model • Strength-based, family-friendly • Broad array of services and supports • Treatment Team meetings = heart of process • Wraparound approach, front-line service providers • Community-based; multi-agency

  19. What not to do • Be patronizing or condescending • Offer unsolicited advice • Solve their problems for them • Act like they are behaving inappropriately

  20. How to help yourself • Be prepared • Seek supervision, input from others • De-brief your supervisor • Look for “lessons” • Become the observer • Work to reorient the system

  21. There’s a hole in my sidewalk • Chapter one: I walk down the street and there’s a big hole. I don’t see it and fall into it. It’s dark and hopeless and it takes me a long time to find my way out. It’s not my fault! • Chapter two: repeat • Chapter three: I walk down a street. There’s a big hole. I can see it, but I still fall in. It becomes a habit. But I keep my eyes open and get out immediately. It’s my fault. • Chapter four: I walk down a street. There’s a big hole. And I walk around it. • Chapter five: I walk down a different street. • Portia Nelson, “Autobiography in Five Short Chapters”

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