EXAMPLE ANSWERS: Q18

Q18. Discuss how you would deal with a client who has become dependent on you.

Learning outcomes: 1.12

Student answer There will be few good therapists who will not experience a patient or client becoming dependent on them at some point in their career. As the therapist you provide an exclusive space, where the client is able to be un-interrupted, and the focus is all about them. The sessions can be perceived as the only thing that helps, or as a solution for everything and you are the god of all progress; therefore dependence can occur. If a therapist perceives that a client is or has developed a dependence on them, the following steps may be appropriate Remind the client of the therapeutic contract and boundaries. As the therapist it is important to stick to these – a work telephone should be turned off out of hours; a skype account offline between sessions and responses to enquiries between sessions should be dealt with appropriately but without an open door access. Within the content of the session, refer back to the client as the agent of change, It is their work and progress which has brought about change. This may include working on recognition of certain aspects e.g. their increasing confidence in their own ability to resolve their future issues; their ability to move on and in ways that they have and can replace therapy with something they enjoy. It could also include future pacing of a time when the client has all of the resources they need to find their own solutions If dependence appears to continue, a re-assessment of the sessions and their purpose should take place. This will enable a sensitive but clear discussion as to the future aims of sessions and whether these can or should be achieved. A decision may need to be made at this point that the therapist withdraws services by referring to another therapist. This is a two pronged approach and it must be clear that the referral and withdrawal will take place even if the referral is declined by the client. (LO 1.12 Knowing how to sensitively and firmly handle clients who breach personal or professional boundaries)

Tutor feedback (DO NOT delete/edit feedback. Write amendments, additional information & thoughts underneath this table) Correct. You have demonstrated how to recognise and then sensitively and firmly deal with situations and personalities which breach your personal and/or professional boundaries. I hope you are able to advise your peers if such situations occur for them too. Thank you.

(Further student work goes here if requested through feedback)

Further Example Student Answer:  Throughout any sessions I would emphasise the progress they are making and the growth as a person they have made. Re-enforcing how well they are managing every situation they have encountered and will manage in the future using the future pacing process.

This positive re-enforcement should help the client to realise how they have grown and changed as well how they are capable of coping with life’s little trials as an individual reducing any dependence on our sessions for answers to their problems and increasing their confidence in their own ability to resolve their future issues.

After an initial session I usually have a fairly closely spaced follow up session to re-enforce and anchor their new thought patterns roughly one week later with one further follow up session up to one month afterwards if considered necessary, my normal block of sessions would only be for 2 or 3 session with email support or possibly phone support should they have a crisis.

Should I consider the client becoming dependant on our sessions I would ensure the next session included plenty of self empowerment suggestions and acceptance of their new found abilities to cope, if they still continued to make contact I would have to re-assess what they wanted from the sessions by further meta-questioning and decide if I was still able to assist them properly or refer them to another therapist or doctor.

Q18. Correct. This is a good answer, ultimately culminating in referral to another therapist if attachment issues persist, after efforts to address. You have demonstrated knowledge of how to sensitively and firmly handle clients who breach personal or professional boundaries.