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Client 17 – year old female with history of ODD/IED/ and perhaps on the spectrum.
Honestly, I dreaded these sessions. I felt incompetent as I could not establish a rapport with this client. She would be nice when she wanted me to do something (write a letter for her service animal) however if I declined her something, she would say “im done” and leave the office. I was forever hopeful she would be a no show/cancel.
Oh, inhibited my empathy for sure. At some point, I don’t think I wanted to try anymore and might have demonstrated my frustration during session subconsciously. I sought out supervision at least twice to try to work through this and gain some insight and direction.
I’m not sure how my own history would have intensified this reaction. Maybe because sometimes I have doubts of my own skills and feel I need so much more “training” and skill development as I’m coming back into private practice. I have always had difficulty getting in deep and often keep things on the surface so as not to offend anyone or “be wrong”. I’m a natural “fixer” or people pleaser which I think contributes to the issue.
I would start preparing more for meetings with the client in advance. I also would back up and focus on meeting the client where she was versus having my own agenda. Developing trust and rapport would need to be primary before digging into any work. If I was feeling frustrated and discouraged, I can only imagine what she must have been feeling. I would continue to seek supervision as well.
With this particular client, I don’t feel disclosure would be helpful. I am not certain she would understand and might only take away the negative aspects of the issue versus the clarity gained.
Anger towards the client, dreading the session or loathing the client, sense of relief if client no shows or cancels, putting off rescheduling.
I would be direct yet supportive in my approach. I might say something like “ Dalene, based on our previous discussion I am aware that you feel less than competent with this client. You have stated that you are struggling with connecting with her and that you feel frustrated with her and yourself. Im wondering if perhaps connecting with a therapist to talk about your feelings of self-doubt and your fears of offending people would be helpful to move you to a place where you could gain some self-confidence and assertiveness skills. I think it would be helpful for your work with this client and in general.