# 140 October 2011

"Nothing is exciting
if you know
what the outcome is going to be"

Joseph Campbell

(continues below)

mental health professional trainings
primary care professional trainings
psychological assessment supervision and consultations
Shawn Christopher Shea
links and recommended readings


# 140 October 2011

When a Client Doubts Our Competence

TISA Description of the Problem: Unfortunately over the past 3 weeks I have been battling Lyme Disease and been pretty much flat on my back. Consequently, I have returned to the wealth of great tips in our archive to re-post another excellent tip. I hope you enjoy it, and I also hope to be posting a brand new tip in November, for my recovery is going well. In any case here is the tip as it appeared in August 2005. Enjoy.

Occasionally a client makes it plain that, at some level, he or she doubts our competence or ability to help. This type of interaction tends to be more frequent within the confines of the initial interview, when clients are often ill at ease and appropriately anxious about what is to follow. Time and again I have found both in my own work and in direct supervision that the less defensive the clinician comes across, the more effectively this hurdle is transformed. In the following tips by Solomon Shapiro, M.D. two very nice ways of approaching this problem non-defensively are described. See what you think.

Tip: Two of my favorite ways of addressing challenges to my competence depend upon conveying that I am comfortable with the client's concerns in an open and relaxed fashion as follows:

1) "I have known people who have stayed in therapy with the wrong therapist. I'm glad that you are raising this right up front."

2) "If you decide I'm not the right person for you, I'm committed to referring you to another therapist."

TISA Follow-up: I like both of these techniques, and they can also be used sequentially. They are a nice example of the power of moving with "resistance" as opposed to against it. Many times supposed "resistance" is not so much a form of opposition as it is a form of wisdom. It is a wisdom that may prove invaluable to both the client and the therapist if they choose to collaboratively tap it. In both of the above examples, the clinician is meta-communicating this fact and offering a chance for just such a joint exploration.

Tip provided by:

Solomon Shapiro, M.D.
Centre for Addiction and Mental Health
Toronto, Ontario, Canada

TISA is a site dedicated to advancing the science and art of preventing suicide and teaching clinical interviewing