Psychotherapists help people through psychotherapy & counselling. People go to psychotherapists for psychological or interpersonal problems such as anxiety, depression, marital problems, problems managing their anger, etc.
Psychotherapy/counselling is effective in helping the person get insight into his problems, into his behaviour, attitudes, the inner working of his mind; Psychotherapy/counseling may help the person change and feel better.
At other times, psychotherapy/counseling is partially successful or not successful at all.
The therapy's effectiveness can slow down to a considerable extent because the client who seeks counseling is resistant to counseling. Resistance can be caused by different reasons. Resistance can be conscious or unconscious.Resistance to counseling can manifest in different ways.
Apart from resistance, many factors in (a)the client, (b)the therapist or (c)the therapeutic process itself can slow down the effectiveness of counseling .Here is a list of resistance to counseling and the causes of the resistance and a list of reasons which slow down the therapeutic process. This list is based on my experience as a counsellor.
My experience as a counsellor: I have counseled children, youth and older people from all walks of life and a variety of psychological and psychiatric diagnosis in India; I have counselled people without a diagnosis i.e. without serious mental health concerns.In Canada, I have mostly counselled adults with developmental delay and autism.
FACTORS SLOWING DOWN THE EFFECTIVENESS OF PSYCHOLOGICAL COUNSELLING
1When a person doesn't believe he has a problem which needs counselling but is persuaded to go to a counsellor by his well-wishers.
When the person doesn't believe that he has a problem; For example, some teenagers like to go to a counsellor and talk...they may lie or be truthful, in the session but they are in the counseling session for a lark!
2When a person himself seeks counselling but in a half-hearted way...i.e. he lacks faith in the counseling process but goes to a therapist 'anyway'.
A person can believe in counselling but may lack faith in the therapist.
This can happen because he is not convinced by the therapist's qualifications
or he may not believe in the therapist's abilities to counsel because he is discriminatory(for example he 'assumes' that the therapist is not good because she is a female or because the therapist is of a different race and so on.)
3 The person can lack belief in himself i.e. he may think "Even if I get counselling, I don't believe it's going to help me'.
4. When a person prefers 'medicine' instead of counselling to help fix his problem. When he believes that a doctor or a psychiatrist would help him but doesn't feel the same degree of confidence when a therapist offers counseling. This person may end up going to the counsellor because the doctor refused to give him medication and suggested counseling or because he could not get a doctor or psychiatrist for some reason. I have had people asking me tablets for 'improving memory', 'increasing IQ', 'reducing anger' and so on! I have often seen many people reluctantly exit the 'psychiatrist's office and even more reluctantly enter mine! They would rather be seen by the doctor than a therapist. This reluctance and lack of faith definitely hinders the counseling process.
5. Progress in therapy slows down to glacial speed, when the people seeking counseling are in denial of their own role in the problem they are facing. Denial is one of the most powerful factors which slows down the effectiveness of counselling. Denial can be unbelievably hard to break and people can be in denial for years and years or even their entire lifetime! The same set of behaviours constituting denial has been called by different names. Behaviours amounting to denial have also been called as delusional thinking, poor judgement, stupidity, blindness and so on.
A few of the many denials I have come across in counselling are given here. An adult with developmental disability does not believe that she has a developmental disability despite proof provided by a series of valid psychological tests. She called the test report as 'a piece of paper' and that she did not do well in the test as she found the tests boring. This denial about her disability has made her take various poor decisions which is leading to severe economic and other hardships for herself and her family.
A mother refused to accept that her daughter is autistic; she fought against this diagnosis until the girl turned 21. She continued to make her daughter attend a regular school for typical children, made her daughter attend all sorts of classes in the hope that she was normal or would become normal.
A middle aged man refused to accept that his financial decisions are terrible. He bullied his adult daughters into borrowing loans and investing in his schemes. He was in denial about his poor finance management and one of his two daughters was herself in denial about her father's deteriorating cognitive abilities; the other daughter was aware but did not have the courage to stand up to him. He was adamant and refused to seek financial counseling or psychological counselling.
6. Poor counselling skills of the therapist is a huge barrier. This can be poor training, poor application of knowledge, personality traits which are vital for counseling but lacking in the therapist such as empathy, patience, non-judgemental attitude, etc.
7. The therapist who is both knowledgeable and has the necessary personality traits but lacks faith in his abilities to counsel, lacks faith in the client's abilities to participate in or benefit from counselling or lacks faith in the therapeutic process, will only put a half-hearted effort in the process, thereby sabotaging the counseling and dooming it to failure.
8. Insufficient time for counseling, interruptions to the therapeutic process, loss of interest or energy through the counseling process by either the client or the therapist can also sabotage the process. This can happen in many ways. Sometimes clients cannot afford to pay for as much counselling as they need and get less sessions than they optimally need. Sometimes the insurance pays for 10 sessions but the client may need more sessions to improve or change. The client may move or the therapist may stop working for some reason or the client may have to change therapists for some unavoidable reason.
9. Certain qualities or absence of certain qualities in the client can interfere with the counseling process. some of those which are extremely interfering with the counseling process are given below.
ADHD or ADD: Clients with poor attention span or low interest span cannot participate effectively in the counseling process. I have observed that they jump from one topic to another in less than a minute and it's not possible to stick to a topic and talk about it in depth even for 5 minutes. Or the ADD can manifest in non-stop talking and the client does not listen when the therapist has something to say. Very limited progress can be made with these clients especially if they are also poorly motivated to engage in counseling.
Moderate DD and severe developmental delay: It can sometimes be challenging to engage clients with moderate or severe DD in the 'typical' therapeutic process. The therapy has to be modified and simplified extensively. The chief barrier to benefitting from counseling for clients with moderate or severe DD is the poor memory and poor ability to practice what was suggested in the counselling. Yet, I have had partial success with many clients with moderate DD due to seeing them several times in counseling, their high level of motivation and other supports they receive, apart from counseling such as supportive families, behaviour therapy, etc. Some clients with moderate DD have concrete thinking and lack flexibility and this makes the counseling process significantly slow.
Clients with Fetal Alcohol Syndrome D and Borderline Personality D often are challenging candidates for counseling. They have poor ability to sustain interest, are often impulsive and difficult to engage in the counseling process.(BPD need a different counseling process by therapists trained in the process and a team works much better than an individual therapist)
Egoism, narcissism, superiority complex, etc all are challenges to candidates for benefitting from counseling.
Sometimes clients who have suffered abuse are referred to counseling. While a few clients prefer to talk about the abuse, some prefer not to talk about the experiences. Therapy would fail if it's for a limited period of time or limited number of sessions as time is insufficient for clients who take a long time to build rapport and open up. When an insurance company pays, the number of sessions can be limited.
A few DD clients who receive 'free' counseling enjoy coming to the counseling sessions. The counsellor and the therapy provides them many benefits which are unrelated to the actual therapeutic process. Clients who consider the therapy as a time for them to 'socialize' or a reason to 'get out of the house' or consider the therapist as a friend and the therapy as a social/friendly interaction don't benefit from counseling. Of course there are the non-therapeutic benefits of meeting the therpist but that is not the aim of therapy! Clients will state the 'problems' they have in order to have an excuse to seek counseling but they do not engage in the therapeutic process. They tend to 'chat', ask the therapist questions about the therapist's life, not take the suggestions given or not do the tasks the therapist has asked them to do.
Clients who attend the counseling sessions to vent about their grievences and dont move to the next stage have limited benefit of counseling.
Psychotherapy/counselling is effective in helping the person get insight into his problems, into his behaviour, attitudes, the inner working of his mind; Psychotherapy/counseling may help the person change and feel better.
At other times, psychotherapy/counseling is partially successful or not successful at all.
The therapy's effectiveness can slow down to a considerable extent because the client who seeks counseling is resistant to counseling. Resistance can be caused by different reasons. Resistance can be conscious or unconscious.Resistance to counseling can manifest in different ways.
Apart from resistance, many factors in (a)the client, (b)the therapist or (c)the therapeutic process itself can slow down the effectiveness of counseling .Here is a list of resistance to counseling and the causes of the resistance and a list of reasons which slow down the therapeutic process. This list is based on my experience as a counsellor.
My experience as a counsellor: I have counseled children, youth and older people from all walks of life and a variety of psychological and psychiatric diagnosis in India; I have counselled people without a diagnosis i.e. without serious mental health concerns.In Canada, I have mostly counselled adults with developmental delay and autism.
FACTORS SLOWING DOWN THE EFFECTIVENESS OF PSYCHOLOGICAL COUNSELLING
1When a person doesn't believe he has a problem which needs counselling but is persuaded to go to a counsellor by his well-wishers.
When the person doesn't believe that he has a problem; For example, some teenagers like to go to a counsellor and talk...they may lie or be truthful, in the session but they are in the counseling session for a lark!
2When a person himself seeks counselling but in a half-hearted way...i.e. he lacks faith in the counseling process but goes to a therapist 'anyway'.
A person can believe in counselling but may lack faith in the therapist.
This can happen because he is not convinced by the therapist's qualifications
or he may not believe in the therapist's abilities to counsel because he is discriminatory(for example he 'assumes' that the therapist is not good because she is a female or because the therapist is of a different race and so on.)
3 The person can lack belief in himself i.e. he may think "Even if I get counselling, I don't believe it's going to help me'.
4. When a person prefers 'medicine' instead of counselling to help fix his problem. When he believes that a doctor or a psychiatrist would help him but doesn't feel the same degree of confidence when a therapist offers counseling. This person may end up going to the counsellor because the doctor refused to give him medication and suggested counseling or because he could not get a doctor or psychiatrist for some reason. I have had people asking me tablets for 'improving memory', 'increasing IQ', 'reducing anger' and so on! I have often seen many people reluctantly exit the 'psychiatrist's office and even more reluctantly enter mine! They would rather be seen by the doctor than a therapist. This reluctance and lack of faith definitely hinders the counseling process.
5. Progress in therapy slows down to glacial speed, when the people seeking counseling are in denial of their own role in the problem they are facing. Denial is one of the most powerful factors which slows down the effectiveness of counselling. Denial can be unbelievably hard to break and people can be in denial for years and years or even their entire lifetime! The same set of behaviours constituting denial has been called by different names. Behaviours amounting to denial have also been called as delusional thinking, poor judgement, stupidity, blindness and so on.
A few of the many denials I have come across in counselling are given here. An adult with developmental disability does not believe that she has a developmental disability despite proof provided by a series of valid psychological tests. She called the test report as 'a piece of paper' and that she did not do well in the test as she found the tests boring. This denial about her disability has made her take various poor decisions which is leading to severe economic and other hardships for herself and her family.
A mother refused to accept that her daughter is autistic; she fought against this diagnosis until the girl turned 21. She continued to make her daughter attend a regular school for typical children, made her daughter attend all sorts of classes in the hope that she was normal or would become normal.
A middle aged man refused to accept that his financial decisions are terrible. He bullied his adult daughters into borrowing loans and investing in his schemes. He was in denial about his poor finance management and one of his two daughters was herself in denial about her father's deteriorating cognitive abilities; the other daughter was aware but did not have the courage to stand up to him. He was adamant and refused to seek financial counseling or psychological counselling.
6. Poor counselling skills of the therapist is a huge barrier. This can be poor training, poor application of knowledge, personality traits which are vital for counseling but lacking in the therapist such as empathy, patience, non-judgemental attitude, etc.
7. The therapist who is both knowledgeable and has the necessary personality traits but lacks faith in his abilities to counsel, lacks faith in the client's abilities to participate in or benefit from counselling or lacks faith in the therapeutic process, will only put a half-hearted effort in the process, thereby sabotaging the counseling and dooming it to failure.
8. Insufficient time for counseling, interruptions to the therapeutic process, loss of interest or energy through the counseling process by either the client or the therapist can also sabotage the process. This can happen in many ways. Sometimes clients cannot afford to pay for as much counselling as they need and get less sessions than they optimally need. Sometimes the insurance pays for 10 sessions but the client may need more sessions to improve or change. The client may move or the therapist may stop working for some reason or the client may have to change therapists for some unavoidable reason.
9. Certain qualities or absence of certain qualities in the client can interfere with the counseling process. some of those which are extremely interfering with the counseling process are given below.
ADHD or ADD: Clients with poor attention span or low interest span cannot participate effectively in the counseling process. I have observed that they jump from one topic to another in less than a minute and it's not possible to stick to a topic and talk about it in depth even for 5 minutes. Or the ADD can manifest in non-stop talking and the client does not listen when the therapist has something to say. Very limited progress can be made with these clients especially if they are also poorly motivated to engage in counseling.
Moderate DD and severe developmental delay: It can sometimes be challenging to engage clients with moderate or severe DD in the 'typical' therapeutic process. The therapy has to be modified and simplified extensively. The chief barrier to benefitting from counseling for clients with moderate or severe DD is the poor memory and poor ability to practice what was suggested in the counselling. Yet, I have had partial success with many clients with moderate DD due to seeing them several times in counseling, their high level of motivation and other supports they receive, apart from counseling such as supportive families, behaviour therapy, etc. Some clients with moderate DD have concrete thinking and lack flexibility and this makes the counseling process significantly slow.
Clients with Fetal Alcohol Syndrome D and Borderline Personality D often are challenging candidates for counseling. They have poor ability to sustain interest, are often impulsive and difficult to engage in the counseling process.(BPD need a different counseling process by therapists trained in the process and a team works much better than an individual therapist)
Egoism, narcissism, superiority complex, etc all are challenges to candidates for benefitting from counseling.
Sometimes clients who have suffered abuse are referred to counseling. While a few clients prefer to talk about the abuse, some prefer not to talk about the experiences. Therapy would fail if it's for a limited period of time or limited number of sessions as time is insufficient for clients who take a long time to build rapport and open up. When an insurance company pays, the number of sessions can be limited.
A few DD clients who receive 'free' counseling enjoy coming to the counseling sessions. The counsellor and the therapy provides them many benefits which are unrelated to the actual therapeutic process. Clients who consider the therapy as a time for them to 'socialize' or a reason to 'get out of the house' or consider the therapist as a friend and the therapy as a social/friendly interaction don't benefit from counseling. Of course there are the non-therapeutic benefits of meeting the therpist but that is not the aim of therapy! Clients will state the 'problems' they have in order to have an excuse to seek counseling but they do not engage in the therapeutic process. They tend to 'chat', ask the therapist questions about the therapist's life, not take the suggestions given or not do the tasks the therapist has asked them to do.
Clients who attend the counseling sessions to vent about their grievences and dont move to the next stage have limited benefit of counseling.
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