Collects anything that is deemed interesting

Alternatively, you can turn the problem into an opportunity to refine your skills of conceptualization, treatment planning, and establishing a sound therapeutic relationship. Difficulties often provide opportunities to improve your technical expertise and your ability to vary therapy for the specific needs of each client. You are bound to face challenges in treatment. Before we go any further, let's clarify the meaning of the word: `motivation' is the desire to do something. And that's all it is. It's not some magical drug that gives us the power to do whatever we want; To illustrate the point, here's a conversation I had with one of my clients. Let's call him Nate. Nate was a keen football player, but he was about to lose his place on the team because he wasn't turning up for his training sessions. We had previously identified some of Nate's key values as keeping fit, honing his skills, supporting his teammates and giving his best to the game. Russ: So what's stopping you from going along to the sessions? Nate: I've just got no motivation. Russ: Okay, so what are you doing instead of going to training? David's response to disagreement is unpredictable--one minute he seems fine, and the next he is purple with rage and explosive. Michelle's responses to disagreements are as sudden and surprising as David's. But instead of heating up, she freezes and withdraws. For days, Michelle will remain silent and icy with those who have inadvertently offended her. Claire comes from a family where conflict routinely ended in punishment. She has learned to conceal--even from herself--situations that make her feel frustrated, sad, or frightened. Her goal is to maintain peace and tranquillity in all of her relationships, but Claire's long string of here today, gone tomorrow relationships calls into question the wisdom of her belief that the way to win friends and influence others is to avoid conflict altogether.

Andrea insists that she can deal with conflict in a totally rational manner. But in the heat of the moment, she often loses it and ends up feeling ashamed and embarrassed by behavior she can't seem to control. Communication Skills That It's important not to blame yourself or the client. Some difficulties arise because you're human and, therefore, fallible. Other difficulties arise because your client is human and, therefore, fallible. You may very well learn the most from clients who have been challenging to treat. At every session, it's important to monitor clients' emotional experience, cognitions about therapy and about you, their depth of understanding, and their progress so you can uncover problems. When you do identify a problem, conceptualize it. Is there something the client is doing or not doing or saying or not saying in session or between sessions that's a problem? Is there a problem with something you're doing or not doing or saying or not saying that's a problem? Is it a limited problem or a more general one? Use the questions in this article to diagnose what's going on and create a plan to improve treatment. Nate: Well, you know, by the time I get home from work, I'm just so tired. I can't be bothered doing anything. Russ: So what do you do? Nate: I guess I usually crash on the couch and watch TV Russ: So suppose I rang you one evening while you were crashed on the couch and I said, `Hey, Nate, get your butt off that couch and go to training', what would you say to me? Nate: I'd say `Get f***ed! Russ: Fair enough.

But once you'd calmed down, and assuming you didn't hang up on me, what reason would you give me for opting out of training? Nate: I'm too tired. Russ: You'd rather watch TV? Help Resolve Conflicts The attuned relationship bond that originates in infancy creates a template for successful communication in adult relationships. Most of the emotionally intelligent, nonverbal skills developed at that time continue to be benchmarks for resolving conflict. These communication skills include the following: The capacity to remain relaxed and focused in tense and intense situations. If you don't know how to stay centered, relaxed, and in control of yourself, you may become overwhelmed emotionally in challenging situations, such as the following: The discovery of marijuana in her son's backpack was very stressful for Sandra. Before acting on her impulse to confront him, however, she honed her emotional intelligence by taking a walk to calm herself down and prepared for a conversation rather than an argument. In this more balanced state of mind, she could express to him how upset and worried she was. She listened to his side of things, and together they worked out a plan to deal with his stress and concerns about peer pressure. REFLECTION QUESTIONS Which kinds of problems do you think you'll have most difficulty handling? What can you do? Mental Status: LENNY appeared to be quite depressed. His clothes were somewhat wrinkled; His movements were a little slow. His speech was normal.

He showed little affect other than depression. His thought process was intact. His sensorium, cognition, insight, and judgment were within normal limits. Nate: Yeah. Russ: So your desire to crash on the couch and watch TV is greater than your desire to go to training? Nate: [sounding defensive] I want to go, I'm just too tired. Russ: I'm sorry if you perceive my words as critical. My aim here is not to criticise you. It is purely to give you a more helpful way of looking at your own behaviour so you can learn from it and change it - if that's important to you. Is that okay with you? Nate: Sure. Russ: So let's think about this for a moment. The first thing to remember is that our behaviour always serves a purpose. The ability to experience intense emotions and recognize what matters most to you. If you numb or ignore basic feelings, such as anger, sadness, or fear, you compromise your ability to face and resolve differences. If you fear emotional intensity--yours or someone else's--or insist on exclusively rational outcomes, you will be unable to use the emotional intelligence tools you need to resolve conflicts, such as in the following example: Michele and Josh were lovers and good friends when something happened that triggered a rush of emotions in Josh. He saw Michele having dinner with another man. Before confronting her, Josh took time to acknowledge to himself the anger and hurt he was feeling. When he subsequently talked with Michele, Josh drew on his emotional intelligence and was honest about his reaction to seeing her with another man.

As it turned out, the other man was an old friend of Michele's who was in town for the day. Josh's conversations with Michele about his feelings led to a new degree of closeness and intimacy in their relationship. These kinds of misunderstandings are also very common in work settings. He was able to fully participate in treatment. Diagnosis (from the Diagnostic and Statistical Manual of Mental Disorders or the International Statistical Classification of Diseases and Related Health Problems): Major depressive disorder, single episode, severe, with anxious distress. No personality disorder but mild obsessive-compulsive personality disorder features. Current Psychiatric Medications, Adherence, and Side Effects; Concurrent Treatment LENNY was not taking psychiatric medication and was not receiving any treatment for his depression. Current Significant Relationships Although LENNY had withdrawn somewhat from his family, his relationship with his two grown children and four school-age grandchildren were good. He sometimes visited them or attended his grandchildren's sporting events. He had a great deal of conflict with his ex-wife and had completely withdrawn from his two male friends. So what purpose is served by crashing on the couch and watching TV, instead of going to training? Nate: It's relaxing, I guess. Russ: So in the short term it makes you feel good and helps you avoid the discomfort of going to training? Russ: But unfortunately, in the long term, it's not helping you to live the life you want. Your skills are getting rusty, your fitness level is dropping, and you're in danger of being kicked off the team. Russ: So can we say it like this: it's not that you have no motivation. It's simply that your motivation to avoid discomfort and do what feels good in the short term is triumphing over your motivation to keep fit, hone your skills, support your teammates and give your best to the game?