Question: “I want to motivate my client to change.”
I have been seeing one of my clients now for 10+ sessions and from the first session, she openly says, “I’m not motivated to try anything in therapy…even though I know I need to change!”
She studies Law (a course she’s not interested in) and puts minimal effort into her studies, even though, when asked how she’d like her life to be, she wants to be “a good lawyer and live a comfortable, successful life.” She describes an “overbearing mother” as someone she has an “OK relationship” with but feels like her mum expects her daughter (an only child) to be as successful as she is.
In therapy, I have tried almost everything to move this client toward a life that she wants and that she’d be willing to work on. We’ve tried planning a study schedule so it’s not so overwhelming and leaves time for her other interests (e.g. dancing and writing). We’ve tried planning daily and weekly schedules that would be in line with the client’s interests and values. We’ve tried exploring issues deeper – comparisons with her mother, fear of failing and being socially judged, her despair at being stuck but unmotivated to do anything about it…
In all of this, I’ve tried to be empathetic, compassionate and to show myself as being on the client’s side – but nothing seems to stick. Every week, I get the usual story, “Everything’s just the same…what to do? I dance, I write, I plan to study and that doesn’t work out so well…life is comfortable and there’s nothing pushing me to do anything, even though I know this can’t last forever and I need to change. Oh well.”
Personally, I like the client. She shows up each week, she’s pleasant enough and receptive to my suggestions (at least on the surface). But at this stage, while I don’t mind catching up with her every week, I’m feeling like it’s a waste of time to carry on the sessions. I’m not saying the client is beyond help, but I feel like there’s nothing I can do. But the client says she enjoys the session because “it’s nice to talk and get some insights to myself.” That’s what she said about her previous therapist, too. What can I do with this client? Should I continue the sessions or admit that I don’t know how to help her?
Response from Dr. Chua:
It sounds like you’re having a tough time trying to pin down what the client wants, given that they seem unsure about how they would like to change, acknowledging only that they need to. You mention the client’s “overbearing mother” who has, perhaps, suggested all kinds of ways for her daughter to be more productive, more efficient, and more ambitious. Your client pushes back against that: she says she’s not interested in studying Law, and part of that might be due to the pressure of expectation she feels to be as successful as her mother.
As her therapist, you’ve tried “almost everything to move this client” – I wonder if there might be a parallel between your approach and that of the client’s mother, from the client’s perspective? It could be that you’re experiencing the same pushback from the client who views your well-meaning approach in the same light as her mother’s well-meaning advice.
You mention that you try to show yourself as “being on the client’s side” – what does that mean to you? Does it mean trying to nudge the client in a direction you feel would benefit her (like a mother), or does it mean seeing the client’s world from their perspective and allowing the room for exploration and explicitly fostering the client’s autonomy?
Life is comfortable, there’s nothing pushing the client to do anything. If life is comfortable, is there a need to change? If there’s no urgency, if the client comes across like “everything’s just the same”, then life might be mundane or a little bit stale for the time being…so what’s the problem?
As the therapist, your desire to solve the client’s issue for them (which is met with resistance) is leading you to feel inadequate and that the sessions are a waste of time. From the client’s perspective, it’s another comparison, another failure – proof that they’re beyond help. “My therapist is setting goals for me – another ‘do this, do that’ expectation that comes from them, not me.”
The client tells you straight away, “I’m not motivated…I know I need to change!” From the first session, they’ve expected you to try to tell them what to do, rather than holding space for them to open up, be themselves, and explore their struggles without judgement. The client has become a problem to fix instead of a person to be listened to, supported, and encouraged from their point of view.
The fundamental focus as a therapist should be on what’s best for the client, first in the “here and now”, and then once they feel validated and heard, to work with them toward the outcome(s) they desire.
It’s also important to check your own motivations during sessions. Ask yourself, “Am I invested in helping the client discover their needs, or am I more invested in ‘doing therapy’ as though the client is a textbook problem needing to be fixed?”
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