therapeutic progress

When a Client Feels They Aren’t Making Progress

You see an email from a client between sessions that states they don’t feel like they are making enough progress in therapy. You find your stomach tightening and your mind begins to spiral. You catch yourself thinking, “am I not an effective therapist? Am I failing them somehow?” After all, many mental health professionals take ownership over session progress or failure as we have a lot invested in the clients we serve.

 

I want to normalize this experience by stating that an initial emotional reaction to perceived negative feedback is valid. Our desire to help others is valid. Even the client bringing up their progress or lack thereof is valid. To truly embrace this experience as a growth opportunity for our clients and ourselves, consider the following steps to remain grounded and present through the process.

 

Notice Your Own Stuff. It’s important to notice our reactions and responses to a client saying they don’t feel they are making progress. We may question our abilities. We may find ourselves hurt or defensive. We may want to argue with the client. Notice how you want to respond and hold space for those feelings. Seek supervision or consultation if it can help you hold and process those emotions in preparation for moving forward to the next step.

 

Remain Curious. It’s important to remain curious about why a particular response is coming up for you. Do you recognize a people-pleasing part of that wants all clients to be happy with the work you do? Are you fearful of a negative review? Did their comment reveal deeper fears of feeling out of your element or incompetent? Perhaps you are feeling blindsided by their feedback because you felt the last few sessions were full of powerful processing. Remain curious about what response is showing up loudest and why.

 

Boldly Brainstorm. Once you’ve recognized your own response to feedback and work through it, you are ready to re-engage your client. What would it be like to explore their bravery at naming how they feel? Can they identify the barriers that prevented them from bringing it into the room in a previous session? Is there an expectation that needs to be clarified for them to feel good about the work? Or do they need a different fit or referral based on their progress to date? By modeling for the client that these types of conversations are welcome, not only can we better understand where they are coming from to brainstorm solutions, we can also encourage transparency in communication going forward.

 

Although a client reporting they feel they aren’t making enough progress can be initially upsetting, it can serve as a powerful opportunity to reconnect and communicate on the expectations and structure of therapy for the better. I hope these ideas can help you navigate unfamiliar territory with grace so that future feedback can not only enhance a client’s therapeutic process, but your clinical skills as well!