By Gareth Holman, PhD
Twenty-percent of our clients account for eighty-percent of our stress. For these clients, good enough therapy is not good enough.
When I consult about “stuck” clients, I often ask the therapist to rate three questions on a ten-point scale:
- Have you given your client honest and complete feedback?
- Does your client ‘own’ the process? In other words, if you were to disappear from his or her life, would he or she have an idea of how to keep the process moving?
- Is your client making real changes in daily life—and not just in the therapy room?
With stuck clients, these ratings are usually between four and seven. In other words, not completely abysmal. But there is a gap between where we know things should be and where they are. The cost of failing to close this ‘good enough’ gap is your ongoing stress and burnout. Whereas the payoff will be some of your proudest and most liberating professional moments.
Scan your client list. Find the clients where the work is stuck, and then rate yourself on the three questions above. Be honest.
Now write yourself a sticky note or put a reminder in your phone to ask yourself the following question daily:
“Did I do my best to move beyond good enough to the living edge of presence, engagement, honesty, and compassion?” (Or if you are asking yourself the question before or during your day, you might phrase it differently: “Am I doing my best to move beyond good enough to the living edge of presence, engagement, honesty, and compassion?”) Ask yourself the question often enough so that you move these needles:
- Lean in to offer honest feedback to your client (be sure to balance your honesty with compassion and clarity about the why behind your feedback).
- Work with the client to find a therapy path that he or she can genuinely own.
- Find a way that the client can begin making real changes in daily life (you might have to slice behavior thinner; or you might need to find a more meaningful change).
Doing all of that skillfully is the work of closing the gap from good enough to life-changing for the people who need you most. They deserve that. So do you. This work is neither simple nor easy. Yet I would guess this work, beyond good enough, is really why you are here.
Gareth Holman, PhD, is a Seattle-based psychologist and consultant. His private practice focuses on improving relationships and communication, and he trains and consults with therapists and coaches worldwide who are practicing functional analytic psychotherapy (FAP) and related behavioral therapies.