Introduction
When supervising group therapy, the professional may encounter problems of various kinds. In particular, there is the issue of the difficulty of working in a group where problem clients are present, and the therapy loses effectiveness. Among the most challenging clients, I would single out such types as silent and help-rejecting clients. These types create difficult conditions in the group and inhibit the therapeutic process.
The Silent Client
The Silent Client has some behavioral characteristics: reticence, difficulty with communication, and poor connection with the group. This type is complex because often, these people are introverts who are not used to having their problems paid attention to. They may have a long history of silencing their problems as the norm. For an open-minded therapist like me, it can be difficult for me to uncover and approach quiet patients.
Yalom and Leszcz (2020) suggest that such clients get few positive experiences from group interactions, and individualized settings are better. They indicate that nonverbal communication and empathic questions about the client’s comfort can help. While I agree with this, I prefer also to seek to integrate such clients into a group – social relationships are essential to some degree. I believe that taking the right approach and seeking answers to specific questions from quiet clients can be the main way to help them, even in group sessions.
In my practice, I have not yet encountered quiet clients. However, I have observed groups with such clients several times while studying the behavior of other professionals. Observation has allowed me to see what difficulties I might encounter and has shown me that it will be possible to deal with them through some techniques.
I would like to highlight one experience in which the leader’s behavior was, in my opinion, the most correct and competent. In such a group, the leader took on the role of not only someone who would lead the group and show ways of coping with stress but also an empathic listener. The leader asked questions that did not require the group members to be explicitly involved, and it was evident from the behavior of the quiet clients that they felt comfortable. Sometimes, the leader would address them directly and ask how the current environment was helpful to them. He also established trust with them through dialog and taught them how to communicate with others, allowing them to work at their own pace. I think this is a good and comprehensive example of behavior with quiet clients.
The Help-Rejecting Client
The Help-Rejecting Client (HRC) can unintentionally exaggerate the severity of the problem and refuse to help in any way. This is a complex type of client for me because they are like monopolists who cannot or will not accept help. In addition, I strive to realize help for the whole group, not just one person; however, HRCs want the therapist’s attention to be entirely theirs. My main difficulty is their competitiveness with other members. Yalom and Leszcz (2020) indicate an increase in persona value in the group, and I do not fully understand how this is supposed to work. Interpersonal communication is vital, but dealing with clients who do not realize their pushiness is challenging.
I once met with an HRC client and found it quite difficult to work in such a group. I encountered difficulties that I would describe as emotionally-involved and energy-consuming. My inexperience was a factor that exacerbated the treatment process. Moreover, each session seemed long and tedious even though I tried to use different techniques. HRC often distracted my attention, and I sympathized with his problem and could not find a solution. Other participants were discouraged that my attention was not evenly distributed among all members of the group.
I realize now that I should have acted differently and taken an example from the leader I observed. He clearly emphasized the therapist-client boundaries and showed that each member of the group was important, and no one was worse than the other. If I had had this experience, I would have been better able to handle the workload and be able to distribute my resources evenly, giving time to everyone and truly helping.
The Role of Culture
Culture can play a role in defining client characteristics and interfere with establishing their real issues. The client’s understanding of communication types may differ from what they are used to. Sometimes, it is difficult for me to establish the client’s real problem and behavior and where cultural conditions have shaped their thinking and psychological type. One’s own culture can get in the way of identifying problem clients because they are disguised as members of the culture. As a result, they do not receive the attention they deserve.
Conclusion
Silent and help-rejecting clients are the most difficult for me to work with. With silent clients, it is difficult due to their peculiar and isolated behavior in the group. With HRC, there are problems related to the therapist’s focus of attention and involvement in group interactions. Culture can inhibit identifying problem clients because one’s beliefs do not mesh with the client’s behavior and prevent them from cataloging it.
Reference
Yalom, I. D., & Leszcz, M. (2020). The theory and practice of group psychotherapy (6th ed.). Basic Books.