When NOT to Take On a Therapy Client

We always want to help. But sometimes the signs that this may not be a therapeutic alliance made in heaven are clear early on.

“What is easiest to see is often overlooked.”

– Dr Milton H. Erickson

Mandy, like me, was a new therapist eager for clients and happy to help. But she looked a little less eager than usual as she told me, “One of the first questions he asked me was ‘What do you look like?’!”

We always want to help. But sometimes the signs that this may not be a therapeutic alliance made in heaven are there early on.

This client came to see Mandy a few times, but always told her he’d “pay next time.” He barraged her with phone calls. He’d turn up to demand therapy without an appointment, on weekends, late in the evening. She eventually told him they couldn’t work together. Not the type to hear “no”, he persisted. Eventually the police warned him off and she was left in peace. But not without a dent to her confidence. She became my client!

Sure, Mandy could have ‘thin sliced’ this man’s communication and taken that one “what do you look like?” as a dealbreaker. But her eagerness to please blinded her to any warning signs.

Mandy’s case was extreme. But there are other, perhaps less obvious, signs that you and your client may not be a workable match.

Be discerning in all things

I’ve written before about when to end therapy with your client and when a client might want to end therapy with their therapist!

But here I want to share a few ideas on those rare times when we might want to not take on a client in the first place. Now, all kinds of clients can present tricky behaviour. They might seem resistant to help but still turn out to be great to work with. Or we might be able to even use their resistance as a force with which they can help rather than hinder themselves.

But sometimes taking on a client may prove to be much more trouble than it’s worth – for you, and ultimately also for them.

A thirst for clients

When I first started out I was desperate for clients. For many years I wouldn’t turn anyone away. And I really do mean anyone. I needed the money! And the amazing thing is, you can often help those clients who seem to have overwhelming difficulties, even if at first it seems a bit… impossible!

But, looking back, there were times I ignored my intuition and took on someone who proved to be a poor match for both of us. And I understood even then that just because I couldn’t help that person didn’t mean there weren’t others who perhaps could.

We work with everything we have, including who we are. Paradoxically, although we must sideline our own ego during therapy (including not requiring praise or reassurance from the client), we still need to use our unique humour, perspectives, insights, and idiosyncrasies to authentically and effectively work with clients. We are not machines.

But sometimes the clash is too great even for the adaptive, flexible, and creative practitioner you undoubtedly are!

So when might it be time to say “not me” to a prospective client?

Warning sign one: They set off your creep alarm

We can all misjudge someone – think things will be fine then later learn that no, this isn’t going to work. Or might even be dangerous. Heck, it certainly happens in personal relationships. We live and hopefully learn. But if we can learn from others, we give ourselves the best chance of staying sane and safe from the strangers we meet.

If that sounds a little paranoid, I want to emphasize that the vast majority of clients are decent people who simply need help. But, as Mandy discovered, a single client can cause serious distress.

Often there are signs very early on that the therapeutic alliance is going to be unworkable, or even that the client may have an ulterior agenda in coming to see you. It’s easy to ignore or discount those little warning signs, to push them to the back of your mind until it’s almost too late. Mandy did it, and so have I.

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As Gavin de Becker writes in his book Gift of Fear, there are always signs ahead of time that someone is going to be trouble.¹ But you have to heed those signs. And it may simply be a sense you get, a tingle of intuition.

Mandy convinced herself to discount her client’s strange behaviour. After all, they had spoken about all kinds of other things on the initial phone call. But the fact is, it stood out when the man wanted her to describe her appearance. Her creep alarm had been activated – yet she’d ignored it.

Your creep alarm is reason enough

I’ve heard practitioners say, after the event, “I knew I shouldn’t have taken them on!” or “I should have listened to my instinct.” This leads us to a really important point.

If your creep alarm goes off (and you’re not the type to be creeped out every five minutes) then that alone may be all the signal you need. It’s so much easier to not take a new client than to try to extricate yourself further down the line.

You might tell them that you are just too fully booked right now or that you feel someone else – perhaps a man if the prospective client is male and you are female – might better serve them. But ultimately you are not required to take on any client, and you are well within your rights to simply state: “I can’t take you on, I’m afraid!”

And if they persist? You can simply repeat this over and over – the famous broken-record technique so beloved of assertiveness trainers.

Mind you, this is far from the only reason not to take on a client.

Warning sign two: Their problems are beyond your expertise

I’m a firm believer that if we have a wide understanding of psychology, how problems arise, and what we all need, we should be able to treat most clients, at least to some useful degree.

But sometimes you might be presented with a client who you sincerely feel might be better treated by someone with a more specialized skill set. Maybe you’re not specifically trained in lifting extreme trauma or you just don’t feel comfortable working with clients prone to psychosis.²

Yes, it’s good to stretch ourselves to learn, but we need to gain skills before we can grow into the kind of practitioner who feels confident facing whatever problems present themselves. There’s no shame in referring a prospective client to someone you feel is currently better placed to help them.

But it may be that the client wants something you’re just not in a position to give them.

Warning sign three: You’re clearly not what they are looking for

“Can you help me discover what adults were saying around me in the womb?”

“I want to know if I was abducted by aliens.”

“Can you hypnotize my girlfriend to tell me the truth about whether she’s faithful to me?”

These are all requests I’ve had over the years. Now I’m sure using hypnosis I could help someone create a memory of having been abducted by aliens of being in King Henry VIII’s court… but then what? This isn’t why I got into therapy.

Now I’m not about to stomp over people’s beliefs. But it’s just not the kind of ‘therapy’ I’m interested in. It’s not my area of expertise.

This isn’t to say that even if you don’t believe in the ideology, you can’t take it as a metaphor for some situation in the client’s life and work within that framework to help effect change in their life. But it’s a lot of work, and there’s a risk they may be unconsciously seeking excitement or feelings of significance, which isn’t necessarily my job to provide (other than to help them meet those needs in more sustainable, useful ways).

Mind you, some requests are a little more sinister.

The man who called me up about his wife said he wasn’t sure whether she was being faithful to him or not. But he seemed to have no real evidence either way. He’d installed CCTV cameras in their home and would study the footage on his return from work. I suggested he come in for therapy, but no, he only wanted to watch as I “got to the truth” using hypnosis with his wife.

When they turned up for the session, I tried to work with him and the relationship and to reassure his wife, but no, he kept insisting I give his wife the “truth serum” of hypnosis. I told him I wouldn’t (and couldn’t) do this, and perhaps he should trust his wife. They didn’t come back!

People sometimes come in with naive notions of “discovering what happened” using hypnosis. When the man who insisted I “discover” what was said around him when he was in the womb came for his session, I had to suggest I wasn’t best qualified to treat him – although I did try to reframe his beliefs as to how memory works. There may be plenty of practitioners out there who will gladly cater for this kind of thing but, for many reasons, the ideas of ‘uncovering repressed memories‘ is not an ideology I can buy into to that extent.

Paradoxically, it’s these kinds of clients who are the most closed minded in some ways. It may be that they are so wedded to the use of psychobabble, mistaking the map for the territory as it were, that we may need to gently help them see their lives, themselves, and their problems in more sensible, less abstract terms.

And that’s okay – as long as they can loosen up their thinking. We may even be able to help them in their terms, using their ideologies and beliefs around their problems. But ultimately you may decide all this is just too much of a tussle – and that’s your right.

As for Mandy, she still practises therapy. In fact, her practice is thriving. But now she trusts her instincts more and always looks for the best possible match between herself and whoever it is that comes through her door for help.

Watch Mark Treat Real Clients

There’s nothing quite like seeing successful therapy done by an experienced practitioner when you’re looking to enhance your skills. Take a look at Uncommon Practitioners TV here – it’s like Netflix for therapists, counsellors and psychologists.

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About Mark Tyrrell

Psychology is my passion. I've been a psychotherapist trainer since 1998, specializing in brief, solution focused approaches. I now teach practitioners all over the world via our online courses.

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