Introduction
My client is Gina, a fifteen- year- old girl in high school who is sexually active. In addition to this, she is having unprotected sex and sees no problem with this behavior. She has been referred to me by her parents and her school counsellor and is here against her will and has clearly expressed the fact that she is unwilling to talk about the “situation”. She displays hostility. The primary problem would be resistance to therapy.
I would be personally challenged in working with this client because we share tremendously different views regarding sex in terms regarding its purpose. My opinion on the matter would be the fact that based on my religious upbringing, sex was a tool for procreation and was meant specifically to be enjoyed within marriage. I would have a hard time being objective due to the attitude and seriousness the client approaches sexual matters. It would conflict with my fundamental values.
Another challenge would be presented by the fact that the client is uncooperative. She is openly hostile and unwilling to venture further into the information I had received concerning her situation from her parents and former counsellors. Her defensive nature inhibits effective communication because it is hard for us to form a connection. (Ellis, 2007). She appears to be in the pre-contemplation stage of change hence, she is not even conscious of any fault in her reasoning or actions. Due to these factors, getting through to her proves to be a Herculean task.
Among the best practices to work with the client effectively would be to understand and measure her level of resistance. Resistance is observed where the client is in frequent opposition to my methods. While impeding progress in finding the root of her problem, it could also shed light on certain details about the client. It would be critical in fostering a working relationship with the therapist who would then inspire change. Some forms of resistance are subtle such as saying, “I don’t know,” when asked certain questions. It is likely that she feels helpless because she has been sent here by an authority figure hence to maintain her autonomy, and she is liable to respond in negative or more evasive ways since she deliberately wants to prove her authority figures wrong. It would, therefore, be critical to remedy this situation by educating the client about therapy (Worden, 2003). Lack of cooperation could be due to certain misconceptions regarding treatment. This education could be in the form of explaining the mode or strategy of treatment, the duration of therapy and the content of the treatment course. It is also important to clarify what your role as the therapy is as well as what is expected of the client which enables us to have a shared or common goal and demystifies the entire process. It is also important to give some form of a performance appraisal or progress report to the client to show progress clearly.
Another practice I would use to work efficiently with the client would be to speak to the patient in a language that she understands (Worden, 2003). Using her language is not to be confused with using slang or mimicking her speech patterns but rather using illustrations or examples or case studies from her life that will enable her to understand the consequences of unprotected sex. For example, one may ask her if she knows a pregnant friend. If she does, it would be prudent to ask her why she thinks that happened. It would then be a wise talking point since the cause of the pregnancy would be identified hence the next step of finding out how all this could have been avoided. The better judgment could be supported by supplementary reading that would instil subconscious lessons and facts regarding risks associated with unprotected sex once a working relationship has been formed.
I would not consider referring her to another therapist because I would have been able to make measurable progress in getting the girl to trust me and have broken down communication barriers. I would only seek to refer if I felt that she needs further support beyond the period allocated for me to assist her.
Conclusion:
In conclusion, therapy would include a much more complex process than simply stating facts regarding why her reasoning and ignorance of consequences of her actions would prove detrimental. It is a process that involves breaking communication barriers and fully understanding your client’s reasoning process.
References
Ellis, A. (2007). Overcoming resistance: A rational emotive behavior therapy integrated approach. Springer Publishing Company.
Worden, M. (2003). Family therapy basics. Brooks/Cole Publishing Company.
