Unrealistic expectations of clients

In the February issue, an Assistant Psychologist asked whether we are demanding too much from our clients, arguing that expectations regarding compliance with out-of-session tasks are unrealistic.

I agree with this assertion. From experience, many clients in group and individual sessions can struggle with the motivation needed to consistently engage with tasks beyond the session. Besides highlighting the unrealistic expectations regarding client adherence to 'homework' and its consequences, I think this article could be the start of an important discourse for therapeutic psychology. Whilst reading and reflecting on the article I could not help but think that there are other areas where therapists may inadvertently expect too much from clients – and it is important to keep this in mind during therapy.

Therapy is difficult and makes many demands on the client, some of which are by no means straightforward. Take therapeutic goals. Clients may be required to be lucid regarding their goals for therapy. Whilst this may seem simple for the conscientious, for the individual preoccupied with depression, grief, psychosis, caregiving or pain this can be challenging as they may not have the capacity or readiness to think beyond their ongoing challenge yet this could be easily forgotten. Furthermore, within therapy, clients may be expected to express their feelings in ways that make sense; recount often emotional memories coherently; participate in abstract thinking; apply novel skills and show improvement as therapy progresses; and throughout the therapeutic process, trust the therapist. None of these things are inherently comfortable or easy.

Granted, psychologists as therapists within the NHS endeavour to work in collaboration with clients to produce meaningful work. In fact, this way of working is dependant on strong client engagement. So when clients are unable to grasp concepts or engage as well as hoped this can engender feelings of frustration. Nonetheless, I believe it is important to acknowledge and always remember that the therapy process is challenging for the client. And it is with this mind-set that we can have realistic expectations of our clients in therapy.

But what problem does this solve? At the very least, having realistic expectations means that feelings of frustration could be substituted with that of understanding and empathy. It means therapists, especially the less experienced, can have an accurate outlook of client engagement in therapy. Moreover, it means that therapists can also be on hand to work with clients to tackle some of the difficulties they may be having in therapeutic process. And of course, it can help limit the discharge of clients who may be misperceived as disengaged with therapy.

Benjamin Kwapong
Assistant Psychologist
Older Adults CMHT, South and Central Liverpool