Encouraging Clients to be Preventative By Dan Bates, LMHC on 3/31/22 - 2:27 PM

Stephen Covey, author of The 7 Habits of Highly Effective People, said in his book, 

Look at the word responsibility—“response-ability”—the ability to choose your response. Highly proactive people recognize that responsibility. They do not blame circumstances, conditions, or conditioning for their behavior. Their behavior is a product of their own conscious choice, based on values, rather than a product of their conditions, based on feeling.

Covey is not a psychotherapist, but as a therapist I find it beneficial to take a page out of his playbook. I encourage clients to assume a proactive stance when it comes to the challenges they may face in life. I do this in a sober-minded manner, not sugarcoating the fact that they will indeed face hardships. In my own practice, I’ve found that upon hearing this uncomfortable message, clients find hearing the truth spoken ennobling, even if it hurts. Clients bring an abundance of untapped strength, fortitude, and resilience, which can be accessed and drawn forth in therapy, a fact that motivates me to candidly share with clients that problems only get worse when ignored. My goal is not to be obvious or annoying, but to lovingly embody the role Socrates played, to be the gadfly in the ointment; to assume the role no one wants to play, the bearer of bad, but truthful, news.

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Out of a sense of compassion, I ask my clients to directly face those ignorable “what-ifs.” In the absence of a plan, in the absence of daily health-promoting routines and rituals, what will happen if a client misses too many days of work? What will happen when a client’s spouse finds them drunk again? What will happen when a client forgets to pick their kid up at school once again? What will happen if a client consistently shrugs off opportunities to support their closest friends? Clients may rationalize and answer that yes, they are prepared to face certain contingencies. But when a problem is up close and personal, I’ve witnessed client after client ignore and avoid problems at all costs. Why do clients do this? Despite my best efforts, clients manage to play out the same pattern of avoidance, over and over again. Don’t get me wrong, I understand that clients are scared. To admit their marriage is struggling, to acknowledge their addiction is out of hand, to recognize their imperfect parenting, to confess their social shyness is causing isolation and loneliness, is truly terrifying. Facing a problem comes with the necessity of change, so, it’s easier to pretend like the problem isn’t there. I see this fear manifest in clients in one way or another, but I see it most clearly with couples.

In my experience based on the clients with whom I’ve worked, and in discussion with colleagues, couples tend to engage counseling services six years after the problem has been going on. Six years! That’s a long time to live with a problem. That kind of time allows resentment, bitterness, and hurt to accumulate to the point of no return. Neurologically speaking, allowing a problem to go on like that creates reinforced neural pathways that are hard to rewire. Relationally speaking, permitting a harmful relational pattern to persist unabated leads to irrevocable harm to intimacy, trust, and communication. So what’s the solution? How can I navigate this and motivate my clients to nip a problem in the bud? My way of approaching this issue is to encourage clients to be preventative, to seek a solution when the problem is in its infancy.

For example, couples who proactively work towards solutions before problems have reared their ugly heads make a commitment to attend maintenance sessions with a therapist once every few years or sooner. They do this habitually not because of a crisis, but because they want to make sure they are on the right track. That’s the ideal scenario, but not every client is at that stage. To get my clients thinking along these lines, I ask clients to take a moment and reflect on the fact that they see a dentist every six months for a cleaning. Why should they attend these appointments if they aren’t experiencing any dental problems? If you don’t have a toothache, why go? I usually get a range of answers, but the theme is usually prevention. It takes little effort to understand the benefit of preventing physical issues, but this logic fails to map onto mental health. So I gently nudge my clients to consider the logical contradiction, asking them to be consistent and apply the same logic to mental, emotional, and relational issues.

The alternative to being proactive is being reactive, I explain to clients. Reactivity, as I have observed over the past several years of doing clinical work, is defined as jumping to conclusions, being on the defense, only seeking solutions when problems are reeling out of control. In other words, it’s a bad strategy that doesn’t work, and it’s no way to live your life. I make the case to clients that if they are being reactive, they are only adding to the problem instead of working towards a solution; reactivity compounds problems. It is so much easier to fix a problem before it starts or in its infancy, instead of when it’s lingered, done damage, and been compounded by time and resentment.

I remember working with a mother and son who lived in a small apartment in the rough part of town. Their relationship could be defined as challenging. Mom fought the urge to not feel disappointed, but she felt like everything her son did made her mad. She was angry at him for getting poor grades, hanging out with the wrong crowd, playing too many video games, and getting into fights at school. She found that it was easier to be mad at him than to look at her own behavior and examine the reasons why their relationship had gotten so rocky. Keeping the focus on him kept the focus off her. Deep down, she was terrified to look in the mirror and acknowledge how her past and present actions had affected her son. I cautioned her that if things didn’t change between them, his behavior would likely worsen. I made the case that she had to come to the table and work on herself and the relationship before having any expectation of seeing him shape up. Despite my urging and pleading, I couldn’t convince her to let go of the blame and evaluate her behavior. Over time, the strain on their relationship grew too strong. He decided to move out of his mother’s apartment, drop out of high school and live with a friend whom she felt like was a bad influence. The day he left, they didn’t even say goodbye to each other.


So I urge you to encourage your clients to avoid living a life of reactivity and instead, to adopt a proactive, solution-seeking, adaptive, contingency-based, response-ability mindset towards current and future problems. You will find that when they do, they will be happy, and you will feel gratified.

Excerpt from: The 7 habits of highly effective people: Powerful lessons in personal change (25th Anniversary Edition). Rosetta Books.

File under: The Art of Psychotherapy, Musings and Reflections