Therapy with Difficult Clients

An approach to working with clients who simply do not want to change. Therapeutic change, in the view of Fred J. Hanna, hinges on the presence of seven ""precursors"" of change: hope, awareness, a sense of the necessity of change, the willingness to experience anxiety or difficulty, the willingness to confront issues, the exertion of the will or effort, and the presence of social support. The presence of these precursors bodes well for a client no matter what the therapist's theoretical orientation. Their absence creates roadblocks to therapeutic change no matter how skilled the therapist, how potent the theory, or how close the relationship. In this guide, Hanna offers a tool for assessing the readiness for change in clients and in therapists. He offers strategies, examples and insights for therapists who face seemingly insurmountable obstacles in the therapeutic relationship.