A few people in this world feel that walls and barriers are the answer to everything. If we block the situation, we can pretend we don't have to address the issue. However, when we work with clients, we need to understand how to remove any barriers that might come up for them. We can't anticipate all of the obstacles, but your experience should lead to some insight.
Estimates regarding premature treatment termination range from 30% to 65% (Baekeland & Lundwall, 1975; Eiduson, 1968).
Reasons include:
Previous treatment experiences (Carpenter et al., 1981; Kournay et al., 1990; McKay, Bennett, Stone, and Gonzales, 1995; Rogawski & Edmundson, 1971)
Expectations of treatment and reasons for seeking help (Carpenter et al., 1981; McKay et al., 1995; Noonan, 1973)
Referral source and motivation for treatment (Armbruster & Fallon, 1994; Carpenter et al., 1981; Kournay et al., 1990)
The therapeutic relationship (Acosta, 1980; Russell, Lang, & Brett, 1987).
Another study shows that merely projecting that one will experience barriers throughout treatment may lead to lower levels of commitment and involvement in treatment (Kazdin & Wassell, 1999).
Exercise:
Write a list of the client barriers that you've experienced.
Understand ways you can provide a resolution to those barriers.
Work on ways to integrate the solution to the barriers to existing and new clients.
Document your client attendance to ascertain if by providing a solution to the barriers assists clients in appropriate discharge and engagement in therapy.
You are reading part ten of our 11-part series around client engagement.
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