The Impasse in Therapeutic Work - Essay Example

Impasse in Therapeutic Work Student’s Name: Instructor’s Name: Course Code and Name: University: Date Assignment is due: Impasse in Therapeutic Work Impasse in therapeutic work is a situation that blocks the agreement or progress of counseling sessions. There is a wide spectrum of causes for this situation. An impasse impedes the progress of counseling either by compromising relationships between the therapist and the patient or causing an internal battle within the patient that impedes his progress during counseling sessions (Cornell & Landaiche 2006, p. 196-213). Some of the most important competencies that are expected of therapists include the ability to identify and repair impasses within a therapeutic alliance. It is not just about the identification of the nature of an impasse but also about learning how to make use of the impasse to improve counseling results. There are various steps that a therapist can take to ensure that they can identify an impasse. In this case, the therapist is able to engage their client in a clear understanding of the relationship elements that seem to have gone wrong in their relationship. This can be done in various ways including letting the client know that the relationship between them and the therapist is a topic that they can discuss (Scheinkman & Fishbane 2004, 2p. 79-299). Consequently, the patient will be able to tell the therapist what they feel went wrong thus enabling the identification of an impasse. In addition, the therapist should offer non defensive responses to the negative experiences that the client has during a therapy session. The client should be helped so that they understand the emotional impact of the interventions as well as the therapy session in general. Clients can also be caught in impasses before they begin the process of therapy. In some cases, the client’s decision to go for therapy is facilitated by the need to resolve an internal impasse that results in the necessity of behavior change (Edgette 2006, p. 112-118). Consequently, the therapy session is seen as a means to an end. Other times, impasses in therapeutic work are characterized by the client taking a rigid position and increased escalation and reactivity. When they are caught up within the impasse, the client is often unable to see the other individual’s point of view, and this prompts the therapist to take steps to correct this. In some cases, such a situation would make it harder for the therapist to continue, as it might make them doubt their abilities in counseling their client. The therapeutic impasse is a stalemate to the processes of achieving the therapeutic goal. Essentially, it is a change in the therapeutic relationship or processes that result in the client feeling that they are not benefitting from the therapy as much as they used to before (Varcarolis 2005, p. 156-170). Manifestations of such as situation take on different forms with some involving emotional withdrawal of the patient and other symptoms such as long periods of unproductive silence between the therapist and the client, increased interest in real life problems while therapeutic issues take a back seat and increasingly emphasizing on symptomatology (Cornell & Landaiche 2006, p. 196-213). These manifestations results in the deterioration of the relationship between the therapist and client. The patient will seem unable to contribute his share in the counseling session and will instead demand that he be given more direct guidance by the therapist. The cause of this deadlock between the patient and therapist is not linear. There are multifaceted issues that all affect the counseling session including internal issues in the client. The common feature in all the different types of impasses in therapy is that they stop or they slow down the progress of the therapy sessions. Some examples of impasses that occur in therapeutic work include a situation where the client is unwilling to explore certain traumatic experiences so much so that they also become resistant to exploring the unwillingness (Johnson, Makinen & Millikin 2001, p. 145–155). In addition, the client and therapist may disagree on ways of resolving a conflict. The existence of sexual feelings between the therapist and client often cause an impasse since the client may be reluctant to reveal some information or they may have greater and unprofessional expectations from the therapist. Another cause of an impasse could be when the therapist and client have an unhealthy relationship. Other than that, the therapist may have used an intervention that is unsuccessful for that particular case. This is common with juvenile delinquents who often hide information from their therapists yet this information is vital to the formation of an effective intervention. They are not always permanent and the therapist can work through it with the client. In order to work through the issues, the therapist has an obligation to remain objective so that he can identify the cause (s) of the impasse (Burns 2007, p. 112-118). Application to two practice situations The first counseling scenario presents the story of a boy called Damien. Damien has several risk factors that make him highly susceptible to reaching an impasse during his counseling sessions. Identifying the risk factors from his historical and biographical background is important in determining the possible causes of the impasse which will give the therapist ideas on the steps to take to get past the impasse. Some of the risk factors include having emotional trauma from exposure to parents who abuse substances, being abused in foster homes, being moved around in foster homes, being a witness of domestic violence and being physically abused. These issues make him susceptible to an impasse because he might be reluctant to trust the therapist after having been moved around and he may also reveal very little about his personal life. Being that he has always moved around, he might also have abandonment issues. Other than that, he may get angry when confronted about his peers and told not to associate with them anymore if he wants to be a better person. He thinks that he owes them and suggesting that he cut ties with them may put the therapy session at an impasse. This case shows how a variety of issues can contribute to the occurrence of an impasse. He counselor executed the role they had been given effectively. After learning about Damien’s background and finding out that he was vulnerable, the therapist then decided on an intervention that ensured little chance of an impasse and if there was one, the therapist would know what to do to get past it. As Damien justified his behavior as being caused by alcohol, the therapist learned that the subject of alcohol was a sensitive one and that it is possible he believed it was an escape. In addition, therapeutic work is subject to influence from outside bodies and Damien was an involuntary client because he had to attend the counseling sessions (Burns 2007, p. 112-118). The counselor thanked and encouraged him as a way of helping him transition to becoming a customer from being a visitor. Another issue that may have been a prerequisite of an impasse is the fact that Damien was worried about how he would be able to cope without taking alcohol to forget his problems. The therapist effectively dealt with this issue by gradually getting Damien to talk about his problems while thinking of the times when he was happy and sober. This illustrates that an impasse in therapeutic work should not just be identified but also changed so that it aids in achievement of objectives that have been set for the therapy session. The counselor in this case had the ability to avert the occurrence of an impasse by identifying possible causes (Johnson, Makinen & Millikin 2001, p. 145–155). In the second case of 15 year old Mike, he is more direct in his manifestation of an impasse. His life is filled with events of great traumatic events coupled with substance abuse. He witnessed terrible things done by those closest to him including his father. This and other issues such as his mother being an alcoholic, violence and the death of his father may be possible causes of an impasse because they contribute to the emotional state of Mike. He may be extremely angry or refuse to respond to questions that touch on these areas of his life. When the therapist went to see mike at the detention center, he was spitting on the floor and refused to stop. This is an instance of an impasse because Mike is not changing his behavior or getting better. Being lied to trigger a reactive mechanism that made Mike escalate and he became worse in exhibiting bad behavior. The counselor responded by finding a reason or motivation hat would make Mike feel like he could benefit from good behavior and that no one would lie to him. Following this, he was responsive even when he was asked to stop spitting. The therapist helped Mike so that he could gain a deep understanding of the emotional impact the interventions are meant to achieve by giving him a chance to prove that he can be well behaved. After he was given this chance, he apologized to the staff and cleaned his room like he had been told. Clients are sometimes caught up in impasses with other people who interact with them even before therapy sessions (Cornell & Landaiche 2006, p. 196-213). Mike had an impasse with the staff and refused to do what he was told. He also reacted when he was asked to change. Using tools to manage impasses, the therapist was able to help Mike. References Burns, GW 2007, “Healing with Stories: Your Casebook Collection for Using Therapeutic Metaphors”, The Australian and New Zealand Journal of Family Therapy, vol. 31, no.1, pp. 112-118. Cornell, WF & Landaiche, M III 2006, “Impasse and Intimacy: Applying Berne’s Concept of Script Protocol”, Transactional Analysis Journal, vol.36, no. 3, pp.196-213 Edgette, JS 2006, Adolescent Therapy that Really Works: Helping Kids Who Never Asked for Help in the First Place, The Australian and New Zealand Journal of Family Therapy, vol. 31, no.1, pp. 112-118 Johnson, SM, Makinen, JA & Millikin, JW 2001, “Attachment injuries in couple relationships: A new perspective on impasses in couples’ therapy”, Journal of Marital and Family Therapy, vol. 27, pp. 145–155. Scheinkman, M & Fishbane, MD 2004, “The Vulnerability Cycle: Working With Impasses in Couple Therapy”, Family Process, Vol. 43, No. 3, pp. 279-299 Varcarolis, EM 2005, “Developing Therapeutic relationships”, Psychological Nursing Tools. pp. 156-170, Viewed 9th Nov 2012 . Read More

When they are caught up within the impasse, the client is often unable to see the other individual’s point of view, and this prompts the therapist to take steps to correct this. In some cases, such a situation would make it harder for the therapist to continue, as it might make them doubt their abilities in counseling their client. The therapeutic impasse is a stalemate to the processes of achieving the therapeutic goal. Essentially, it is a change in the therapeutic relationship or processes that result in the client feeling that they are not benefitting from the therapy as much as they used to before (Varcarolis 2005, p. 156-170). Manifestations of such as situation take on different forms with some involving emotional withdrawal of the patient and other symptoms such as long periods of unproductive silence between the therapist and the client, increased interest in real life problems while therapeutic issues take a back seat and increasingly emphasizing on symptomatology (Cornell & Landaiche 2006, p. 196-213). These manifestations results in the deterioration of the relationship between the therapist and client.

The patient will seem unable to contribute his share in the counseling session and will instead demand that he be given more direct guidance by the therapist. The cause of this deadlock between the patient and therapist is not linear. There are multifaceted issues that all affect the counseling session including internal issues in the client. The common feature in all the different types of impasses in therapy is that they stop or they slow down the progress of the therapy sessions. Some examples of impasses that occur in therapeutic work include a situation where the client is unwilling to explore certain traumatic experiences so much so that they also become resistant to exploring the unwillingness (Johnson, Makinen & Millikin 2001, p.

145–155). In addition, the client and therapist may disagree on ways of resolving a conflict. The existence of sexual feelings between the therapist and client often cause an impasse since the client may be reluctant to reveal some information or they may have greater and unprofessional expectations from the therapist. Another cause of an impasse could be when the therapist and client have an unhealthy relationship. Other than that, the therapist may have used an intervention that is unsuccessful for that particular case.

This is common with juvenile delinquents who often hide information from their therapists yet this information is vital to the formation of an effective intervention. They are not always permanent and the therapist can work through it with the client. In order to work through the issues, the therapist has an obligation to remain objective so that he can identify the cause (s) of the impasse (Burns 2007, p. 112-118). Application to two practice situations The first counseling scenario presents the story of a boy called Damien.

Damien has several risk factors that make him highly susceptible to reaching an impasse during his counseling sessions. Identifying the risk factors from his historical and biographical background is important in determining the possible causes of the impasse which will give the therapist ideas on the steps to take to get past the impasse. Some of the risk factors include having emotional trauma from exposure to parents who abuse substances, being abused in foster homes, being moved around in foster homes, being a witness of domestic violence and being physically abused.

These issues make him susceptible to an impasse because he might be reluctant to trust the therapist after having been moved around and he may also reveal very little about his personal life. Being that he has always moved around, he might also have abandonment issues. Other than that, he may get angry when confronted about his peers and told not to associate with them anymore if he wants to be a better person. He thinks that he owes them and suggesting that he cut ties with them may put the therapy session at an impasse.

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