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Introduction
Among the many tasks that therapists need to perform in their work with clients is to serve as positive role-models for effective communication and interpersonal problem-solving. For example, therapists often have to provide clarity about diagnostic issues and treatment planning to clients who sometimes enter therapy in an unsettled and apprehensive state. Therapists also help their clients remember important details about interventions (including homework) by being clear and organized in the process of explaining them. Perhaps most challenging for therapists are those times when they have to give their clients feedback that may be difficult for the clients to hear and accept. This webinar will describe how therapists can enact their best interpersonal and verbal skills in having difficult and sensitive conversations with their clients, toward the goals of promoting and maintaining a constructive therapeutic relationship, keeping the clients appropriately engaged in treatment, and amplifying the beneficial effects of evidence-based interventions. These skills (collectively comprising an overarching “meta-competency”) have multiple components, including a mindset that embraces facing challenging situations, an optimistic outlook about working through interpersonal disagreements, the capacity for tact and diplomacy, sufficient self-awareness to refrain from contributing to escalating power struggles, and a manner that allows for delivering difficult messages to a patient with empathy.
The event will be equivalent to 2hrs of CPD.
Content
This webinar will address some of the many situations in which therapists have to bring high levels of interpersonal and verbal skills in talking to their clients about important matters. Examples of such situations include: (1) discussing differences of opinion about the client’s diagnosis and/or targets for therapeutic change, (2) giving corrective feedback to and setting limits with clients who are engaging in therapy-interfering behaviours, (3) constructively addressing strains or ruptures in the therapeutic relationship, (4) needing to give their clients a “reality check” when the clients’ views (and resultant behaviours) are hazardously off the mark (including being “in denial”), and (5) navigating sensitive cultural matters, including times when clients express hateful, prejudiced views and/or when clients view the therapist as being patriarchal or discriminatory. Having difficult, sensitive conversations of this sort with clients starts with the therapist’s recognition that giving the clients feedback is necessary, along with a willingness to engage, even though it may be quite uncomfortable, and the outcome uncertain. The process of having difficult, sensitive conversations with clients is assisted by therapists being good listeners who can accurately summarize (or otherwise take into account) their client’s viewpoints as a foundation for expressing their own (likely differing) viewpoints. Additionally, the therapist has to make a decision about “if and when” to introduce the challenging conversation, seeking a middle ground between avoiding the conversation for too long and rushing in impulsively. The process of having difficult conversations with clients is furthered by the therapist having a repertoire of statements that demonstrate good will and tact, being honest without being “brutal,” and being able to enact “empathic confrontation.” Numerous clinical vignettes and two role-play demonstrations (conducted in-vivo during the webinar) will be presented to demonstrate these skills in maximizing the chances that a difficult conversation with a client will have a constructive result.
Learning Objectives
• Adopt a positive mindset that looks at a difficult conversation with a client as an opportunity to address an important issue constructively, taking pride in trying to prevent or repair a strain in the therapeutic relationship.
• Express opinions that have both validity and utility, while having the patience and awareness to refrain from making comments to clients that are lacking in these qualities.
• Practice the therapeutic skill of empathic confrontation.
• Utilize well-attuned listening skills to assist in eliciting maximum collaboration in the midst of an otherwise tense or awkward conversation with a client.
Training Modalities
Didactic presentation with slides. Vignettes and two demonstration role-plays that illustrate the clinical methods being described. Q & A.
Key References
Anderson, B. M., & Kalil, D. (2024). Overcoming the aversive: Handling difficult conversations with professionalism and compassion. In C. Hall, K. Maich, & B.M. Anderson (Eds.), People skills for behavioral analysts (pp. 159-168). Routledge.
Eubanks, C. F. (2022). Rupture repair. Cognitive and Behavioral Practice, 29(3), 554-559.
Newman, C.F. (in press). Clinical guidance points for maximizing the therapeutic relationship and creating change in cognitive behavioral therapy. In A. Wenzel (Ed.), Cultivating the therapeutic relationship in cognitive behavioral therapy. SpringerNature.
Scott, A. M. (2022). Difficult conversations between healthcare providers and patients. In T.L. Thompson and N. G. Harrington (Eds.), The Routledge handbook of health communication (pp. 179-193). Routledge/Taylor & Francis Group.
Zilcha-Mano, S., & Barber, J. P. (2018). Facilitating the sense of feeling understood in patients with maladaptive relationships. In O. Tishby and H. Wiseman (Eds.), Developing the therapeutic relationship: Integrating case studies, research, and practice (pp. 105-131). American Psychological Association.
About the presenter
Cory F. Newman, Ph.D. is Director of the Center for Cognitive Therapy, Professor of Psychology, in Psychiatry at the University of Pennsylvania Perelman School of Medicine (in Philadelphia, Pennsylvania, USA), and Adjunct Faculty at the Beck Institute for Cognitive Behavior Therapy. Prof. Newman did his postdoctoral training under the mentorship of Prof. Aaron T. Beck, and he is a Founding Fellow of the Academy of Cognitive and Behavioral Therapies. Prof. Newman has maintained a full clinical caseload and has extensive experience as a CBT supervisor, having supervised over 350 professionals-in-training, both at the University of Pennsylvania, and through the Beck Institute’s international training programs. Prof. Newman was recognized by the Association of Behavioral and Cognitive Therapy with the Outstanding Clinician Award for 2019. Prof. Newman is an international lecturer, having presented over 300 cognitive-behavioural therapy workshops and seminars at home in the U.S. as well as in twenty-three other countries. Prof. Newman is author of over 100 articles and chapters on cognitive-behavioural therapy for a wide range of disorders and clinical issues, and he has authored or co-authored six books, including two with Prof. Aaron T. Beck. On the side, Prof. Newman is an avid classical pianist.
Who should attend
This presentation is suitable for mental health practitioners across disciplines and substance use counsellors. Therapists who practice low-intensity CBT as well as standard-course CBT will benefit from this presentation, as will clinicians of all levels of experience.