Bringing Up Difficult Issues

I. Confrontation
 A. Matter-of-factly bringing up something out to better gain a better understanding and perhaps to make meaningful changes or take important new steps

II.When to Use Confrontation
 A. Discrepancies
  1. Times when a client will communicate two different messages
  2. The client says one thing but does another
  3. The client has one perception of events or circumstances and you have another
  4. The client tells you one thing but the clients body language sends a very different message
  5. The client purports to hold certain values but the clients behavior violates those values
B. Other reasons to use confrontation
  1. The client has unrealistic expectations for you
  2. The client has expectations for him or herself
  3. The client asks for assistance but actions indicate the client in not interested
  4. The clients behavior is contradictory

III. The I-Message in confrontation
 A.The problem is yours so it should include a reference to you
 B. A complete I-message includes 4 parts
  1. Your concern, feeling, observations about the situation
  2.A non blaming description of what you have seen or heard of the behavior
  3. The tangible outcome for you as a result or the possible consequences for the client
  4. An invitation to collaborate on a solution

IV. The rules for confrontation
 A. Be matter of fact
 B. Be tentative
 C. Focus on tangible behavior or communication
 D. Take full responsibility for your observation
 E. Always collaborate
 F. Do not accuse the other person
 G. Do not confront because you are angry
 H. Do not be judgmental
 I. Do not give the client a solution

V. Asking permission to share ideas
 A. Rather than give advice ask if it is ok to share solutions

VI. Advocacy: Confronting collaterals
 A. If someone is interfering with the clients treatment or your ability to help them you need to speak up

VII. On not becoming overbearing
 A. Sometimes a I-message is really about your agenda and is not sensitive to the client and where the client is with the problem at that moment
 B. 5 ways we can make a I-message ineffective
  1. Using the word "but" or "however" reverse what we have just said supporting the clients point of view
  2. Expressing how we see the situation using I correctly but never inviting the client to describe how she sees the situation
  3. Coming across as the way we view the situation is the only way to view the situation
  4. Failing to consider that there are extenuating circumstances that you are not privy to

  This is video that discusses what confrontation is and gives examples of it in couples therapy.


What do you do if you are overbearing with a client? How do you fix it?