HELPING THE HELP-REJECTER PART II:

WORKING WITH SKEET SHOOTERS, EEYORES, PARENT-SCHEDULERS, AND DRIVE-BY-CRISIS CLIENTS AT COLLEGE COUNSELING CENTERSShelly Lear, Hobart & William Smith Colleges

Mark Rice, Binghamton University

Darlene Schmitt, The College at Brockport

Camille Simonetti, Hobart & William Smith Colleges

Panel• Introductions•Goals/learning outcomes•Conversation & Discussion format

•Observations from this year

4 TYPES OF HELP-REJECTING CLIENTS

“Skeet Shooters”

“Eeyeores”

“Parent-schedulers”

“Drive-By-Crises”

• May shoot down reflections, possible treatment plans, interventions, ideas. 

• Can be direct (arguers, philosophers)• Can be indirect (Yes, but…I’ve tried that…change of subject)

• Therapist mounting frustration is good signal

Description

Skeet Shooters

SKEET SHOOTERS

• Several possible angles in relational dynamics or client motivations:

• Could it be therapist approach?  (relationally or strategically)

• Client need for autonomy in the process…who is leading? Reactivity? (per John Norcross)   

• Therapy-interfering behavior as a window onto core beliefs or ‘positions’

• Milton Erickson donkey metaphor

Understanding them

SKEET SHOOTERS

• Acknowledge possible lack of fit for an idea / intervention and regroup

• Step back into further exploration with client…as a whole, or problem area

• Tailor types of strategies to overall stage of change

• Engage client as an agent in exploring strategies, e.g. finding pathways vs. hard goals

• Explore and empathize with the stuck position…AND reframe as strategy for coping with core beliefs/wounds

Strategies for helping

Managing the Relationship• Who is working harder? Find the balance

but don’t bail out• Cultivate authentic compassion for the

stuck position• Seek self-supervision or external

supervision for reactions: managing helplessness, how to bracket heroic therapist role, let go of pressure to change

• When student does start to shift, stay mindful of relational pacing / patience

EEYORES

Description

EEYORES

• Pessimistic view of themselves, others and the world around them

• Because they tend to be profoundly conflicted, (i.e. craves love, and often laments their outsider status)

• they struggle to give and receive it.• Often described as “gloomy”, but capable

of enormous compassion• Benefits of this personality type include

being dependable, organized, and a reflective, deep thinker

Understanding them

EEYORES

• Using basic reflective listening skills and open ended questions that allow them to reflect on what works and what doesn’t (i.e. “how’s that been working for you?” What purpose does it or has it served you in the past”)

• Challenge their all or nothing, over-generalized cognitive distortions by replacing them with facts and evidence to the contrary.

• Focus on their strengths and how they can build upon them

Strategies for helping

EEYORES

• Early on in the process, discuss expectations and define goals. Set up a concrete treatment plan; highlight what they want to get out of counseling. Include timeframes and specific homework.

• Eeyores are very pragmatic, and are hard workers who are dedicated and thorough, as long as the work has purpose.

Managing the Relationship

PARENT-SCHEDULERS

• “How do I make an appointment for my son?”

• “Could you call my daughter and tell her that she should come in for counseling? But don’t tell her I called you!”

Description

PARENT-SCHEDULERS

• Parent agendas• Fear of making it worse, losing the relationship• Lack of parenting skill or sense of authority• Fear or ignorance of developmental issues• denial

• Student agendas• Fear of developmental changes necessary• Low motivation for change/counseling• Bad previous experience with counseling• AOD issues

Understanding them

PARENT-SCHEDULERS

• The old “bait and switch” - coaching• Educating about the limits of

counseling• Educating about the other resources

on campus• Educate about developmental issues

• Talk like a family therapist

Strategies for Helping

PARENT-SCHEDULERS

• Convey caring• Invite them to call again• Predict the future for them if they

don’t change• Help them manage their anxiety –

and remember that the student isn’t the client yet!

Managing the Relationship

DRIVE-BY-CRISES

Description

DRIVE-BY-CRISES

• Voluntary• State of distress• Seeking immediate relief • Want someone to take away emotional pain

• Involuntary• Brought in by campus community• Sometimes in denial about symptoms• Repeated at risk behaviors which lead to more involuntary crisis appts

Understanding Them

DRIVE-BY-CRISES

• Building rapport early by being transparent

• Dealing with resistance by emphasizing client responsibility

• Managing splitting as a team with consultation and supervision

Managing the Relationship

DRIVE-BY-CRISES

• Increasing support and coping• Psycho Ed• Crisis vs. Counseling

• Planting a seed• Team approach

Strategies for Helping

DISCUSSION

Thoughts Questions Challenges Other ideas