Guidelines for Management
A severe HRC is an exceedingly difficult clinical challenge, and many such clients have won a pyrrhic victory over therapist and group by failing in therapy. It would thus be presumptuous and misleading to attempt to prescribe a careful therapeutic plan; however, certain generalizations may be posited. Surely it is a blunder for the therapist to confuse the help requested for the help required. The HRC solicits advice not for its potential value but in order to spurn it. Ultimately, the therapist’s advice, guidance, and treatment will be rejected or, of used, will prove ineffective or, if effective, will be kept secret. It is also a blunder for the therapist to express any frustration and resentment. Retaliation merely, completes the vicious circle: the clients’ anticipation of ill treatment and abandonment is once again realized: They feel justified in their hostile mistrust and are able to affirm once again that no one can ever really understand them.