Strategic Therapy Institute
What to Do When Your Client Refuses Every Suggestion You Make
Includes 4 printable worksheets — free for registered members below.
The client who refuses everything is not a treatment failure. They are a clinical puzzle with a specific solution.
Every experienced therapist knows this client. The suggestion comes back refused. The adjusted version comes back refused. After several months, the therapist is not sure whether they are treating the presenting problem or managing the client’s relationship to every suggestion they make.
Strategic therapy offers a different starting point. In Jay Haley’s framework, a client’s refusal of a suggestion is a move in the therapeutic relationship, not evidence of pathology or incompetence. The refusal is doing something. It carries information about what the client needs from the relationship, what the suggestion got wrong structurally, and what has to shift before a directive can land.
What to Do When Your Client Refuses Every Suggestion You Make builds twelve specific clinical techniques from that starting point. Each one is grounded in Haley’s strategic approach or Erickson’s utilization principle. Each one addresses a specific form that client refusal takes in practice.
The techniques cover how to diagnose which therapist-side factors triggered a given refusal, how to prescribe the resistance paradoxically using Haley’s symptom prescription framework, how to structure directives as genuine choices using Erickson’s double bind so the client decides how to do the work rather than whether to, and how to use problem elaboration to build the readiness that makes suggestions receivable.
The book also covers Haley’s ordeal structure for clients who refuse every conventional option, and the clinical differentiation between a client whose resistance is structural and a client whose resistance is about a specific rupture, a cultural mismatch, or a credibility problem that was never addressed.
Four worksheets come with this book as free downloads for registered members. Print them, add your practice branding, and put them to work before the next session with a client who won’t cooperate.
Published by Strategic Therapy Institute.
Free for Registered Members
Worksheets included with this book
Each worksheet opens in the Directive Printer — add your clinic name and logo, then print or save as PDF. Register free to access all four.
Refusal Pattern Tracker
Log each refusal across sessions until the pattern behind it becomes readable.
Paradoxical Directive Planner
Design a formal prescription for the client's refusal — so compliance and defiance both move the work forward.
Reframe Builder — Refusal as Strength
Build a strategic reframe from the client's own language before you offer it in session.
Minimal Directive Design Template
Reduce any directive to its smallest effective form before offering it to a client who refuses.
Get the worksheets free
Register for a free Rapport7 account to download and print all four worksheets with your practice branding. No payment required.