Instilling Hope in Your Clients
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When clients show up for therapy, they often have exhausted all other resources, such as Internet searches, self-help videos, books, and other people’s advice. They may feel drained and unsure if therapy can help them. A counselor’s role is to educate the client about the therapeutic process and instill hope.
Snyder et al. defines hope as, “A cognitive set that is composed of a reciprocally derived sense of successful (1) agency (goal-directed determination) and (2) pathways (planning of ways to meet goals).”
Hope is the belief in a better future. It is based on having the motivation, energy, and will to achieve a desired goal, even in the face of obstacles. Counseling can help support clients who navigate change, as they achieve their goals.
Change often triggers anxiety and, at times, resistance, even when it is a transition a person desires. As counselors, working through these subconscious fears with your client and instilling hope based on realism is essential.
Hope vs Optimism
In The Journal of Personality and Individual Differences, Alarcon, Bowling, and Khazon, state:
“Simply put, the optimistic person believes that somehow—either through luck, the actions of others, or one’s own actions—that his or her future will be successful and fulfilling. The hopeful person, on the other hand, believes specifically in his or her own capability for securing a successful and fulfilling future.”
Optimism is more based on external factors and a belief that everything will fall into place or work out, whereas hope is an internal belief in oneself that is validated through actions taken by the client. Counselors must be aware of when the client is optimistic about change or willing to take action. In either instance, it is essential to support the client therapeutically.
Benefits of Hope
Why work towards hope? In a 2016 study by Luo et al., “Reasons for living and hope may protect against suicidal ideation and attempts in patients with depression. Especially hope could reduce the possibility of a suicide attempt.”
Long et al., 2020 report:
“Data from the Health and Retirement Study with 12,998 people with the average age of 66 were analyzed. A greater sense of hope was associated with: better physical health and health behavior outcomes on some indicators (e.g., reduced risk of all cause-mortality, fewer number of chronic conditions, lower risk of cancer, and fewer sleep problems), higher psychological well-being (e.g., increased positive affect, life satisfaction, and purpose in life), lower psychological distress, and better social well-being.”
Formulating Goals
At the initial counseling session and subsequent sessions, you will create and review client goals together. During this discussion, you will both form what needs to happen to consider a goal complete. This means each goal will have a clear and specific behavioral target.
Creating realistic and achievable goals with your clients helps them gain efficacy and have hope for their future. The counselor’s job is to ensure each goal is within the client’s reach and allows the client’s growth.
Whenever a goal is achieved, this is an opportunity to give praise for a job well done. For any ongoing goals, discuss the effectiveness of the therapy method used and instill hope where progress has been made.
False Hope
As a counselor, you want to steer away from false hope. Looking on the bright side or being overly optimistic can cause harm to your clients, in certain situations. Being hopeful at all times is unrealistic and denies feelings of fear, anger, and sadness that clients need to experience.
When false facts are exposed, the counselor, who is viewed as an expert, can no longer be trusted. This creates a trust issue in the therapeutic relationship. Some clients may internalize false hope and interpret it as a personal failure, not a failure of unrealistic expectations or overreaching goals. This can exacerbate symptoms and worsen client outcomes.
When Clients Lack Hope
Many symptoms of mental health disorders feature hopelessness. For example, one of the symptoms of major depressive disorder, from the 2022 Diagnostic Statistical Manual-5-TR edition, lists a feeling of hopelessness among the criteria. Hopelessness increases the risk of suicidality in clients with all types of mental illnesses. Without hope, clients may stop taking their medications, and withdraw from therapy and life.
A 2015 research paper entitled, “Hope and Hopelessness: The Role of Hope in Buffering the Impact of Hopelessness on Suicidal Ideation:”
“Although high-hope individuals may feel depressed, they are likely to rebound from the state of hopelessness when confronting adversity by formulating new goals or redirecting their goals; they may interpret goal blockage as a challenge and seek alternative pathways to re-channel their motivation toward achieving their goals. Conversely, goal blockage in adversity could be disastrous to low-hope individuals as they might fail to generate new goals or find alternative ways to achieve their goals. They may feel hopeless in such a situation and perceive suicide as the only way out, thus resulting in suicidal ideation.”
Identify Cognitive Distortions
Cognitive distortions are faulty thoughts that lead to skewed perceptions of reality. These false beliefs are based on the work of Aaron Beck and David Burns. Some cognitive distortions listed below relate to hopelessness. In session, counselors can identify these thoughts and refute them with their clients, to restore a sense of hope.
- Mind reading is the assumption that others think negatively about oneself.
- Catastrophizing is making negative predictions based on little or no evidence.
- All-or-nothing thinking is viewing something as either-or, without considering a range of possible outcomes.
- Emotional reasoning is believing something to be true based on emotional responses rather than objective evidence.
- Labeling is classifying oneself negatively after the occurrence of an adverse event.
- Mental filtering focuses only on negative information and devalues positive information.
- Overgeneralization is assuming the occurrence of one negative event means that additional bad things will happen.
- Personalization assumes that one is the cause of a negative event.
- Minimizing or disqualifying the positive ignores or dismisses positive things that have happened.
- The fallacy of fairness is based on the assumption the world is always fair. When faced with life’s unfairness, negative feelings ensue.
Acceptance
Sometimes we all feel hopeless, and it is okay to express that feeling in the therapy session. Keep in mind, clients, who speak of hopelessness may be guarding against future disappointments. For them, hopelessness can become a protective measure that needs to be honored as part of the therapy process. Certain therapeutic tools and medications may not work for everyone. Accepting this fact could be a part of your client’s experience.
Once the hopeless feeling is validated as part of the client’s experience, it also creates room for hopeful thoughts to exist. When counselors accept clients where they are, this naturally supports and contains them.
Teaching clients that certain elements of life are out of everyone’s control and showing them where they can effect change helps them accept themselves and set realistic goals.
Methods of Building Hope with Clients
Using cognitive therapies, work with clients to reframe negative events as opportunities for personal growth. Finding the silver lining in a difficult situation does not change or alter your client’s circumstances. It also does not ignore the pain or difficulty experienced but rather looks at the difficulty to see where your client has demonstrated strength and resolve.
Increase client’s efficacy by creating if/then plans. If something happens (worst case scenario), then what will you do? Having a plan gives the client hope that they are capable and can handle life’s circumstances.
Celebrate all signs of progress, big and small. Any step forward is one toward a client’s therapeutic goals. It can be maintaining medication compliance, attending sessions on time, or completing homework outside of therapy.
Using narrative therapies. Have the client review times in his or her life when things went well. Have your clients make a list of successes to remind them of all the times something they hoped for manifested.
Increase the client’s social support to be around hopeful, positive people. This can include support or recovery groups. Remind clients that it can take time to find a good fit for a group and not to give up.
Incorporate spirituality, when appropriate. Meditation or prayer can help clients feel connected to a higher power or greater being. A research study by Whittington & Scher states:
“Our results confirm the well-established finding that prayer can have positive effects on psychological well-being. We found that only some types of prayer have positive effects: adoration (pure worship of God without reference to specific events or needs), thanksgiving (thanks to God for specific positive outcomes or circumstances), and prayers of reception (prayers focused on opening oneself up to the closeness with God).”
Find examples of hope through true life stories of those who have overcome adversity. Counselors can share examples of other clients’ successes without exposing confidential information. It can also be helpful to look at numerous celebrity stories demonstrating hope for a better tomorrow. Reading about others’ struggles helps clients know they are not alone.