narcissistic

Managing difficult reactions to difficult clients by Sydney Forensic Clinic

Many legal professionals will be used to managing clients with challenging behaviour, developing professional relationships, and de-escalating the situation when needed in order to do the best by their client. It is also important, however, to take the time to prepare and reflect on the impact that challenging behaviour has on us as professionals.

Clients encountered in the forensic and especially the forensic mental health space can present with unique challenges. They may be suffering from mental health issues, which may not be adequately treated. They may present with personality vulnerabilities, making communication and collaboration difficult. They may lack motivation to obtain a good outcome and to compromise. At the severe end of the spectrum, forensic clients may present as dominating and aggressive.

Clients in this space may present with a great deal of mistrust towards legal and medical professionals. It may be challenging to establish positive therapeutic rapport, particularly in the context of providing constructive feedback or challenging their perspective of past or current events. A helpful strategy may be agreeing with the client from the outset with him that any concerns or disagreements could be openly discussed, and regular check-ins conducted at the outset and conclusion of any interactions to check for any misunderstandings or grievances. Another strategy is to maintain a light-hearted and friendly tone when appropriate and use humour. Giving clients agency and a sense of control may also help them to feel more comfortable in a situation where agency is limited.

More specifically, clients with narcissistic traits may present as distrustful and defensive, inflating their own worth by denigrating the value of other people, particularly when triggered by feelings of loss of autonomy and power. Naturally, it can be difficult to develop a good professional alliance when dealing with this challenging behaviour. In such cases, it may be beneficial to return to the client’s goals in terms of legal proceedings. Again, it is important to maintain openness and consistency in every interaction.

Lastly, it is vital for professionals interacting with clients with challenging presentations to maintain their own professional boundaries, proactively address any negative reactions they feel towards their clients, and practice a non-judgemental stance towards themselves and colleagues who may react negatively to challenging clients. It is inevitable that as human beings working with challenging populations, we will experience our own reactions. These can be addressed with regular debriefs, reflective practice and clinical supervision.

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