November 7, 2023

How to Get a Client to Open Up in Therapy

Fewer dynamics can be more challenging for therapists than clients who respond minimally and without significant emotion in session. It is difficult to want to help someone who seemingly remains on the surface level. It is also unnerving to feel like you’re not doing enough as a clinician when working with these types of clients.

While there is no universal “trick” that guarantees a client will open up in therapy, it’s important for therapists to keep these essential reminders in mind.

Understand Their Fears About Opening Up 

Many clients struggle to open up in therapy because they are afraid to be vulnerable. This fear may have very little to do with your personality and everything to do with their past experiences associated with being honest and forthcoming.

Here are some possible reasons why your client may be having a difficult time opening up: 

History of judgment or rejection: When someone has felt shamed for opening up in the past, there’s often an immense hesitation to face that risk again. Nobody wants to be rejected, and clients with extensive histories of rejection may be more guarded in therapy (even if they want help).

Cultural beliefs related to emotional expression: It’s always important to consider a client’s cultural upbringing when doing your case conceptualizations. There is no right or wrong way to express emotion, but cultural factors undoubtedly shape how people identify, express, and even cope with their feelings. What may seem closed off to you may feel entirely normal to them.

Worries about getting into trouble: Clients understand that therapists are mandated reporters, so they might withhold important information because they don’t want their confidentiality to be breached. This can be more prevalent in children who feel anxious about something bad happening to their parents. It can also be a typical response when someone experiences suicidal ideation but fears hospitalization. Keep in mind that some people may not fully understand what is and isn’t reportable, but they will err on the side of caution.

Lack of trust in the therapeutic relationship: Trust unfolds at different paces, and it’s not uncommon for clients to need significant time before they feel comfortable disclosing sensitive information with you. If they’ve had negative experiences with therapists in the past, feeling safe may take even longer. 

Low self-esteem: Some clients struggle to open up because their self-esteem blocks them from feeling comfortable with their own feelings. They may have already internalized that what they’re feeling is “bad” or “wrong,” so instead of sharing it, they keep it within.

Reason for seeking therapy: Some clients enter therapy ready to spill their entire story quickly. But others may not have any desire to actually be in treatment. Mandated clients, for example, might be more closed off when it comes to seeking help. This effect may also occur in family members or partners who feel “dragged” to attend therapy on behalf of a loved one.

Concerns about your ability to help: Although this may not be your fault, clients may be hesitant to work with someone if they doubt their competence or expertise. Therapy does come down to fit, so, if after several sessions, they still present as disconnected or closed off to you, it may be worth considering a referral elsewhere.

Don’t Push Someone to Open Up 

It’s never effective to demand a client to open up in therapy. Therapy is their time and process, and clients undoubtedly deserve their provider’s respect throughout this time. Ultimately, they don’t owe you their story, even if knowing more about it would help you better help them.

Instead, it’s important to convey that you respect their pace. Practice active listening as much as possible. This means being mindful and attentive to what the client is saying. Don’t interrupt and be cautious of making snap assumptions without truly understanding a story. It’s also helpful to reflect back their feelings to demonstrate that you are present with them. 

By letting someone open up on their terms, you model a sense of acceptance. You are not asking the client to be someone they’re not, and you’re also not pushing an agenda on them.

 If clients sense that they are disappointing their therapists, they may resort to either people-pleasing behavior or even more avoidance. Neither of these situations is optimal, and they can be detrimental to your therapeutic relationship.

Ask Deliberate, Open-Ended Questions 

There is a time and place for close-ended questions in therapy, but open-ended questions often have far more merit when navigating more guarded clients. 

With that, it’s also equally important to try to avoid being vague. For example, “how are you doing?” is so broad that it’s easy for a client to default to a generic answer like “okay” or “good.” Instead, it may be better to reference something they recently talked about (“How did the conversation with your mom go last week?”) or something related to the here-and-now (“What is most stressing you out right now?”) 

These types of questions won’t automatically open someone up. However, they do offer more space for clients to start talking about themselves. In time, as they start feeling comfortable, they might respond with more depth.

Honor Silence and Slowness

Many therapists feel pressure to fill space in sessions. They want to master their interventions and take charge of the work, and they hope their clients will leave each session feeling both pensive and satisfied. 

While these are virtuous goals, it’s also worth noting that sometimes therapy moves slowly and cautiously. There might be moments of silence or pausing. Conversations may be focused on lighter topics that feel safe for the client.

Pacing is an integral part of good therapy, and it’s imperative that therapists are mindful of honoring a client’s comfort as they move through their treatment. Some people will naturally need to move slower than others. While things shouldn’t be moving so slowly that a client feels like they’re just “talking for the sake of talking,” the slower moments can help build and maintain rapport, which is a key component of effective therapy. 

Aim to Be As Consistent As Possible 

The therapeutic relationship is one of the most important variables predicting treatment success. Clients rely on their providers for warmth, safety, and a professional presence. With that, it is your responsibility to demonstrate consistency throughout your work.

Be punctual: Take your sessions seriously. Start every appointment on time and end on time. If you know you need to miss a session, give your client as much notice as you can. 

Uphold your boundaries: If you say you’re going to do something for your client, be sure to do it. At the same time, if you say you’re not going to do something, it’s also important to implement that limit as well. Boundaries can be tricky for therapists, but the consistency of them provides a necessary sense of predictability for clients.

Make sure your marketing reflects your practice: It’s important that you accurately advertise yourself across all channels. Don’t say you treat something that you don’t treat. Avoid putting out a false front- it’s essential to have an idea of how people might perceive you based on how you market yourself outside of your practice. 

Be present in your sessions: Clients deserve to have your full attention. Even if you’re having an off-day, aim to be mindful of your work. Clients are coming to you for support, and they might struggle to open up if they sense you’re distracted or agitated to be with them.

Model Authenticity 

Clients may be more apprehensive to open up to therapists due to the inherent nature of being in this unique one-sided relationship. It can be difficult to share your innermost feelings with someone who doesn’t reveal much at all about themselves.

Regardless of your stance on self-disclosure, most people would agree that therapist authenticity is valuable. Clients generally value it when their therapists honestly express their feelings and reactions. They don’t want you to pretend to be someone you’re not.

In modeling authenticity, it’s also important to remember that you’re a human. Sometimes showing this humanness is invaluable to clients. Therapists can achieve this in multiple ways, including infusing humor, sharing relevant details about themselves, or engaging in creative interventions.

Collaborate Together on Treatment Goals

Even though you may think “going deeper” would be beneficial for the client’s well-being, not every client will feel the same way you do. Regardless of your personal beliefs, a client has a right to guide their treatment. What is most important to them? How do they most want to use this time together? What goals feel most essential?

Keep in mind that some clients will struggle to articulate their treatment intentions. Some might present completely disinterested in therapy, even if they show up time and time again. Others will have overly grandiose goals and may put pressure on you to help them fix their lives.

When these situations happen, it’s important to embrace a more curious stance. What might they be getting out of your time together? What are you providing for them that other people aren’t? Is it possible that you have unrealistic goals for them- whereas they may simply want a place to vent or receive support? Do they understand how therapy really works? 

It’s important to continue having conversations about what they want to get out of treatment and what they’re already getting out of treatment. You might realize that, even though you don’t think they’re opening up much, they think they’re being incredibly transparent!

Be Mindful of Your Own Countertransference

It may be worth exploring if your desire to have a client open up is a product of countertransference. For example, you might unknowingly project that their one-word answers reflect negatively on your competence. Or, their aloof behavior might remind you of someone in your life that you don’t like.

Regardless of your particular situation, it’s also helpful to consider which biases or feelings may be present in the room. You don’t need to be fully objective to be effective, but you do need to pay attention to when your thoughts are impacting the treatment process.

Keep in mind that countertransference isn’t bad or wrong. Every therapist experiences it, but it’s important to process and work through it when it’s impacting your therapeutic relationships. Consider talking about this specific case with a supervisor, case consultation group, or your own therapist if you need more feedback.

Final Thoughts

There’s no quick, guaranteed trick to get clients to open up in therapy. People are far more complicated than simple communication strategies.

Focus on what you can control. You are in charge of your presence, reactions, and skill set. It is the client’s choice to decide how much they want to reveal. It’s also up to them how and when they choose to tell you this information. The more you can trust the process, the easier the process inevitably becomes. 

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Disclaimer: This information is not specific medical advice and does not replace information you receive from your healthcare provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or lifestyle choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care provider’s advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you.

You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care provider’s advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you.

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