Working with feeling stuck & hopeless in TF-CBTp: Insights from STAR research
Feeling hopeless and helpless is common in the face of challenges.
Collaboration is key to empowering clients and sparking hope for change.
Traumatic experiences and psychosis can make survivors feel hopeless in their situation. As therapists, we want to hold this hope for our clients and help them feel less stuck. To do this, you can help acknowledge the hardships survivors face and build a safe and trusting relationship to reflect and explore how things have changed.
The STAR therapy protocol highlights the importance of collaboration and empowerment in order to help survivors feel hope for change.
Top tips for supporting survivors who feel helpless & hopeless about change
Validate – Acknowledge and normalise hopelessness and feeling stuck.
Explore – Do past life experiences play a role in these feelings? Does the feeling link to times when they had little choice or control?
3. Introduce hope – What is or can be different now?
Share survivors’ stories of recovery and resilience to help instil hope for change (Add link to Resource section).
4. Highlight their resilience: They have encountered such challenges, yet they are here - still willing to try and change.
5. Build confidence - Share resources to understand the rational and evidence base of TF-CBTp.
Share your confidence that TF-CBTp can potentially help and can be navigated safely.
6. Build safety - Collaboration is key to building a sense of safety and sparking hope for change.
Value their expertise and lived experience, alongside your professional expertise support their recovery. (Add link to resources or STAR testimonial quotes)
Highlight how important it is to work as a team. Together agree goals and pace.
7. Hold the hope - Be a ‘Compassionate Cheerleader’.
Highlight their qualities and strengths survivors may not notice in themselves.
Recognise the effort and commitment they are putting in by turning up to sessions. Celebrate their bravery and courage.
Notice and acknowledge valued characteristics such as humour, curiosity, perceptiveness, kindness. Reflect these back so they can begin to recognise them e.g. “I see how kind and compassionate you are to other people in your life”; “I hear how much courage that must have taken from you”; “Thank you for letting me know that the strategy we tried last week wasn’t helpful for you”.
8. Develop self-compassion - Notice their compassion towards others. Explore how they might turn that inward to themselves.
(See Self-Compassion Tool card resource)
9. Celebrate glimmers of progress. The going may get tough but notice any small signs of effort or change.
Notice any shifts in how they understand or manage their difficulties? Are flashbacks less frequent or more manageable? Is dissociation more understood? Are there signs that life is becoming easier in any respect? Have they strived to build a positive therapeutic relationship?
Quote from STAR research participant
Routine outcome measures can help monitor change, and provide a useful visual reminder that change is happening.
Quote from STAR research participant
10. Pass on the hope – How can they learn to cheerlead themselves?
We all have times where we feel stuck or hopeless – and need to remember the skills learnt to help empower us to keep moving forward. Don’t forget to include reminders of this in your therapy summary. (See blog on Endings for ideas of creative staying well plans)
Summary
