Therapeutic Change with Difficult Clients Precursors and Techniques in the CHANGES Model

by Wilkinson, Brett D; Hanna, Fred J.

• ISBN13: 9781433843167
• ISBN10: 1433843161
• Edition: 2nd
• Format: Paperback
• Copyright: 2025-06-17
• Publisher: American Psychological Association

Summary

Now in its second edition, Therapeutic Change with Difficult Clients describes a common factors model for understanding and activating the process of change with challenging clients. 

For therapists, the most difficult clients to treat are often those who have little interest in change. Whether they believe that change is a waste of time, or a threat to their personal freedom or sense of being, the difficulty of treating such clients reveals the limits of typical approaches to psychotherapy. A thorough understanding of the true nature therapeutic change is often the most important step toward improving psychotherapy effectiveness. 

The CHANGES model, which has been significantly expanded and updated since the first edition of this book, is founded on the seven precursors of change, which are identified, assessed, and activated in the context of therapeutic encounters. The authors examine the capacities of individuals to generate therapeutic change, identify the barriers to change, and discuss the power of therapists to catalyze the change process using a variety of well established techniques. In addition to updated supporting literature, the authors discuss recent advances in neuroscience and the cognitive sciences, as well as new developments in the interpersonal aspects of therapeutic engagement. 

Author Biography

[Note: This is a draft bio based on information obtained online. The proposal included only a bit of information about Dr. Wilkinson.]

Brett Wilkinson, Ph.D., is associate professor of counselor education at Purdue University Fort Wayne and director of the university's Institute for Counseling Research (ICR). He trains master's-level clinical mental health students in the application of Dr. Hanna's precursors model, has published on the precursors model, and is currently conducting ICR research on the use of the model in clinical practice and counselor training. He earned his PhD in Counselor Education and Supervision from the University of Northern Colorado.

Fred J. Hanna, Ph.D., is a professor and co-designer of the PhD Program in Counseling at Adler University, in Chicago. He was previously a Senior Faculty Associate at Johns Hopkins University where he taught graduate counseling courses for 25 years, including 11 years full time, leaving as a Full Professor. Fred has served as a consultant and trainer to the medical, mental health, corrections, business, and education communities, including such places as the Johns Hopkins School of Medicine Department of Psychiatry, the Fort Peck Sioux Reservation in Montana, the Department of Psychiatry at Yale University, and a wide variety of school systems, community agencies, prisons, and criminal justice settings across the U.S.