Three Sessions, One Goal
A client is funded for six sessions to address "anxiety affecting work attendance." After session two, it becomes clear the main driver is an unresolved dispute with a sibling over their late mother's estate, and that the work anxiety is secondary. The client wants to talk about the dispute. The funder's referral specifies anxiety-focused work and requires a progress report at session four. You have skills to address the dispute but it would consume the remaining sessions and leave the funded goal unmet. The client has already missed two weeks of work this quarter and is at risk of disciplinary action.
1. How do you plan the remaining sessions?
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Plan around the funded goal while acknowledging the real driver. The work-anxiety goal and the estate dispute are not fully separable, but the contract is for attendance-related anxiety, and the client's immediate risk is disciplinary.\n\nA workable structure: sessions three and four focus on practical anxiety management and a return-to-work plan, explicitly linking the strategies to the dispute as a stressor. Session four's report notes the dispute as a contextual factor, states that it is outside the funded scope, and recommends a separate referral if the client wishes to pursue it. Sessions five and six consolidate and plan for relapse.\n\nThis is not avoidance: it is prioritisation under constraint, with the limitation documented and the client informed of what is and is not covered.
2. How do you explain the scope limit to the client without seeming to dismiss her concerns?
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Be transparent about the constraint and separate it from your view of its importance. For example: "The estate situation sounds like the heart of this, and I don't think it's a side issue. The funding I have is specifically for the work-attendance goal, so I want to use our remaining time to protect your job - and then help you get proper support for the dispute, which deserves more than the few sessions left."\n\nThen be concrete: name what the separate referral would be, and confirm she understands the plan. The risk to manage is the client feeling unheard, which damages engagement and the therapeutic relationship. Acknowledging the dispute as legitimate while being clear about the boundary preserves both honesty and rapport.