Before you consider the Tough Love approach, this is what happened to my sister's mother-in-law:
The woman is medically obese, and got the same message from her doctor-I can't help you anymore- so she stopped going for checkups because she feared if she did, she would just get a scolding from her doctor. Two weeks ago, she finally was forced to go because she was having severe pain. the short of the story is, that she was diagnosed with terminal liver cancer and has three months to live. Had she not been discouraged from going for checkups, this might have been caught earlier and treatable(I concede also that maybe not)
I think that a psychotherapist would be remiss in not treating a depressed but uncooperative patient,and that if such a patient were told not to come back for treatment because they weren't doing their part, and then committed suicide because their therapy would be cut off, this would be the same kind of unnecessary tragedy that has befallen my sister's mother-in-law. As practitioners, we are there to help, not to judge. If patients/clients could do it on their own, we wouldn't be needed in the first place.
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