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Clients often reject recommendations to engage in self-care outside of the therapy session.

Personalizing recommendations to the client, identifying benefits and obstacles, can help.

No client enters therapy with a problem of deficient self-care or relaxation skills. Yet, common mental health recommendations, such as these, can be helpful. Why do some clients reject them? “Yeah, yeah. I tried, but it didn't work for me.” “When would I have time for that?” When parent self-care was suggested as a topic for a webinar at Boston Children's Hospital, my colleague said, “Parents will only come if we pitch that it is about taking care of someone else.”

The very reason self-care skills, such as exercising, eating well, sleeping enough, and using relaxation skills, are helpful is often the reason that the person does not succeed in using them. Sometimes clients aren’t relaxed or able to take care of themselves because of their mental health concerns. Self-care may feel like an unaffordable luxury. Their time is swallowed up by what brings them in for treatment. Standard recommendations, if given out of the gate, serve as a dismissal of their experience. “Haven’t you heard me? Don’t you know what I am........

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