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Where Angels Fear To Tread:

Becoming more effective with emotionally vulnerable clients

Working with emotionally vulnerable clients is often a challenging experience for therapists. When clients become easily dysregulated, this can trigger therapists to avoid presenting the client with important feedback and impede forward progress.  For the therapist, this can also lead to feelings of ineffectiveness, increased burnout, and premature termination.  Drawing primarily from dialectical behavioral therapy, Becca Edwards-Powell will provide strategies to help therapists and clients handle this painful territory. These include the judicious use of radical genuineness, irreverence, transparency, validation, honesty, and removing secret judgments.  These techniques are utilized to increase trust and safety in the session and produce a more satisfying working alliance. Drawing from her experience as DBT therapist, supervisor, and trainer, Becca will discuss how increasing awareness and acceptance of their own discomfort and limits can lead therapists to provide increased safety, deeper work, and decreased burnout with this challenging population.

Bio: Rebecca E. Edwards-Powell, LCSW is currently an adult services supervisor at Carolina Outreach, LLC., where she trains and supervises clinical staff in CBT and DBT, provides case consultation, helps implement crisis interventions, and provides psycho educational activities and treatment team services including on substance abuse, educational, vocational, residential, financial, social, and other non-treatment needs. She is intensively trained in DBT through the Behavioral Tech Intensive Training and participates in an ongoing Intensive team. Previously, she worked as an intensive in-home specialist, client services director at the Orange County Rape Crisis Center, and support group coordinator at the Family Violence Prevention Center.

click for:  SLIDES  | printable  Handouts


  1. Identify avoidance patterns in therapy sessions that can interfere with progress and reinforce client’s inability to handle difficult observations.
  2. Discuss the increasing transparency and genuineness, in the moment, during work with emotionally vulnerable clients, which can lead to greater sense of safety.
  3. Identify a variety of strategies to allow for greater trust and progress in therapeutic work with emotionally vulnerable clients.

Three-part video (from UNC School of Social Work)

(sound improves after first few minutes):