When working with an adult that does not want to get help, I think the therapist should consider the family or person closest to the patient that may possibly be enabling them without even knowing they are doing it. If the patient sees no problem with their actions and do not want to change, then the next best thing is the person who is allowing, or reinforcing, the behavior. Talking to the enabler can help them to understand the issue and what they are doing to contribute to the issue instead of the solution. Then the therapist can help them to learn how to set limits and boundaries to enforce on the adult that does not want help, and will also be able to teach them ways to cope with the process.
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