After several client problems have been identified, which is the best way for a therapist to decide which problem to deal with first?

• A. Address the most recent problem
• B. Choose the problem the client identifies as his or her main concern
• C. Address the easiest problem
• D. Let the supervisor decide

Answer: (B)

Prioritizing treatment around the client’s main concern. When a client presents several problems, beginning with the issue they identify as their primary worry aligns therapy with their goals, strengthens the therapeutic alliance, and clarifies what success looks like. Focusing on the main concern helps set meaningful, motivating goals and creates momentum as the client sees progress on what matters most to them. Choosing the most recent problem can misalign the work with what the client finds distressing overall; picking the easiest problem risks skipping what the client truly cares about; and letting the supervisor decide undermines client autonomy and the collaborative nature of counseling.