Fred Hanna, PhD
Counseling Difficult Clients
Fred Hanna, PhD, is a professor, counselor educator, author, researcher, and professional trainer whose work focuses on therapeutic change, client motivation, difficult clinical presentations, integrative counseling, humanistic practice, and multicultural and social justice concerns. He is currently a professor in Counselor Education and Supervision at Adler University in Chicago, where his teaching and scholarship connect psychotherapy theory with practical strategies for clinicians working with clients who appear guarded, discouraged, ambivalent, defiant, or uncertain about change. His official Adler University faculty profile identifies advanced counseling techniques, treatment integration, therapeutic change, phenomenology, oppression and liberation, and work with difficult adolescents among his principal areas of interest.
A central contribution of Dr. Hanna’s work is the CHANGES Model, an expanded version of his Precursors Model of Change. Rather than treating resistance as a fixed client trait, the model helps clinicians assess whether specific conditions for change are present, blocked, or underdeveloped. These conditions include confronting the problem, hope, awareness, a sense of necessity, grit, effort, and social support. The framework gives therapists a structured way to understand why otherwise appropriate interventions may stall and what may need to be strengthened before treatment can move forward. Adler University’s overview of the CHANGES Model explains how these precursors can be assessed and supported through targeted therapeutic techniques.
Dr. Hanna’s approach is both practical and humanistic. It encourages clinicians to preserve empathy and respect for client autonomy while remaining attentive to behavior, responsibility, willingness, culture, relationships, and the realities of the client’s environment. His work is relevant to counselors, psychologists, social workers, marriage and family therapists, addiction professionals, educators, supervisors, and other behavioral health professionals seeking stronger ways to engage clients without reducing them to labels such as “resistant” or “difficult.”
Professional Background
Dr. Hanna is a professor in Adler University’s Counselor Education and Supervision program in Chicago. Adler University identifies his areas of expertise as advanced counseling and psychotherapy techniques, integrative approaches to treatment, therapeutic change with difficult clients, phenomenology, Asian theories and practices, multicultural counseling, and interventions for difficult and defiant adolescents. The university also credits him with developing a comprehensive model of oppression, liberation, and the cognitive therapy of oppression. His current faculty profile documents more than 70 peer-reviewed articles, book chapters, and professional publications, as well as more than 500 presentations, workshops, seminars, and trainings.
Dr. Hanna earned a PhD in Counseling, an MA in Counseling, and a BS in Philosophy and Human Services from the University of Toledo. Adler University’s current faculty record also lists professional counseling licenses in Maryland and Colorado. His academic career has included attaining the rank of full professor at three universities, including Johns Hopkins University, and developing post-master’s certificate programs and partnerships with schools and community agencies.
His scholarship spans psychotherapy integration, therapeutic motivation, multicultural counseling, oppression and liberation, phenomenology, humanistic and existential approaches, spirituality, counselor education, and work with adolescents. His publications have examined the precursors of change, freedom in counseling, cultural oppression, difficult family engagement, defiant and aggressive adolescent behavior, and the integration of cognitive and existential therapies. This breadth allows his teaching to move between detailed clinical technique and larger questions involving dignity, culture, meaning, power, and psychological freedom.
In 2025, the American Psychological Association published Therapeutic Change With Difficult Clients: Precursors and Techniques in the CHANGES Model, Second Edition, coauthored by Brett D. Wilkinson and Fred J. Hanna. The book substantially updates Dr. Hanna’s earlier APA volume, Therapy With Difficult Clients: Using the Precursors Model to Awaken Change. The second edition incorporates updated research, assessment guidance, interpersonal engagement strategies, and developments in neuroscience and cognitive science.
The updated model is designed to help therapists identify which conditions for change are missing and match those barriers with more targeted interventions. This gives clinicians an alternative to assuming that a failed intervention proves either that the client is unwilling or that the treatment model itself is ineffective. Once the necessary precursors become sufficiently available, established therapeutic approaches may have a stronger foundation on which to operate.
Dr. Hanna’s professional recognition includes the Humanistic Impact Award from the Association for Humanistic Counseling, university teaching awards, a Faculty Member of the Year award, and a Social Justice Award from Adler University. These distinctions reflect the combination of clinical practicality, humanistic values, teaching, scholarship, and advocacy that characterizes his work.
Areas of Expertise
Therapeutic Change and the CHANGES Model. Dr. Hanna’s best-known work examines the internal and relational conditions that make change possible. The CHANGES Model organizes seven precursors—confronting the problem, hope, awareness, necessity, grit, effort, and social support—into an assessment and intervention framework. When treatment is stalled, the clinician can examine which precursor may be missing rather than repeatedly applying techniques the client is not yet prepared to use.
Working With Difficult, Defiant, or Ambivalent Clients. Dr. Hanna helps clinicians reconsider behaviors commonly labeled as resistance. Avoidance, missed appointments, argument, denial, limited follow-through, or rejection of advice may reflect fear, shame, hopelessness, coercion, mistrust, previous treatment harm, cultural difference, or weak ownership of the treatment goal. His work encourages curiosity about the function of the behavior while preserving appropriate expectations and accountability. Clinical Events’ discussion of challenges therapists face when treating narcissistic clients offers a related examination of low motivation, defensiveness, alliance strain, and therapist reactions.
Client Motivation and Therapeutic Engagement. Motivation is not treated as a simple quality that a client either possesses or lacks. Dr. Hanna’s model helps therapists differentiate among limited awareness, low hope, insufficient necessity, weak support, and difficulty sustaining effort. This distinction can improve case formulation and help clinicians select interventions that match the actual barrier. The Clinical Events Articles and Resources library includes complementary materials on motivational interviewing, chronic care, mindfulness, ethics, and therapeutic engagement.
Difficult and Defiant Adolescents. Dr. Hanna has published and trained extensively on counseling adolescents who present with aggression, defiance, justice-system involvement, substance use, or externally mandated treatment. His approach emphasizes relationship-building, autonomy, realistic assessment of motivation, and careful attention to family, school, legal, cultural, and developmental contexts. Clinicians working with young people can also review Clinical Events’ guide to managing confidentiality with minors and families, where trust, parental involvement, informed consent, and client safety intersect.
Humanistic, Existential, and Integrative Counseling. Dr. Hanna combines structured assessment and targeted intervention with a humanistic commitment to dignity, agency, meaning, and growth. His scholarship has also explored phenomenology, existential thought, cognitive therapy, Asian contemplative traditions, and psychotherapy integration. This allows clinicians to use structure without becoming mechanical and to remain compassionate without losing clinical precision.
Multicultural Counseling, Oppression, and Liberation. Dr. Hanna’s work examines how perception, social power, cultural context, and oppression influence psychological well-being and access to change. His model of oppression and liberation challenges clinicians to consider whether apparent hopelessness or avoidance reflects realistic barriers, discrimination, institutional harm, or treatment goals that do not fit the client’s values. Clinical Events’ overview of ethical practice in therapy provides additional context on cultural responsiveness, competence, boundaries, and professional responsibility.
Counselor Education and Clinical Training. As an educator and presenter, Dr. Hanna translates research and theory into practical assessment questions, case formulations, and intervention strategies. His work supports clinicians who need more than a single technique: it provides a way to decide when an approach is likely to work, why it may be failing, and how the therapeutic relationship can become a vehicle for readiness and lasting change.
Authored Publications
- Therapeutic Change With Difficult Clients: Precursors and Techniques in the CHANGES Model, Second Edition
- Therapy With Difficult Clients: Using the Precursors Model to Awaken Change