how ro deal with treatment resistant clients

How to Deal With Difficult and Resistant Clients

• Calm yourself. Fighting back will quickly escalate an already difficult situation. Rather than react to it, become aware...
• Express empathy. While challenging, validate what the client is saying. Tell them you are sorry for doing something that...
• Reframe resistance. If the client is resisting and the therapist gets...

Full Answer

What to do when a client is resistant to therapy?

When resistance comes into the mix, wait a beat, center yourself in your loving heart, and avoid treating your client like their family of origin has treated them for years and years and years. More times than not, resistant clients are accustomed to living life at this adversarial level.

What is it like to work with a resistant client?

With a resistant client, they have met an internal impasse. The client's basic personality is threatened by the mere thought that they are going to be dominated and changed against their will.

What is the best approach to coping with client resistance or noncompliance?

The best approach to coping with client resistance or noncompliance is for the therapist to look in the mirror. If all efforts at treatment have apparently failed, then the therapist can step back, regroup, and assess the problem (s) in the treatment protocol.

What can counsellors do to engage resistant clients?

Counselors who refine their strategies to engage resistant clients can help impart some measure of therapeutic relief or open some avenue of expression. Considering how complex and dense resistance is, counselors will likely need all the tools and education they can to meet the task.

How do you address client resistance in therapy?

1) Therapist's inability to develop rapport with the client.Managing eye contact appropriately.Helping clients feel a sense of relatedness to you. ... Keeping negative topics neutral—avoid framing statements using negative connotations.Using the client's name.Setting the tone.More items...•

How do you overcome resistance to therapy?

Resistance is a normal part of the therapeutic process and therapists should be prepared to deal with it. By establishing a positive relationship, using paradoxical interventions, and working toward mutually created goals, you can tear down the walls of resistance and help your client make the progress they desire.

What strategies can you use to explore and reduce client resistance?

5 Steps to Overcome Client Resistance.Step 1: Acknowledge. Everybody wants to feel listened to. ... Step 2: Validate. Nobody wants to be told that they don't have a right to their feelings, or to have their feelings dismissed. ... Step 3: Clarify. ... Step 4: Create Buy-in. ... Step 5: Make your case!

What are the four types of client resistance?

The four categories described by Otani are response quantity, response content, response style, and logistic management. Response quantity resistance is viewed as the client's noncompliance with the change process.

How do consultants overcome resistance?

In “Dealing With Resistance,” Phil Grosnick suggests that “the first step in dealing with resistance is to respond to the clients' behavior with goodwill, treating their reactions as totally legitimate.” But he says “offer no more than two good faith attempts.” It also helps to be forthright with the client; Grosnick ...

How would you engage clients who may be resistant to monitoring and evaluating their progress?

Allow the client to find and develop their skills and means to address problems. Use open-ended questions to help the client explore their personal experience without influence. Let the client sit and silently experience their emotions, even uncomfortable ones.

How do social workers deal with resistant clients?

9 Simple Strategies to Dealing with Difficult Clients: Social Work EditionStay calm.Set boundaries.Respect the person.Read their body language.Fix the problem and leave immediately.Be empathetic.Build a rapport.Get other people's point of view on the situation.More items...•

How do you build rapport with difficult clients?

Talk about the relationship. Set aside time to ask your client what they need for the relationship to succeed and let them know how you work best. Set expectations for communication cadence. Discuss and align about shared objectives. Periodically check in with them to get feedback.

How do you handle aggressive clients?

Stay calm and keep your emotions in check. Adopt a passive and non-threatening body posture (e.g. hands by your side with empty palms facing forward, body at a 45 degree angle to the aggressor). Let the client air his/her feelings and acknowledge them. Ask open-ended questions to keep a dialogue going.

How do you challenge a client in therapy?

Working With Challenging Clients in PsychotherapyDetermine the Client's Stage of Readiness. ... Give the Client Choices. ... Establish a Set of Rules. ... Focus on Client Strengths. ... Don't Ask “Why” ... Pay Attention to Patient Behavior. ... Provide Alternative Constructs. ... Be Aware of Client Questions.More items...•

How do therapists deal with manipulative clients?

The best way to increase your ability to handle the manipulative client is by relying on your own intuitive judgment: listen to your inner voice. Make sure that you aren't used–consciously or unconsciously–by customers who are nice people but who have emotional needs far greater than those you are prepared to handle.

How do you build a therapeutic relationship with a client?

Some strategies that may help include:Help the client feel more welcome. ... Know that relationships take time. ... Never judge the client. ... Manage your own emotions. ... Talk about what the client wants from therapy. ... Ask more or different questions. ... Don't make the client feel rejected. ... Refer to another therapist.More items...•

Why is sales resistance helpful?

Sales resistance is helpful for the purpose of practicing thrift and saving money. ”. Clients are sometimes resistant because the counselor is asking them to deal with an undesired agenda, Wubbolding says. “Resistance means we’re working on the wrong problem a problem that the client doesn’t care to work on.

Why do counselors need to connect with clients?

Counselors need to connect with the client in order to find the right problem. I suggest connecting on the basis of clients’ perceived locus of control. Many clients resist because counselors focus too quickly on the clients’ feelings, behaviors or sense of responsibility.

What happens if clients don't disclose their inner wants?

If clients will not disclose their inner wants, actions, feelings and thinking, change is very difficult. But in the context of a safe, trusting relationship, they are more likely to disclose such information. After clients lower their defenses, they can then more freely discuss their inner thoughts and feelings.

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Psychology is my passion. I've been a psychotherapist trainer since 1998, specializing in brief, solution focused approaches. I now teach practitioners all over the world via our online courses.

How to deal with resistance from client?

Here are five general considerations when dealing with what seems to be resistance from a client. 1. Reframe the idea of ‘control’. If you suspect your client is concerned with ‘losing control’, you can talk about how you use hypnosis, coaching or counselling only to increase the client’s control and freedoms.

What does it mean when clients are resistant?

When clients are resistant, they may be looking out for language from you that confirms their hidden bias that this is a confrontational tussle rather than a collaborative situation from which they can benefit.

What is resistance in hypnosis?

Resistance is an energy and a force – sometimes a really strong one. The woman in the video on stopping smoking says to me, “I don’t want to resist hypnosis.” I surprise her by responding that she should resist more:

When we hypnotize someone, do we need to respect their freedom?

People’s unconscious need for a sense of autonomy may feel greater than their need to overcome their problem. Even if that problem has a devastating impact on their life.

What is resistance in counseling?

Resistance, when displayed in a counseling setting, should be treated like any other client emotion or behavior: something that is often intrinsically linked to a client’s character and personal life experiences. Resistance should always be accepted as a clue to what is really the matter.

Why is response quality resistance important?

This is done because a client wants to withhold or restrict information given to the counselor as a means of taking control of the session. Response quality resistance is most commonly seen in clients who are mandated to attend counseling (for court or disciplinary reasons).

How does race affect counseling?

Authors of “Broaching the subjects of race, ethnicity, and culture during the counseling process” explained that race, for example, can affect how clients interpret and ascribe cultural meaning to different phenomena; which can be difficult for counselors to understand without first recognizing the role of race.

Can counseling help clients shed their resistance?

Helping clients shed their resistant to counseling can be done, but even with great effort not every case will be successful. These are realities counselors must internalize when confronted with clients who pose challenges. Counselors must understand what leads to resistance in clients, what their own limitations as counselors are ...

Is resistance a client fault?

Resistance is not a client fault, but rather a manifestation. When stumped on how to most past resistance, counselors have a couple factors in their control to look at. One is getting outside guidance. Reaching out for supervision or advice can bring added expertise and perspective to resistance.

Can you change how you interact with your clients?

You can only change how you interact with your clients and hope that changes results.”. When faced with a resistant client, counselors should practice mindfulness toward this balance of change.

Can a counselor change a client?

Counselors can’t make clients change. Counselors need to acknowledge that there is only so much within their power to combat client resistance. If a client does not want to change or is not ready to change, a counselor cannot force to change to occur. Exerting too much pressure during a session could further reinforce resistant behavior.

Therapists Need to Monitor Intent

When clients are resistant, it is imperative for therapists to monitor their own intent. As a therapist, do you want to force the client to “get it,” to change, to do whatever you want them to do? As the therapist imposes his or her will, the relationship dynamic suddenly shifts to the therapist being a bully and trying to get their needs met.

Demeanor is Key

In resistant counseling relationships, therapists tread on troubled ground. Our demeanor is the key. To avoid our natural tendency to “fix,” a therapist’s internal environment needs to come into play. A person-centered approach works best.

Client Resistance as Healing Device

As the wall begins to fade, options can be explored, but again we are on tentative ground. Resistance can be used as a healing device if a client is able to look at the underlying hurt. Utilizing a Spiritual Psychology approach “ When love is applied to hurt we heal ” can address the underlying issue beyond the resistance.

How to help clients feel empowered?

You can help your client to feel empowered to do this by encouraging them to identify opportunities to get in touch with positive, supportive, protective things in their lives such as: You, their counsellor. A family member or friend. A pet. A soothing book.

Is it normal for a therapist to evade their client?

Lots of therapists have reported clients evading their main issue until the last minutes of a session leaving no time to properly process what they have said, this is all very normal and you can become skilled in helping clients break through their resistance so they can engage most effectively in healing.

Is therapy collaborative?

First of all, remember that therapy is a collaborative enterprise. Yes, engaging resistant clients in therapy is part of our task as mental health professionals, but responsibility also lies with client and they will have their own work to do in order for them to most effectively use their therapy time.

Is resisting therapy normal?

An important thing to remember is that resisting therapy is normal! Wanting to avoid questions that are difficult or uncomfortable is a very common defense mechanism. Perhaps we developed this trait in order to not be mistreated when we were young, perhaps we learned to distract our parents or teachers to avoid their disappointment. Normalizing the behaviour, by talking congruently about what is happening, can be powerful for the client as they may have some belief that they are bad or unusual for being resistant.

What is realistic resistance?

Such resistance, or objection, to both the therapist and therapy is sometimes referred to as ‘realistic resistance’ and includes opposition to (Rennie, 1994): The therapist’s overall approach to therapy. Specific in-session techniques. Some of the terms used by the therapist.

What is resistance in cognitive psychology?

In cognitive models such as Albert Ellis ’s, resistance is often the result of unrealistic expectations and other irrational beliefs. According to such models, resistance, like other irrational beliefs, requires head-on confrontation. The client must be helped to surrender irrational beliefs to move forward (Leahy, 2003).

Why is labeling behavior as resistant?

Labeling behavior as resistant may result from a lack of knowledge or therapeutic skills, and an inadequate response to the situation can damage the client’s progress (Shallcross, 2010). Reframed, uncomfortable interactions can strengthen the therapeutic relationship and further treatment, and encourage client growth.

Can a client claim to be on board with the therapy process?

The client may claim and even appear to be on board with the therapy process and the therapist’s recommendations, yet keep their disagreement hidden. However, observant therapists are likely to spot covert acts of resistance when the client (Ackerman & Hilsenroth, 2001): Uses statements that distance the therapist.

Should a therapist avoid challenging the process?

The therapist should not avoid situations that risk challenging the process, but work to address the resistance (communicated directly or indirectly). Unless confronted, the therapist risks strengthening the client’s need for nurturance rather than growth (Safran et al., 1990).

Can breaks in the therapeutic alliance hinder the therapeutic process?

While breaks in the therapeutic alliance are often inevitable, they can obstruct client engagement and hinder the therapeutic process. Such resistance can result from (Safran, Crocker, McMain, & Murray, 1990):

What is resistance in therapy?

Resistance to the therapist’s general approach to therapy (e.g., involving discrepancies in general expectancies and/or objectives for treatment) Resistance to specific in-session techniques (e.g., session structure, particular interventions, etc.) Resistance to words or phrases used by the therapist. Although a strong working alliance tends ...

What is psychological resistance?

Sigmund Freud originally described psychological resistance as a phenomenon wherein patients unconsciously “cling to their disease” through “tenacious” and “critical objections” in order to repress distressing thoughts, emotions and experiences as they are raised by the therapist (Freud, 1904; 1920; 1940).

What is realistic resistance?

Broadly defined, realistic resistance refers to clients’ conscious, deliberate opposition to therapeutic initiatives that they fail to understand or accept.

Should therapists avoid alliance ruptures?

In fact, rather than allow for a client’s resistance (whether communicated directly or indirectly to the therapist) to dictate the course of therapy, therapists should not avoid potential alliance ruptures and instead work with and address resistance as it arises.