how to work with treatment resistant groups of clients

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.

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How do you manage resistant clients in counseling?

Apr 04, 2017 · 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.

How many types of client resistance are there in addiction treatment?

Feb 14, 2010 · “Stay out of an excessive questioning mode of responding with resistant clients,” Mitchell says. “Questions are micro-confrontations with resistant clients that invite unproductive answers. Excessive questioning is the primary means by which therapists get sucked into the client’s ’stuckness.’ Learn to dialogue without questions.”

How can therapists use resistance in therapy?

Nov 19, 2018 · Establish best therapy interventions to incorporate into treatment. Address client self-sabotage. Assess and evaluate effectiveness of current strategies, and make adjustments as necessary. Remind ...

Is resistance a client’s best attempt?

Nov 09, 2015 · Here are 3 things I did that can help you also deal with resistance in your clients 1. Don’t take it personally It’s perhaps natural to find yourself becoming exasperated or frustrated, as I was with... 2. See what’s behind it One way to help yourself feel …

How do you treat resistant clients?

How do you deal with resistance in therapy?

How do you build rapport with resistant clients?

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

How can you most effectively deal with resistance?

What are the four types of client resistance?

How do you engage involuntary clients?

How do you build trust with a client in therapy?

How do you establish rapport and trust with clients and your peers?

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

What to do as a social worker if a client refuses to see you?

What are some red flags that would indicate client resistance?

How to avoid resistance in counseling?

Instead, he advises counselors to simply listen to the client and focus on not creating resistance and not fostering defensiveness. Then, step back and let change happen, he says. “If you go in there and make not creating resistance your first priority and let the change come as a second priority, with highly resistant clients, you’re more likely to get change.”

What is the key to resistance management?

The concept of counselors focusing exclusively on their interactions with clients and letting change happen on its own is key to the successful management of resistance and the pivotal point of effective therapy, says Mitchell. For 10 years, the American Counseling Association member has studied and presented seminars on dealing with resistance in therapy. “Although most therapists have been trained extensively in theoretical approaches, few have had extensive training in dealing with resistance,” he says.

How does a counselor help a client move forward?

The counselor-client relationship is key to helping the client move forward, Wubbolding says. “Clients are less resistant if they feel connected with the counselor. If counseling is to be successful, the client must be willing to discuss the issue, examine it and make plans. 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. After this occurs, the counselor can help them conduct a more fearless self-evaluation.”

How does reality therapy help with resistance?

“As a teacher and practitioner of reality therapy, I suggest that the counselor begin by asking clients what other people in their environment are doing to them, how they oppress them, reject them, make unreasonable demands on them and control them. It is important for counselors to connect with clients on the basis of the client’s reality rather than putting emphasis on the counselor’s agenda. In other words, the counselor may want the client to make better choices, but without connecting with the client’s perceptions in the beginning of the counseling process, the counselor might facilitate more resistance rather than less.”

Why do counselors label clients as resistant?

So, we label them as resistant as a result of our inability and lack of therapeutic skills. There is always a reason the client is responding the way they are. Our job is to understand the client’s world to the degree that we see their behavior for what it is and not as resistance.”

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.

How to deal with client resistance?

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. In fact, if the therapist finds themself frustrated with the client’s effort, they may be best-served to “let go” of expectations, as this is a sign that the therapist’s personal agenda is not being met.

What does a therapist assume about client resistance?

Oftentimes a therapist will assume that client resistance is 100% based on something within the client. In reality, the therapist’s inability to build a strong therapeutic relationship with the client may be a contributing factor.

Why do therapists need to be willing to engage with their clients?

When a therapist tries to keep the relationship with their clients at a distance because of fears, such as fear of countertransference issues, the clients may sense this distancing. The effectiveness of therapy might then be diminished. A therapist can benefit from taking emotional risks with their clients. Client relationships aren’t so fragile that mistakes can’t be dealt with and overcome.

What happens if a therapist is not client centered?

If a therapist lacks a client-centered approach, then the client will notice (if not consciously, then unconsciously) that their therapist is inflexible or rigid. If a client has issues from childhood resulting from a controlling parent or has problems with authority figures, then they may unconsciously resist what is being perceived as external control from the therapist.

What are the issues that contribute to client resistance?

Issues contributing to client resistance may include fears of failure or the fear of terminating therapy. One question a therapist can use to address these types of fears is, “What would happen if you were successful?” or something else along those lines. Always explore topics of resistance with curiosity and encouragement.

Why is it important for therapists to understand when they are placing unrealistic expectations on clients based on the therapist

Remember, clients have their own personal experiences that may or may not be conducive to certain treatment outcomes.

How to explore a client's fears and early life experiences?

A therapist can explore a client’s fears and early life experiences by using the Socratic questioning method. Determine what the client’s underlying beliefs about life are. For example, does the client have a strong need to manipulate others or have power over them? Unmasking and revealing underlying maladaptive schemas, along with addressing their protective factors, should be addressed in the treatment plan.

Why is resistance used in therapy?

Why? Because resistance, whatever it’s focussed on, is energy (just like that pushing and pulling) and all energy and motivation can be managed and used in therapy. (I’ll talk more about this in Tip 3.)

Who encouraged the resistance of his patients?

If you read the case studies of the psychiatrist Milton Erickson , you’ll see that, time and time again, he encouraged the ‘resistance’ of his patients, seeing it not as a problem but as a vital energy that could, if properly directed, actually help the client.

What does it mean when you are always under resistance?

Appreciating that there is always something behind the resistance – whether it’s anxiety, out-of-control competitiveness, or merely the habit of contrariness – means you have a chance of handling it effectively, rather than just emotionally reacting against it by becoming upset or angry yourself.

What is a habit in a relationship?

Habit – They may live with someone with whom they are in constant conflict. Or perhaps they work in or were brought up in an environment in which they have/had to constantly ‘fight’ and they haven’t yet settled into a non-conflicting role.

What is the resistance to counseling?

Logistic management resistance refers to a technical form of the behavior in which clients disrupt counseling by forgetting or ditching appointments , refusing to pay and asking personal favors of the counselor. Clients who want out of counseling try to create openings for themselves by “ignoring, and in some cases outright defying, established counseling guidelines.”

When encountering resistance, counselors could benefit by taking some of their own advice?

When encountering resistance, counselors could benefit by taking some of their own advice, said Clifton Mitchell, a professor and author of “Effective Techniques for Dealing with Highly Resistant Clients.”

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).

Why do counselors resist?

In some cases, such reluctance may be due to the level of trauma or physical and mental harm a client has sustained (as in cases of child or spousal abuse) increasing the difficulty for them to open up to a counselor. In other cases, what may look like resistance is actually a product of culture. Such behavior needs to be recognized by counselors as separate from resistance.

What is response content resistance?

Response content resistance: When a client does engage, but seemingly deflects direct questions or certain topics, they may be demonstrating response content resistance. For instance, small talk (about trivial topics like entertainment, rumors or the weather) may not be viewed as harmless in a counseling context, but rather a deliberate manipulation of the relationship. By diverting attention or overreacting, clients block the two-way street a session is intended to create, becoming more difficult for counselors to reach the underlying issues.

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.

How to use resistance to your favor?

That is the first step in using resistance to your favor: steering clear of generalizations and exasperation. Though this is easier said than done (expending empathy and effort can be exhausting for counselors who see no forward progress with a client).

How to help a client with distress?

Acknowledge the client’s distress and encourage them to engage fully in the group conversation. Ask them to sit up, remain focused, and talk openly in this safe space.

What is resistant behavior?

Resistant behavior may occur when positive actions are not reinforced immediately or the client has to wait for their desired result.

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.

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).

What is Freud's model of resistance?

Freud’s model suggests that resistance results from the patient’s confrontation with unresolvable conflicts.

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.

How to help teens overcome resistance?

1. Understand Resistance 2. Develop a personal philosophy on dealing with resistance. 3. Understand reasons teens are often resistant to treatment 4. Learn tools to help teens gain motivation to engage in treatment

What is resistance in psychology?

resistance is what we do to protect ourselves from awareness of that which we fear will overwhelm us

What is the paradox of therapy?

The paradox of therapy is that people do not begin to change until they feel as accepted as they are

When is resistance normal?

o Resistance is ‘normal’ when being asked to change o Telling others what to do is often deemed confrontational and met with resistance o Seek to clarify and understand o Invite consideration of and openness to new perspectives

Is there a right way to change?

There is no “right” way to change. Support all clients

Can you change your clients?

You cannot change your clients; you can only change how you interact with your clients

Can a client fail in therapy?

The client cannot fail in therapy/school; the therapy/school fails the client

What does a therapist do when a client is ready for change?

When the therapist thinks the client may be ready for change, the therapist elicits the client's thoughts about how to go about making that change. Throughout MI, the therapist is a consultant to the client's change program, but the client is always in the lead. As a consultant, however, the therapist can and should offer advice and suggestions about change strategies that may be helpful. The therapist asks to be "invited in" by statements and questions like: "I have some thoughts about what's been helpful for other people with similar problems that might be helpful for you. Would you be interested in hearing them?" The client is then free to accept, reject, or modify the therapist's suggestions.

How does a therapist respond to a should self?

For example, the self that was initially reactant may respond to the should self by saying "Your criticisms make me even more afraid and unwilling to change. I need you to back off from these criticisms. If you do I might be more willing to try changing."

What is the two chair method?

The Two-Chair method has its roots in the Gestalt therapy of Perls, Hefferline, and Goodman (1951). This therapy makes use of "experiments" that are semi-structured novel experiences related to the problem under discussion and constructed jointly by the therapist and client. They are discovery-oriented and designed to increase the client's awareness of feelings and change dysfunctional ways of thinking about themselves and others. They may take place during or between therapy sessions. For example, Perls and colleagues (1951) described the use of two-chair experiments in which the client engages in a dialogue between conflicting aspects of the self. The client may take one role (e.g., the critical self) in one chair and another (e.g., the rebellious self) in the other chair, with the therapist facilitating a dialogue between the two. In recent years, Greenberg and his associates have expanded on this work and developed Emotion-Focused Therapy (EFT) (e.g., Greenberg & Safran, 1987; Greenberg, Rice, & Elliott, 1993; Greenberg & Watson, 2006) that builds upon Rogers' (1951) client-centered therapy as well as Gestalt therapy. The part of their work that is most relevant to ambivalence is what Greenberg, Rice, and Elliot (1993) call "conflict splits." Here, there is a sense of struggle between the two selves that pull a person in different directions, e.g., "Part of me wants this, but another part of me wants that." We built on this work to develop a two-chair procedure specifically aimed at resistant ambivalence and its resolution.

How did Arkowitz and Engle study ambivalence?

Arkowitz and Engle (1995) conducted a small single-group pilot study on the Two-Chair procedure for resolving ambivalence. People who were having trouble making an important change in their lives were recruited from advertisements in the campus newspaper. Seven respondents were deemed appropriate for the study. Their focal problems included: two women who wanted to leave what they considered to be bad relationships but were unable to do so; one smoker who wished to stop; one who was trying to lose weight; one who was messy to the point of embarrassment about having people visit her; one who was indecisive in her career choice, and a depressed man who was unable to move ahead on many of the goals he set for himself. Each subject received four half-hour sessions devoted almost entirely to the Two-Chair procedure applied to the focal problem. Of the seven, there were clear resolutions and behavioral changes in four, improvement but short of full resolution change in two cases, and no change at all in one.

What is the purpose of a MI therapist?

Instead, the MI therapist seeks to increase intrinsic motivation and reduce ambivalence about changing. With these changes, it is assumed that behavior change will occur naturally, with the client perceiving the locus of change as internal rather than residing in the therapist.

What is the two chair procedure?

Early studies (Greenberg & Clarke, 1979; Greenberg & Dompierre (1981); Green-berg & Higgins, 1980) compared empathic reflection (derived from Carl Rogers' Client-Centered Therapy) with Two-Chair work for clients who were experiencing ambivalence about a decision. Both groups made considerable progress toward behavioral goals, but were not significantly different from one another.

What is a therapist's statement?

The therapist's statement is just a small step beyond the client's statement and makes a reasonable guess that the client feels angry when bugged by parents. But it's an attempt to deepen the client's experience and check the therapist's understanding of it.