Silence and minimal talk are typical forms of resistance in this category. Otani (1989) identified such behaviors as frequent pauses, taciturnity, silence, and minimal talk as signs that the client may be engaging in this type of resistant behavior.
Full Answer
How do you know if a client is resistant to therapy?
However, resistance in this population may still be apparent through covert acts such as statements that distance the therapist, avoidance of certain topics, or physical withdrawal (Ackerman & Hilsenroth, 2001; Hill et al., 1993).
Why do clients become resistant to change?
In some cases clients may be resistant to change because change in and of itself is a frightening prospect. As human beings we are creatures of habit, and asking someone to change may lead to the development of resistant behaviors as a productive measure. The counselor Counselors, both consciously and unconsciously, contribute to client resistance.
Why is my client reluctant to see a counselor?
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.
What would wubbolding say to a resistant client?
“It seems to me,” Wubbolding might tell this resistant client, “that you have two choices” to continue down your current path or to choose a different path. “You can continue to do what’s not working, or you could try something different. One road maintains the misery you (currently) have and will probably make it worse.
What may cause a client to become resistant?
Clients may be resistant to the counseling process because they have feelings of shame. There also may be a misalignment of goals. Counselors try to move their clients towards an acceptance of responsibility while clients may be more inclined to strive for evasion of responsibility (King, 1992).
What are two signs that a client is resistant to change?
Signs of resistance: The client may interrupt you. The client seems distracted (looking at watch, cell phone, etc.). The client may get defensive.
What does resistance in therapy look like?
When you feel like a client is not making progress, it is a sign of resistance. They may come in regularly but they keep having the same experiences and don't show improvement. When you feel like a client is not much making much progress it is natural to feel frustrated and a bit guilty.
In what ways might resistance be displayed by a client?
Such tactics that indicate a response style resistance can include: “discounting, limit setting, thought censoring/editing, externalization, counselor stroking, seductiveness, forgetting, last minute disclosure, and false promising.” Clients exhibiting this resistant behavior use guile to avoid talking about sensitive ...
What causes resistance in therapy?
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.
What is a resistant client?
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. Counselors need to connect with the client in order to find the right problem.
What does resistance mean in therapy?
In psychoanalysis, resistance is loosely defined as a client's unwillingness to discuss a particular topic in therapy. For example, if a client in psychotherapy is uncomfortable talking about his or her father, they may show resistance around this topic.
What is an example of resistance in psychology?
Examples of psychological resistance may include perfectionism, criticizing, disrespectful attitude, being self-critical, preoccupation with appearance, social withdrawal, need to be seen as independent and invulnerable, or an inability to accept compliments or constructive criticism.
When resistance occurs in therapy what event is taking place?
antisocial personality disorder. When resistance occurs in therapy, what event is taking place? The client is using unconscious defense strategies that prevent progress.
What makes a client difficult in therapy?
Therapy is much more difficult with coerced, reluctant, or challenging clients. These are typically clients who are not necessarily ready to make a change in their life, but have been forced to do so by the court system, the child welfare system, or their spouse or significant other.
How do you deal with resistant patients?
7 Tips for Handling Difficult PatientsDon't Get Defensive. ... Watch Your Body Language. ... Let Them Tell Their Story and Listen Quietly. ... Acknowledge the Situation. ... Set Boundaries. ... Administer Patient Satisfaction Surveys. ... Be Proactive.
What is Process resistance?
A Resistance Process consists of activities of biologic molecules or complexes involved in processes that maintain immunity to, or counteract, defeat, or withstand the effects of, an antagonistic agent. ( NCI Thesaurus)
When faced with a resistant client, should counselors practice mindfulness toward this balance of change?
When faced with a resistant client, counselors should practice mindfulness toward this balance of change. Delineating between what is within a counselor’s control and what isn’t can help professionals retool approaches or recognize when a certain path of interaction isn’t worth pushing.
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.
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).
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.”
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 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 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.
How to deal with anxiety in a therapist?
To address therapist anxieties, a therapist needs a good support system, including people with whom they can discuss their fears. It is also good for a therapist to reframe their fears with anxiety-reducing strategies, such as: 1 Challenging unrealistic performance expectations placed on the self 2 Reminding oneself that it’s okay to make mistakes 3 Focusing on the client rather than on the self 4 Realizing that no mistake is fatal and that part of good therapy involves the concept of “rupture and repair.” When ruptures in the therapeutic relationship occur, repairing of the relationship can be healing in and of itself.
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 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 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.
Why do people resist therapy?
Many times, resistance in therapy stems from inadequate interventions in the motivational stage, which is a crucial part of the therapeutic process.
What to do if a patient doesn't do self-records?
When this happens, as a last resort, you can confront the patient. Tell them that if they don’t do their self-records, there won’t be a therapy session the following week. To condition the therapy, call the patient the day before the appointment and ask if they completed their self-records.
What is resistance in therapy?
Resistance in therapy refers to patient attitudes, behaviors, or cognitions that may delay or avoid therapeutic change. Usually, it’s present during the first stages of evaluation because that’s where the client may begin to question the treatment. In addition to this, they may refuse to speak sincerely or answer the therapist’s questions politely.
What is the ultimate goal of therapy?
The ultimate goal will always be to offer the client the most appropriate, effective, and useful therapy according to their issue. If there’s the possibility of changing the type of task or eliminating it and finding other means to reach the goal, don’t hesitate to look for them.
How to help a patient who forgot to fill in self records?
Allow external aid. For example, if the patient forgets to fill in their self-records, send them a text reminding them. There are also things they can do during the therapy session. Help them establish a series of alarms or make reminders they can place in easily-seen spots so they never forget.
Why are there age gaps between therapists?
The reason for this is that older patients are most likely going to believe a young therapist won’t be able to relate to their issues.
What can be a simple comment at the beginning of a treatment?
What may start as a simple comment at the beginning of the treatment can become a resistance later on. That’s when the patient will begin to doubt their psychologist in every way. Perhaps they think their therapist doesn’t have the right tools or information in order to help them.
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.”
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.”
What does it mean when a counselor says "I don't know"?
If a counselor empathizes with the client and agrees that the problem is difficult to figure out, the counselor is indicating that he or she is joining the client in the attempt to find a solution, Mitchell says. Too often, he adds, counselors make the mistake of treating an “I don’t know” answer as a barrier rather than an opportunity to work with the client. “Use it as a doorway into the struggle,” he says. “Most people don’t realize it’s a great place to get to.” Assuming the role of “expert” can also get counselors into trouble with resistant clients, Mitchell says. When a counselor gives ideas or suggestions related to a client’s problems and starts hearing “Yes, but …” answers, it’s time for the counselor to vacate the expert seat, he says. “You need to stay in a naïve, puzzled, unknowing, curious position. You need to not have knowledge; you need the client explaining to you. We want them talking, not us talking. If you’re not buying what I’m selling, I need to quit selling.” Encouraging clients to analyze their situation and explain it to the counselor is important, Mitchell says, because in the process, they might discover insight for improving the situation.
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.”
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 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 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.
How to know if a client is avoiding a topic?
/ Gently push the conversation back to this topic to assess if the client is truly avoiding it. Notice the client’s affect during the discussion and whether avoidance of the topic is consistent with symptoms of their clinical presentation or may rather suggest an unspoken disagreement with the therapist’s direction of the conversation .
How to respond to a client withdrawing?
/ Share your emotional response in the moment of feeling some distance between yourself and the client or that perhaps the two of you are not on the same page. Ask if the client noticed this and feels this as well. Perhaps posit that it might be related to the topic of conversation. Ask your client if he or she has anything they would like to share with you.
What happens when a therapeutic alliance ruptures?
When not addressed, resistance can lead to therapeutic alliance ruptures. Such, ruptures are unavoidable in therapy (Safran, Crocker, McMain, & Murray, 1990). When not appropriately addressed, such rifts interfere with client engagement and ultimately thwart therapeutic progress. Ruptures can stem from instances in which the therapist actively engages in techniques that do not resonate with the client, as well as when the therapist does not do what the client does want. However, despite their treatment-interfering potential, ruptures are not considered to be problematic by many therapists and clinical scientists. Rather, they are seen as vehicles that may be used to deepen the therapeutic bond and promote growth by allowing patients—and their therapists—to practice skills needed for interpersonal conflict resolution (Muran et al., 2009; Safran, Muran, & Eubanks-Carter, 2011). Indeed, rupture repair may foster a particular kind of therapeutic change that would be unlikely to occur within unruptured relationships. The resolution process often provides compelling and experiential disconfirmation of clients’ long-held, maladaptive interpersonal schemata (Safran et al., 1990).
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 to do if client did not do homework?
Your client did not do their homework. / Ask your client to cite back to you their understanding of the homework assignment to ensure it was clear. Then discuss with them what might have hindered their completion of it. Notice specifically any disagreement on treatment tasks or goals and consider collaborating to adjust them.
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 realistic resistance?
Broadly defined, realistic resistance refers to clients’ conscious, deliberate opposition to therapeutic initiatives that they fail to understand or accept.
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.)
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.
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 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.
Why are clients resistant to change?
Counselors try to move their clients towards an acceptance of responsibility while clients may be more inclined to strive for evasion of responsibility (King, 1992). Clients simply may not be ready to move where their counselor is taking them. Some clients may be resistant because there is a purpose for their symptoms. The benefits of maintaining their dysfunctional beliefs or behaviors far outweigh the benefits of overcoming them. These clients may enjoy the support and attention they receive by having a mental health condition and may be hesitant to lose the associated benefits. In some cases clients may be resistant to change because change in and of itself is a frightening prospect. As human beings we are creatures of habit, and asking someone to change may lead to the development of resistant behaviors as a productive measure.
What are the causes of client resistance?
Counselors, both consciously and unconsciously, contribute to client resistance. Counselors may have failed to establish rapport with their client. They may have misguided expectations of client behavior and client
How do counselors contribute to client resistance?
Counselors, both consciously and unconsciously, contribute to client resistance. Counselors may have failed to establish rapport with their client. They may have misguided expectations of client behavior and client roles. The counselor may expect the client to respond in a particular way, and when they do not respond accordingly they assume the client is being resistant. The interventions and techniques used by counselors also may contribute to in-session resistance. Counselors need to be cognizant of the interventions they use, ensuring that they are appropriate for their client in the given moment. Similarly, counselors should only assign homework assignments that are relevant to the issue at hand and that are not too time consuming for the client.
What role does a counselor play in a client's resistance?
roles. The counselor may expect the client to respond in a particular way, and when they do not respond accordingly they assume the client is being resistant. The interventions and techniques used by counselors also may contribute to in-session resistance. Counselors need to be cognizant of the interventions they use, ensuring that they are appropriate for their client in the given moment. Similarly, counselors should only assign homework assignments that are relevant to the issue at hand and that are not too time consuming for the client.
What are the resistances in counseling?
This category of resistance consists of behavior patterns clients engage in that violate the basics rules underlying the practice of counseling. The most common forms include poor appointment keeping, payment delay/refusal, and personal favor asking. The object is to avoid engaging the counselor in the counseling process by creating a distraction. These forms of resistance signify that the client may have a negative attitude towards the counselor or towards the counseling process. By ignoring, and in some cases outright defying, established counseling guidelines clients are creating a way for themselves to not participate in the therapeutic relationship.
How does resistance affect the family system?
The family systems theorists view resistance as an unconscious attempt to protect other family members by avoiding any disturbance to the delicate homeostatic balance of the system in which change and growth have unconsciously become associated with disloyalty, betrayal, and loss. Clients become reluctant to change their beliefs or behaviors for fear that doing so will negatively impact other family members. While these changes might be in their best interests, clients place the family’s welfare ahead of their own.
What is response quantity resistance?
Response quantity resistance is viewed as the client’s noncompliance with the change process. This category consists of a class of behaviors whereby the client limits the amount of information communicated to the counselor. Silence and minimal talk are typical forms of resistance in this category. Otani (1989) identified such behaviors as frequent pauses, taciturnity, silence, and minimal talk as signs that the client may be engaging in this type of resistant behavior. By limiting the amount of information they give to the counselor, clients are able to control the counseling session and prevent the discussion of difficult or emotionally painful topics. This behavior is observed most frequently among involuntary clients, such as court-referred clients (Dyer & Vriend, 1988).
What to do if counseling doesn't work?
If counseling doesn't seem helpful, talk to your psychotherapist about trying a different approach. Or consider seeing someone else. As with medications, it may take several tries to find a treatment that works. Psychotherapy for depression may include:
What to ask a psychiatrist about depression?
Consider your response to treatment, including medications, psychotherapy or other treatments you've tried.
How to help someone with depression?
If you have trouble sleeping, research ways to improve your sleep habits or ask your doctor or mental health professional for advice. Get regular exercise. Exercise has a direct effect on mood. Even physical activity such as gardening or walking can reduce stress, improve sleep and ease depression symptoms.
What to do if your doctor prescribed antidepressants?
If your primary care doctor prescribed antidepressants and your depression symptoms continue despite treatment, ask your doctor if he or she can recommend a health care provider who specializes in diagnosing and treating mental health conditions.
Can you stop drinking alcohol and drugs?
In the long run, alcohol and drugs worsen depression and make it harder to treat. If you can't stop drinking alcohol or using drugs on your own , talk to your doctor or mental health professional. Depression treatment may be unsuccessful until you address your substance use. Manage stress.
What Are The Signs And Symptoms Of Treatment-Resistant Depression?
The number one sign of TRD is that you’ve tried multiple antidepressants as directed (no skipping doses!) and still aren’t feeling better.
Why is TRD easy to diagnose?
TRD is easy to misdiagnose for a number of reasons. Doctors prescribe the wrong dose. Patients forget to pack their meds while they’re on vacation. People simply get frustrated and quit taking their pills. There are many scenarios that could cause someone to think an antidepressant isn’t working when it is (or could with minor adjustments).
What is the best treatment for TRD?
To fight TRD, the medical community is embracing an array of methods—some familiar, some totally unexpected: Ketamine and esketamine. Originally developed as an anesthetic (and popularized as a club drug) ketamine quickly produces an antidepressant effect by increasing the amount of neurotransmitters in the brain.
What journal published treatment resistant depression in later life?
Seniors and risk: Journal Of Psychiatry & Neuroscience (2015). “ Treatment-Resistant Depression In Later Life. ”
Why don't people respond to antidepressants?
There’s certainly no lack of theories explaining why so many people don’t respond to antidepressants, but it likely has to do with a fundamental misunderstanding of depression’s biology.
Can treatment resistant depression be frustrating?
Having treatment-resistant depression can be really (really) frustrating. But, it doesn’t mean you’ll feel like this forever. There are things you can do. Keep the communication lines open with your health care pro. You’ll get through this.