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.
What happens when a client is resistant to therapy?
Anyone who has ever performed therapy such as psychotherapy has run into resistance. When you have a resistant client, you often leave the session feeling like you just spent the therapeutic hour banging your head into a wall. Put simply, it can be highly stressful and frustrating.
How do you deal with resistance to therapy?
If goals for therapy have been arrived at collaboratively between therapist and client and there is still noncompliance, then resistance can be addressed as part of what needs to be focused on in treatment. The resistance should be actively discussed with the client, without judgment or surprise.
What is actively fighting resistance in therapy?
Actively fighting resistance is an approach that rarely works in therapy (Beutler, Moleiro & Talebi, 2002). Instead, this strategy involves noting the resistance so you can explore what is causing it. Pointing out that a client appears to be exhibiting some resistance allows you to process it and move beyond it (Austin & Johnson, 2017).
Is there a categorical definition of treatment resistant psychiatric disorders?
The evidence for a distinct psychopathological or neurobiological nature of treatment resistant psychiatric disorders, and hence for a categorical definition of treatment resistance, is limited and, outside of a clinical trial context, not very useful 3.
What does it mean to be resistant in therapy?
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.
Why does resistance happen in therapy?
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 does resistance look like in therapy?
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.
Why can't I open up in therapy?
If you're finding it difficult to open up at first, don't worry. It might take some time for you to really get in the swing of it. But with time, you should start to feel yourself becoming more comfortable and opening up more. If not, consider whether you might want to work with another therapist.
What do you do if therapy isn't working?
If therapy isn't working, the first person you should talk to is your therapist. She may opt to change her approach to treatment, pursue more “homework” options for you, or even refer you to another therapist. Be sure to ask the following questions: How long should it take for me to see results?
What is a resistant person?
(rɪzɪstənt ) adjective. Someone who is resistant to something is opposed to it and wants to prevent it. Some people are very resistant to the idea of exercise. Synonyms: opposed, hostile, dissident, unwilling More Synonyms of resistant.
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 does resistance mean in psychology?
1. generally, any action in opposition to, defying, or withstanding something or someone. 2. in psychotherapy and analysis, obstruction, through the client's words or behavior, of the therapist's or analyst's methods of eliciting or interpreting psychic material brought forth in therapy.
What is the sign of resistance in therapy?
A telltale sign of resistance is a client who does not complete their homework or follow up on your suggestions. In order for therapy to be successful, a client needs to at least think about what was discussed in session in their daily life.
What is the job of a therapist when a client is exhibiting resistance?
If the client is exhibiting resistance, it is the job of the therapist to assist in reducing it as much as it is the client’s responsibility to change their behavior. Whatever your definition, one thing is sure, resistance is negatively related to treatment success (Beutler, Moleiro & Talebi, 2002).
How to deal with a client who is resistant to change?
One of the most effective methods to deal with resistant clients is to use a paradoxical intervention. When you use a paradoxical approach, you don’t try to fight the resistance, you actually support it. For example, say a client is having trouble sleeping and you have recommended some changes in their sleep hygiene. You find out they have not changed any of their behavior and are still complaining of sleep. Instead of chastising them for their non-compliance, you tell your client that they should not change any behavior and just keep on taking the same approach to bedtime. Because certain clients are oppositional in nature, it is hoped they will defy your recommendations and actually do the opposite behavior (which is what you wanted them to do in the first place). Numerous research studies have supported the use of paradoxical interventions for those with highly resistant behavior. (Beutler, Moleiro & Talebi, 2002).
When to revisit goals?
When you have established goals, you can easily revisit them, especially when you feel therapy may have veered off course due to resistance. This will remind the client what they are working towards and spur internal motivation, helping break through the blockades of change.
What does it mean when you feel like a client is not making progress?
When you feel like a client is not much making much progress it is natural to feel frustrated and a bit guilty. You want to make sure you are providing them with the best therapy possible so you spend extra time on their case, planning new strategies and interventions.
What is treatment resistant?
Treatment-resistant is a clinical term used to describe the situation when your condition doesn’t respond to a prescription medication as expected – it may work partially, or not at all . Unfortunately, this is an all too common experience for patients diagnosed with major depressive disorder. [ i] Treatment-resistance occurs in a variety ...
What happens when a medication fails to alleviate your suffering?
When a medication fails to alleviate your suffering, there is always the possibility that you were misdiagnosed or that one or more additional undiagnosed medical conditions (called comorbidities) may be present.
Do psychiatrists treat patients the same way?
Not all psychiatrists treat patients in the same way even when they agree upon the diagnosis. Some have preferences for particular medications and type of psychotherapy (talk-therapy) they prefer to administer. If you have given your current treatment plan a few months and there is no improvement in how you are feeling or functioning, it may be time to seek out another psychiatrist with a different approach, that would include a thoughtful, stepwise set of interventions until you find a therapeutic regimen that’s most effective. It is imperative that you trust, connect with, and respect your doctor. Feeling that the two of you are a good fit, and that you observe a gradual improvement in your condition over time, are the “must haves” when it comes to mental health treatment. Accept nothing less!
What type of counseling involves a group of people who struggle with depression working together with a psychotherapist?
Group psychotherapy. This type of counseling involves a group of people who struggle with depression working together with a psychotherapist. Mindfulness. Mindfulness involves paying attention and accepting one's thoughts and feelings without judging them as "right" or "wrong" in a given moment. Behavioral activation.
What type of therapy is used to help with depression?
Interpersonal psychotherapy focuses on resolving relationship issues that may contribute to your depression. Family or marital therapy. This type of therapy involves family members or your spouse or partner in counseling. Working out stress in your relationships can help with depression.
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 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.
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.
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.
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.
What Is Treatment-Resistant Depression?
Experts don't agree on one definition. But in general, it's a form of depression that doesn't improve after you try two antidepressants from different classes of drugs. "If you have to go to a third medication, that's the standard threshold," Krystal says.
How to Get a Diagnosis
Before you get a diagnosis of treatment-resistant depression, Krystal says you'll need to go through two rounds of antidepressant treatments. That typically means giving each antidepressant 6 to 8 weeks to work.
What Causes Treatment-Resistant Depression?
There are some theories about genetic and brain differences, Clark says, but there isn't a biomarker or other mechanism that can identify people who'll have treatment-resistant depression. "There's no definitive answer on that question."
Symptoms
There isn't a specific set of symptoms that makes treatment-resistant depression different from other forms of depression. Experts agree it'd be a lot easier if that were the case. But Krystal says your antidepressant definitely isn't working if you wake up every morning and think, "I don't know how I'm going to get through the day."
How to Manage Treatment-Resistant Depression
Antidepressants alone may not work very well. Seek help from a doctor who'll give you more choices. "I encourage people to make sure they're working with a psychiatrist who feels comfortable going through the gamut," Clark says. "Not just with oral therapies, but someone who has knowledge of some of the more advanced and novel treatments."
