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How to understand resistant clients

Date: April 9, 2018

Withdrawn woman sitting alone.

How to understand resistant clients

Professional counselors may be altogether too familiar with this phrase: “I don’t have anything to talk about today.” For every client who comes in ready to talk and dig through issues, there are as many clients who are resistant to initial or ongoing counseling efforts.

Encountering resistance is a common experience for counselors. Clients naturally weigh trusting a perfect stranger with personal issues, as well as their fear of rejection. 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.

However, sometimes clients may simply believe they’re wasting their time or that seeing a professional who’s earned a Master of Counseling in Arts (MAC) won’t actually help them.

Whether clients are resistant due to previous experiences or a lack of understanding of the benefits of counseling, such opposition to engagement can raise tremendous roadblocks for counselors. Resistance can also be a frustrating symptom of the root issue that’s brought a client in for counseling. Trying to get to the root cause is a challenging task for counselors who must work with clients in an attempt to have them interact and share more.

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 and what they can do to encourage clients to engage and express emotions in a healthy way. Here’s what MAC-prepared counselors should know:

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. The boundary line is not always clear, however, and in many cases is something counselors will have to figure out on their own, informed by years of experience.

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.”

“We tell our clients things like, ‘You can’t change other people; you can only change yourself.’ Then we go into a session trying to change our clients. This is hypocritical,” Mitchell told Counseling Today. “I teach, ‘You can’t change 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. 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.

There are many types of resistance

Though a blanket term, resistance can take on several distinct forms. If counselors are educated on the different forms of resistance, they may more effectively tackle the issue. Understanding how a certain type of resistance manifests in a certain client can present counselors with an opportunity to engage on more personal terms.

  • Response quality resistance: A form of resistance more to do with verbal cues than nonverbal ones, response quality resistance is typified by silence, indifference, noncompliance and minimal effort. 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).
  • 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.
  • Response style resistance: Some clients are even savvier in their attempts to redirect or influence the client-counselor relationship. Response style resistance is a form whereby engaging clients may use flattery, charm or wit to disarm a counselor. 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 topics and disincentivizing counselors to probe.
  • Logistic management resistance: This type of resistance doesn’t have to do with interactions in a session so much as the lengths to which some clients will avoid the situation. 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.”

Frustration during a counseling appointment.

Resistance is more than just resistance

A refusal to participate in the counseling process is not always clear cut. 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.

This notion was parsed out in a 1994 article “Understanding Client Resistance: Methods for Enhancing Motivation to Change.” Author Cory Newman, of the University of Pennsylvania, wrote that “[Resistance] is not simply an impediment to treatment, but also a potentially rich source of information about each client. This information can be assessed and utilized to strengthen the therapeutic relationship, help the therapist better understand the ideographic obstacles to change, and devise interventions that may motivate the client toward therapeutic activity and growth.”

Instead of having a rigid interpretation of resistance as an impossible roadblock to navigate, counselors can instead try to engage the client through resistance. 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).

To dig deeper into what resistance says about a client, counselors should consider asking themselves a few questions, as outlined by Newman:

  • What is the function of the client’s resistance? Undermine the counselor’s authority? To redirect from topics the client doesn’t want to address? What level of control does the client seek?
  • How does the client’s current resistance fit into his or her developmental/historical pattern of resistance? Is resistance a constant theme with a client? How do previous relationships factor into the present?
  • What might some of the client’s idiosyncratic beliefs that are feeding into his or her resistance? Why does the client think being resistant is in his or her favor? What does being resistant mean to them?
  • What might the client fear if he or she complies? Does the client fear change? Does he or she fear being unequipped to handle change? What can a counselor do to help the client process their own resistance?
  • How might the client be characteristically misunderstanding or misinterpreting the counselor’s suggestions, methods, and intentions? Does the client willfully distort interactions, or do they simply misunderstand the relationship? How can the counselor improve communication?
  • What factors in the client’s natural environment may be punishing the client’s attempts to change? What does the client struggle with? How can this be related to resistance as presented in the counseling session?

If resistance cannot be broken down, look inward

Sometimes, even after hours of effort and inquisitive outreach, resistance may not always yield. At this point, counselors must look inward, to their experiences and methods, to try to find solutions. 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.

Another concept to consider is pacing. Counselors are in control of how appointments progress, and if things begin moving too fast, resistance may not be adequately addressed, or further hardened.

Resistance can be a form of cultural resiliency

Counselors may also struggle to connect with clients of oppressed groups, like those from minority ethnicities. However, such behavior can’t always neatly be typified as resistance. What counselors may view as resistance is actually a form of cultural resiliency that has been built up to help clients endure, navigate and survive life.

When in such situations, counselors must do all they can to consider the impact sociopolitical factors have on a client. 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. Characterizing a reluctance to engage may not be resistance at all, but a client’s mechanism for coping. Counselors who can’t make this distinction may reach a perilous stage of discriminating against clients, which underscores the need for multicultural competency.

Get a MAC from Bradley University to counter resistance

Resistant clients present some of the most challenging situations for counselors to address. Yet getting past resistance is central to understanding why barriers are built in the first place. 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. One option professionals may want to pursue is earning a graduate degree. Bradley University offers an online Master of Arts in Counseling program that readers can investigate further as a means to becoming more equipped to work with resistance in clients.

Sources:

http://ct.counseling.org/2010/02/managing-resistant-clients/

https://www.counseling.org/Resources/Library/VISTAS/vistas06_online-only/Watson.pdf

http://www.chan6es.com/uploads/5/0/4/8/5048463/101213newmanresistanceincbt.pdf

Recommended reading:


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Building trust with counseling clients

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