What is client resistance?
According to Watson (2006,) client resistance can be defined as: “a process of avoiding or diminishing the self-disclosing communication requested by the interviewer because of its capacity to make the interviewee uncomfortable or anxious.” It is believed that resistance is a “self-protective and adaptive process that functioned to preserve core attitudes about the self, others, and life” (Watson, 2006).
Behaviors commonly displayed would be labeled as defiant, avoidant, reactionary, unmotivated, and oppositional. Clients may cancel appointments and during sessions act as if “everything is fine.” Sometimes client resistance takes a “sweet” form, such as when a client is overly complimentary to the therapist or brings him/her gifts. This can be the client’s attempt at pleasing a therapist.
Resistance has also recently been termed a pejorative and is frowned upon in note taking. Resistance is normal, and even the most motivated clients will experience resistance. The concept, pejorative or not, is to be expected during therapy. It is hard to believe, but the reality of therapy is that people often work against the actual changes they profess to want to make.
Reasons for resistance:
- Client shame. The client may have been raised to believe that he/she is internally flawed, and has a fear of looking at himself honestly.
- Therapist agenda does not match client’s. The therapist may want to impose his/her goals for therapy into the process rather than honor the client’s goals.
- The resistant behavior benefits the client. The benefits of preserving the dysfunctional beliefs or behaviors dwarf the benefits of overcoming them.
- Most people hate change. Clients in therapy are no different in this regard. Resistance can help keep the status quo.
- The resistance has been a person’s “survival skill.” The particular “technique” used could be the person’s internalized “survival skill,” which could be considered mal-adaptive in therapy.
What can therapist do when faced with resistance?
In general, resistance is viewed as a negative. The first approach towards working with what is perceived as resistance would be to reframe the belief of its negativity to one of “it’s just part of the process of growth.”
After this reframing, it would be helpful, for you, as the therapist, to self-reflect. Perhaps something in the relationship is not working for the client and what is being perceived as resistance is just evidence that that client does not feel safe with you yet.
According to Teyber and McClure (2011) there is a two-step process to working with resistance:
- Support the client where he’s at. Don’t argue with the client about his sense of “stuckness,” rather, provide validation to his feelings and beliefs.
- Respond flexibly. Try to do what you can to help resolve the client’s “problems.”
It is important to follow this two-step process because it helps prevent clients from feeling misunderstood or blamed. You never want to say, “I see you are resisting treatment,” or “I see you are throwing roadblocks in the way of treatment.” These types of statements will cause the client to feel judged and scrutinized.
Rather that pointing out problems, focus on building rapport. The most important aspect of therapy is the relationship between the therapist and the client. Building rapport leads to trust. Here are some strategies for building rapport:
- Don’t rush. Take your time. Relax. Show your client the time you spend together is important.
- Call your client by his/her name. This shows you care about your client as an individual.
- Set the tone for each session. Be inviting, warm, encouraging, personable, and interested in the client.
- Be a safe person. Don’t act superior or judgmental. Judgment precludes connection. Be approachable. Be real.
- Check in with your client and ask how he/she is doing. Ask for feedback.
- Demonstrate concern for your client. Look him/her in the eyes. Pay attention when he/she is speaking. Use active listening.
- Be yourself. If you are inauthentic, client’s will see right through that and will sense your need to “put on a mask.” If your client sees you with a mask, he/she will not be able to connect to you in a helpful manner.
- Create a safe space. In other words, make sure your environment feels comforting, relaxing, and inviting. Be calm and patient. Don’t act as if something needs to happen at all during the session.
- Ask open ended questions. Try to ask questions that are broad and general and do not give the client an opportunity to reply with simply a “yes” or “no” answer. This will help draw your client out and help your relationship grow closer.
What not to do:
No matter what you are experiencing with your client, there are some definite “no nos.” These are behaviors on your part that should be avoided:
- Exhibit hostility.
- Avoid eye contact.
- Utilize passive aggressive behaviors.
- Act with contempt toward client.
- Be judgmental.
- Be defensive.
Regardless of the source of or reason for the client “resistance” there are some key concepts to remember as a therapist.
First and foremost realize that counselors are not God. Your job is not to change anyone; all you are is one person in a client’s life, whose job is to help clients reach their goals (not the counselor’s.) If a client is resistant to making changes, you cannot force him/her to. I’m sure you’ve heard this line before: Do not work harder than your client.
Use evidences of resistance as information about your client. Rather than seeing it as a negative, see it as a source of information regarding areas in your client’s life that need exploring. If a client is avoiding something through resistance, then oftentimes that means he/she is afraid of “going there.” Respect this message and help the client heal from whatever the underlying reasons are.
Ask your client some questions to help explore his/her barriers to success. What are you feeling right now? Where do you feel this in your body? I notice some tension, are you okay with discussing what that means?
My personal approach to resistance is to look at it as a client’s sub-self or separate persona whose job is to protect the client. I ask myself, what is this person trying to protect? What happened that made this persona present him/herself just now? What is the purpose of this sub-self? I point this out to the client as well and ask him/her to honor the parts of self that are resistant because they have an important job to protect their inner child from vulnerability and future pain.
Always remember and never forget to not have power struggles with your clients and avoid personalizing their negative behaviors. Keep good internal boundaries and don’t bring your own issues into the room when facing challenges with clients.
Bradley University (n.d.) How to Understand Client Resistance. Retrieved from: https://onlinedegrees.bradley.edu/blog/how-to-understand-resistant-clients/
Lang, E. (2012). A Better Patient Experience Through Better Communication. HHS Public Access Author Manuscript. J Radiol Nurs. 2012 Dec 1; 31(4): 114–119.
Smith, A. (n.d.) Building (and Maintaining) Rapport In the Classroom. Retrieved from: https://www.depts.ttu.edu/tlpdc/Resources/Teaching_resources/TLPDC_teaching_resources/Documents/Building_Rapport_new.pdf
Teybor, E., McClure, F. H. (2011). Interpersonal Process in Therapy: An Integrative Model. Belmont, CA: Cengage Learning.