20190614223333feedback_2 x
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2 posts
Re: Topic 7 DQ 1 (Obj. 7.1 and 7.2)
Sometimes a counselor will encounter a client that fails to act in their best interest and they will negatively respond to every counseling intervention presented to them and this client can be referred to as oppositional, reactionary, noncompliant, intractable and unmotivated (American Counseling Association, 2006). These types of clients are also defined as resistance which is defined as, by American Counseling Association (2006), “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” (pg. 2). Clients may be resistant for a number of reasons and one could be a protection mechanism. Most people are not used to sharing their deepest darkest secrets with another person. Some people keep secrets their whole life span and they never tell anyone what they are struggling with. It is important for the counselor to note the resistance and work on gaining the trust of the client. The counselor should remind the client that they are there for the client and to make the client the best person they can be. Without all, or a majority of the background and important experiences, the counselor may not be able to help the client on a greater level. Therapy is the client time, their time to share, express themselves, learn about themselves but also they can set boundaries. If the client does not want to share they should not be forced. It is their time and although the overall goal is to better the client, these things take time and the client has to go at their own pace. Red flags for resistance can include body language, short answers, lying and other things like missed appointments.
Even with a client dealing with substance abuse resistance can stem from the client not being ready to do something versus them not wanting to do something (SAMHSA, 2004). There can be a line when it comes to because when substance abuse is involved there is a lot of discipline when it comes to abstaining from a specific substance. So it could seem like clients with substance abuse issues have more resistance than clients with just general mental health issues. If there is a healthy relationship with the family member then the presence of the family member could be welcomes. However if the is a toxic family relationship then the client should work on their issues first before inviting another party into the overall treatment.
American Counseling Association. (2006). Addressing client resistance: Recognizing and processing In-session occurrences. Retrieved from
https://www.counseling.org/Resources/Library/VISTAS/vistas06_online-only/Watson
My response:
Good afternoon Shatera
3 posts
Re: Topic 7 DQ 1 (Obj. 7.1 and 7.2)
There has been substantial evidence to support that of the 18 million people who needed treatment for substance use in 2017, less than 1 million or 5.7% of these people actually believed that they needed treatment (AA, 2018). The biggest indicator to us that an individual is being resistant is simply a lack of engagement or participation within treatment. If a client is not consistent with meetings, that is a red flag that the individual is not willing to engage in treatment. It can be particularly challenging in substance abuse cases, because the client is likely experiencing withdrawal symptoms if they are working on kicking a substance within treatment. These symptoms can cause an array of physical discomfort which can lead to a lower level of willingness to change or engage in treatment. That being said, resistance can look different on different individuals. If a client is stuck in a contemplative or pre contemplative stage, it will be difficult for them to fully exert enough energy to engage in treatment. Instead of “dealing with resistance”, I find that it is more important to meet the client where they are at as opposed to having expectations around their “resistance”. The clinician can not work harder than the client because this will lead to an unbalanced dynamic. Ross Ellenhorn, a clinician that I very much respect pointed out many significant reasons as to why a client may be resistant to change. One idea that really struck me is the following theory, “Not changing is a legitimate and time-tested means for gaining immediate security.” There are countless reasons as to why a client may be resistant, but overall, it is imperative to understand why this might be the case instead of fighting against the problem.
Regarding the significant other, I feel as if we simply do not have enough information to make a clinical decision regarding the significant other’s involvement. Generally, it can be very important to include some kind of family work as an integrative, supplemental portion of treatment. Regarding the individual therapy, it is up to the client to decide the significant other’s level of involvement within their own treatment.
Reference
s:
Alcoholics Anonymous. (2018).
Estimated Worldwide A.A. Individual and Group Membership
.
Ellenhorn, R. (2015). Assertive Community Treatment: A “Living-Systems” Alternative to Hospital and Residential Care. Psychiatric Annals, 45(3), 120-125. doi:10.3928/00485713-20150304-06
My response:
Good afternoon Anna
1 posts
Re: Topic 7 DQ 1 (Obj. 7.1 and 7.2)
Every clinician is bound to have some resistant clients. Resistant clients could be those who are forced into therapy, are not in the mood, or simply do not care and do not want to put in the work. The above “excuses” can be frustrating for the clinician, especially when they know that the client has the potential of changing their life in a positive manner (Shallcross, 2010). Lynn Shallcross’s article in the publication from the American Counseling Association, Counseling Today, gives some insight into how a clinician can combat resistance and keep a check on themselves:
· “Stay out of the ’expert’ position…The more resistant the client, the less knowledge you should profess to know. The more motivated the client, the more knowledge you can express.”
· “Don’t buy into and encourage feelings of victimhood and powerlessness. Discussion of these perceptions are useful in the beginning of the counseling session, but the counselor needs to move beyond them and lead the client beyond them. Facilitating feelings of powerlessness only communicates to clients that they are powerless. Empathize, but don’t sympathize…Try to see the client’s point of view without communicating a sense of victimhood.”
· “When you encounter resistance, slow the pace,” Mitchell says. “Trying to go too fast is a perfect way to increase resistance. Only take baby steps with resistant clients.”
· “Don’t argue.”
· “Focus on details.”
· “Don’t blame the client, and don’t blame the people they think are creating their problems.”
· “Always treat the resistance with respect…The client has a reason for what they just said, (so) respect it.”
· “Do not waste time trying to create change through logic.”
· “Stay out of an excessive questioning mode of responding with resistant clients…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” (2010).
Depending on the relationship that the client has with their significant others, it could be beneficial for them to be included in a therapy session here and there. This could spark a determination for change to be better for their S/O and give the S/O a deeper glance into what the client is needing and feeling. It could also go the complete opposite way and cause more resistance so, the clinician needs to be careful in that decision and also make sure that the client feels safe with having their S/O in a therapy session with them.
Reference
Shallcross, L. (2010). Managing resistant clients – Counseling Today. Retrieved from:
https://ct.counseling.org/2010/02/managing-resistant-clients
MY response:
Good afternoon Kristen
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