Resistance during therapy refers to the client ‘s attitude toward the therapist or therapy. Also the behavior or cognitions that can delay or avoid a therapeutic change. It is usually present during the early stages of evaluation as the client may question the treatment.
In addition, clients may refuse to speak honestly or answer the therapist’s questions. Sometimes they can agree to answer them but choose to share very little information. They may also contradict the therapist or disbelieve in therapy, especially if the therapist is younger.
Often resistance during therapy stems from inadequate interventions during the motivation phase, which is an important part of the therapeutic process.
Many therapists choose to place all responsibility on the client, with reference to passivity and stubbornness. This, as you can see, is very detrimental to the whole process.
Resistance is a matter for the therapist
Therapists can undoubtedly stop the therapeutic process if they think it is no longer profitable for the client. However, it is wrong to view clients’ resistance as the reason why they cannot be treated or to assume that they do not want to get well.
We can see this problem in the motivational therapy approach. For example, the motivational interview is based on adapting the therapeutic style to the different stages of change that the client is undergoing. Thus one can see that the client’s resistance is the therapist’s problem. Not the client’s.
Therefore, the therapist should not immediately be convinced that the client does not want to undergo any treatment and/or improvement. Instead, it is better to think about why the client has built those barriers. Perhaps the type of therapy is not appropriate.
To prevent this from continuing, it would be best to address the issue in the next session. Sincerity is very relevant in building a good therapeutic relationship and finding solutions to the resistance that may arise along the way.
A possible cause of resistance during therapy is the age of the therapist
Resistance during therapy is more common than you think. A common case of resistance is that the client questions the therapist’s professionalism if he does not have gray hair, a face full of wrinkles, or is not wearing a suit.
What may start as a simple comment at the beginning of treatment can become resistance later on. Then the client begins to doubt his or her psychologist.
They may think that their therapist does not have the right resources or information to help them. Another common problem is that the client thinks the therapist is far too young to understand his problem.
In addition, it is important to note that age difference between therapist and client is usually a problem in the beginning (on the client’s part). This is because older clients are likely to believe that a young therapist will not be able to relate to their problems.
However, it is important to address the problem right away. Using the right strategies can turn the expectations of a seemingly pointless treatment into an opportunity to strengthen the therapeutic relationship.
Labrador has proposed important strategies in his textbook Difficult Situations in Therapy (2011). For example, solving the client’s problems, asking about his resistance and the skills he thinks he does not have. He also advises clients to focus on the positive side of having a young therapist.
Breaking Resistance During Therapy
During the evaluation and the intervention itself, there is a good chance that the client will not do his homework. Even the most basic things, such as performing self-reports, are very important because they are necessary for the functional analysis and the preparation of a treatment plan.
That is why it is very important that the client brings his homework every week. Some strategies to achieve this are:
- Do not assume that your client has fully understood your explanation of how to create a self-report. Perhaps you were not clear or your language was not well suited to the needs of the individual. Therefore, do not hesitate to explain again what the task consists of.
- Emphasize the value of the task. Insist that while self-reports are helpful to you as a therapist, they are also valuable to the client. In addition, it is important that you indicate that not doing the homework conflicts with what the client wants to achieve.
- Be sure to request self-reporting in an appropriate manner. Try not to say, “You should do a self-report and take it with you to the next session.” Instead, it would be much more helpful to motivate them and emphasize that it is beneficial for both of you.
- Ensure that the material used to create the self-reports is appropriate. The educational and socio-cultural level of the clients can be very different. It’s common to think that a pencil and paper are tools that everyone knows how to use. However, that is not always the case.
- Allow outside help. For example, if the client forgets to fill in their own details, send them a reminder message. There are also things they can do during the therapy session. Help them set a series of reminders on their phone so they won’t forget.
Some people are unable to carry a piece of paper with them everywhere. Others may not be fond of writing, which could cause them concern and therefore not do it.
On the other hand, others can be so forgetful that they don’t even remember to write anything down during the day. When they start writing in the evening, they have forgotten everything from the morning.
That is why it is important that you have an open mind and remain flexible. Give them the opportunity to make the self-reports in a different way. We all know that technological progress has been on the rise for a while now.
So don’t be afraid to encourage your clients to write them down on their smartphones. They can be very helpful in moving therapy from incomplete self-reports to excellent assessment sessions.