Categories of Client Resistance Chamberlin, Patterson, Reid, - - PowerPoint PPT Presentation

Categories of Client Resistance

Chamberlin, Patterson, Reid, Kavanaugh, and Forgatch (1984)

• Arguing-client contests the accuracy, integrity, or

expertise of the therapist

• Interrupting- client breaks in and interrupts the

therapist in a defensive manner

• Denying-client is unwilling to recognize problems,

cooperate, accept responsibility, or take advice

• Ignoring-client doesn’t follow or ignores the

therapist

Arguing

• Challenging-client directly challenges the

accuracy of what the therapist has said

• Discounting- client questions the therapists

authority and expertise

• Hostility- client expresses direct hostility

toward the therapist

Interrupting

• Talking Over- client speaks while the

therapist is still talking

• Cutting Off- client breaks in with word to

cut the therapist off

Denying

• Blaming
• Disagreeing
• Excusing
• Claiming Impunity- client is not in danger
• Minimizing
• Pessimism
• Reluctance
• Unwillingness to change

Ignoring

• Inattention
• Non-answer
• No response
• Sidetracking

Traps

• Question and Answer
• Taking Sides
• Expert
• Labeling
• Premature Focus
• Blaming

Initial Approaches

• Open-ended Questions
• Reflective Listening
• Affirmation
• Summarization
• Eliciting Change Talk

Eliciting Change Talk

Evocative Questions

– Disadvantages of the status quo – Advantages of change – Optimism about change – Intention to change

Eliciting Change Talk

Exploring the Decisional Balance Elaborating Querying Extremes Looking Back Looking Forward Exploring Goals and Values

Approaches to Resistance

• Reflection

– Simple – Amplified-exaggerate what client has said – Double-Sided-adding the other side of the clients ambivalence

• Shift Focus
• Agreement with a twist
• Emphasize personal choice and control
• Reframing
• Paradox

Sign of Readiness for Change

• Decreased resistance
• Decreased questions about the problem
• Resolve
• Self-motivational statements
• Increased questions about change
• Envisioning
• Experimenting

Recapitulation

• Summarize the clients perception of the problem
• Summarize the clients ambivalence
• Summarize the objective data about the problem
• Restate any indications the client has made

regarding change

• Provide your assessment of the clients situation

Key Questions

• What do you think you will do?
• What does this mean about your drinking/drug use?
• What’s the next step?
• What do you think has to change?
• What could you do?
• What are your options?
• How would you like things to turn out?
• What concerns do you have about changing your

alcohol/drug use?

• What would be some of the positive things about

change?