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Therapy challenges when working with a resistant client

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Give two challenges that a therapist can encounter working with a client who appears to be resistant. Explain how the therapists strengths and challenges could influence a client's resistant behavior. How should the therapist address such behavior with an adult, an adolescent, and a child? What insight into a client's issues can a therapist can gain by understanding resistance from the client's point of view?

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Solution Summary

Therapists' behaviors and the impact on clients' resistance are uncovered in this response. References are also provided to further validate the findings.

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1. Give two challenges that a therapist can encounter working with a client who appears to be resistant. Explain how the therapist's strengths and challenges could influence a client's resistant behavior.

It may be that the client's resistance is evidenced through be argumentative as if the therapist is out to get them, always coming late or not showing up for appointments or the client might not open up and share essential information ("I want to leave what happened in the past, in the past"). Some clients just sit there and will not talk except to answer questions with "yes" or "no" or "I don't know" answers. To open ended questions, the client may just refuse to talk about it or turn it back to the therapist and ask them what they think they did or would do in that situation. Others turn aggressive and get angry or try to intimidate the therapist. The greater the resistance, the more likely it is that the client will refuse to consider any of a host of possible solutions (Mitchell, n.d.).

Some clients resist treatment though holding onto old views of self or the side of personality that is less threatening to them, while refusing to go deeper to the side of their personality that is causing the problems in their life. For example, a client may admit the depths of his feelings of fragility, fear, and loneliness. However, if the client gets stuck in this perceptive of himself as a hurt, lost soul , this becomes a form of resistance to go deeper to acknowledge and express the angry, bitter, vengeful, and even sadistic aspects of his personality that are actually at the root of his present problems that landed him in therapy: "As long as he is stuck in the perception of himself as a hurt, lost soul, his subtle acts of hostility that are endangering his career and his relationship with his girlfriend remain unattended to." (www.aboutpsychotherapy.com/Twhatshouldhappen.htm)

Therapists' behaviors can impact client resistance. For example, the therapist's approach may in some way put the client on edge, on guard, and consequently, will not open up. Perhaps the therapist did not take enough time to build rapport initially and jumped into therapy without the relationship building phase necessary for the client to build trust and feel safe to open up. Some therapists do not confront clients when they need to (i.e. need to be liked) and the resistance continues.

In fact, one primary error of the therapist that may lead to resistance is the failure to establish a mutually agreed-upon objective. When the therapist and the client is not in agreement about a desired outcome, resistance and problems occur. To be sure, the therapist and the client should be able to clearly state the mutually agreed-upon objective. If a mutually agreed-upon objective has not been established and reasonable time has been devoted to establishing rapport and understanding the client's situation, then it is critical to focus session time on ...

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