Client resistance to therapy can pose serious challenges for the mental health professional. One step, among many, that we can take involves examination of our own attitudes about resistance (for a full discussion on the topic of resistance, please see the Play Therapy Videos page). Reprinted below is a brief article which can help us redefine resistance in a way which increases our likelihood in handling it effectively.
Psychological research and common sense suggest that it’s important for people to feel in control of their lives. When control isn’t possible, predictability is a characteristic that helps people cope with and adapt to situations. When families encounter problems with their children and/or their relationships with each other, they often feel as though they have little or no control over their home lives. Furthermore, American culture emphasizes the value of independence and the ability to handle one’s own problems. Some families may perceive attendance at therapy as a very visible reminder that they are unable to handle their own problems as they “should,” and that there is something “wrong” with them. This creates an atmosphere where resistance is possible, and the negativity of this climate can be compounded by misrepresentations of therapy in the media and even by some therapists.
The purpose of therapy is to help families change. Although families may dislike the problems which have brought them to therapy, there are at least some elements of predictability to the problems (e.g., although Freddie may misbehave, which may seem out of the family’s control, at least his misbehavior is somewhat predictable for them). The changes suggested by a therapist sometimes seem like a leap into the unknown, which has no predictability at all for the family. If therapy helps Freddie change, he may no longer be as predictable, and if therapy focuses on parents’ changing, they may feel lost in foreign territory. (The predictable nature of the problem may be preferable to the positive, but unpredictable offerings of therapy.) Regardless of the situation, families often resist change in order to restore their home life to it former, more predictable state.
Considering these dynamics, resistance can be seen as a natural outgrowth of the change process. Expecting resistance as a natural part of the therapeutic process can help practitioners to handle it more effectively.
Therapists and change agents often become frustrated with the resistance they encounter, sometimes assuming that parents or family members are deliberately trying to sabotage therapeutic efforts. While this can be the case, it is rare. When therapists view resistance as something that needs to be eradicated, they may unintentionally set up antagonistic relationships that are inconsistent with the changes they are trying to facilitate. Instead, it can be helpful for therapists to alter their expectations: to think of resistance as a natural part of the change process and as an expression of parents’ or family members’ unmet needs. This view of resistive behavior is more likely to help therapists select helpful interventions.
Family members who seem reluctant to embrace therapeutic changes may be expressing their need for a greater sense of control or predictability, fears about losing control or independence or status, anxiety about adopting new roles or behaviors which are not yet clearly defined for them, doubts about their own ability to carry out changes, concern that the changes might result in a weaker rather than a stronger family, and other reactions. If therapists can determine and understand the needs that are being expressed through the resistance, they are in a better position to help families overcome their reluctance to make changes.
Frank discussion of family members’ concerns should be encouraged. It is important for therapists to listen without judging family members’ reactions in order to maintain open communication. Patience is also essential. A climate of understanding can set the stage for more collaborative working relationships with even quite challenging parents.