Motivational Interviewing Chapter 5 – Change and Resistance – Opposite Sides of the Same Coin.

Motivational Interviewing

Chapter 5 –

Change and Resistance – Opposite Sides of the Same Coin

Chapter 5 – Change and Resistance – Opposite Sides of the Same Coin

Resistance is a result of two people interacting with each other


Traditionally, resistance is used to describe the behavior of only one person, (the client) however it is a two-way street


Although transference has its countertransference in psychoanalysis, there is no corresponding concept of counterresistance to describe the counselor's role in evoking and maintaining this interaction.


Client resistance behavior is, at most, a signal of dissonance in the relationship

Dissonance: lack of agreement or consistency

What Causes Dissonance?

Dissonance also means: a discordant combination of sounds

Maybe you can think of two people being “out of harmony” with each other


There are many other possible sources of dissonant communication, besides the two parties having different goals.


1. Some arise from a mismatch of counselor strategy to client readiness level. If a person is ambivalent about a particular change, for example, and the counselor has jumped ahead to talk about how the person can take action to accomplish the change, there is dissonance.


2. If either the client or the counselor brings into the room a high level of anger or frustration, there can be dissonance at the outset


3. If the counselor, instead of listening, responds in the ways characterized in Chapter 6 as roadblocks, there is likely to be dissonance


4. A misunderstanding of the other's intent can yield dissonance


5. Lack of agreement about roles in the relationship (adolescent/parent)

Change Talk and Resistance

Client resistance behavior can be increased or decreased depending on how the counselor responds to it


Change talk reflects movement of the person toward change, while resistance represents and predicts movement away from change


Motivational Interviewing tends to evoke high levels of change talk and relatively low levels of resistance.

In contrast, confrontational counseling tends to evoke high levels of resistance and relatively low levels of change talk.

Resistance Behavior

• Box 5.1 Four Process Categories of Client Resistance Behavior

• 1. Arguing

• 2. Interrupting

• 3. Negating

• 4. Ignoring

Advocacy

Counselor responses that tend to elicit and reinforce resistant behavior

Counselor Advocacy Responses

• Box 5.3 Six Types of Counselor Advocacy Responses

• 1. Arguing for change• 2. Assuming the expert role• 3. Criticizing, shaming or blaming• 4. Labeling• 5. Being in a hurry• 6. Claiming preeminence - the counselor's goals

and perspectives override those of the client

Motivational Interviewing Chapter 5 – Change and Resistance – Opposite Sides of the Same Coin.

Documents

Transcript of Motivational Interviewing Chapter 5 – Change and Resistance – Opposite Sides of the Same Coin.