Contribution from Sally Wilden based on Egan (1994, 1998)

Defining reluctance and resistance

Reluctant clients those who really don't want to be there. There can be a number of reasons for this. For example, they:

• fear the unfamiliar
• are apprehensive about what is involved in any change they might make
• are unsure of the demands of undertaking a new experience
• discover the price of change is higher than expected
• fear their own weakness might be revealed if they make a change
• have difficulties making decisions and have changing priorities, aims and goals
• have difficulty in persisting with a courses of action

Resistant clients

Themes may emerge that indicate repeated patterns in the ways they deal with and interact with individuals and systems. There are a number of factors that can contribute to this. For example, they:

• may talk about only safe or low-priority issues
• benignly sabotage the helping process by being uncooperative and/or setting unrealistic goals (then using them as an excuse for not achieving them)
• tend to blame others or their social settings
• play games with helpers
• do not know how to participate in constructive change
• have a history of rebelling against systems
• have had bad experiences of interviews before
• are dealing with many problems all at once and feel overwhelmed
• have had lots of negative experiences and have given up
• have been told to attend by an authority figure (teacher, parent, agency);
• are suspicious of authority figures & have negative attitudes towards helping agencies
• believe going for help is the same as admitting weakness, failure, inadequacy
• have no plans at the moment and can't see the point of it all

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Implications for practice

When working with reluctant clients, it is sometimes difficult to establish an effective relationship.

When working with resistant clients, it is sometimes difficult 'to find ways forward' in the interview.

With reluctant and resistant clients, it is helpful to acknowledge how clients are feeling and responding. For example:

“It seems you've tried lots of things before, and they haven't worked, and now you can't see the point of going through all of that again.”
“You've been told to come here, and you don't know what it's for, and that's made you a bit annoyed”

“You've got a lot on your plate at the moment, and it feels as if this is the last thing you need right now”

Unhelpful responses to reluctance and resistance

“Helpers, especially beginning helpers, who are unaware of the pervasiveness of resistance are disconcerted by it and face unexpected feelings and emotions in themselves when they encounter it. For instance, they feel confused, panicky, irritated, hostile, guilty, hurt, rejected, meek or depressed” (Egan, 1994)

It is easy for clients' behaviours to trigger responses in the interviewer which may not help the client and situation and can make matters worse. For example (Egan, 1994):

• You become impatient or hostile. You might be tempted make comments like: “You haven't got all day to waste like this.”
• You do nothing and hope the resistance will disappear.
• You lower your expectations of yourself and the client. For example, you assume early on that the client is not capable of achieving very much.
• You hope to win the client over by pacifying them.
• You blame the client and end up in a power struggle. For example: “If you had come to the interview last time, then this mess wouldn't have happened.”
• You allow the client to make you the scapegoat.
• You let client take total control of the exchange between you.
• You terminate the session at the first hint of difficulty.

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Ways of increasing client commitment

The overall aim is to develop a supportive relationship based on trust which helps clients move towards more productive action.

Reluctant clients

Ways of dealing with the impact on the relationship in the interview:

• be aware of the effects of client's behaviour on you and how it triggers unhelpful responses. Consciously move into a more productive way of responding
• acknowledge what is happening between client and yourself. For example, “We don't seem to have got very far. Perhaps we can think of better ways of tackling this and how we could work together'
• develop a more open discussion between you. For example, ask client what would be useful to discuss. Ask them what might be getting in the way of working together
• build in feedback/review opportunities to discuss how you are working together (as well as what is being achieved)
• signpost to client why you are asking about a particular topic/issue. Explain it's importance and why it could be helpful to discuss this area. Don't bombard them with question after question without giving a reason

Involuntary clients

State or ask who referred the client.
• Explain, in positive terms, why referral was made.
• Explain to the client the range of help you can offer. Describe this in positive but realistic terms. Keep this brief and focused on the particular needs of the client.
• Listen to the client's response and pick up on feelings expressed. Acknowledge these in your response.
• Explain (if possible) that the client is free to leave or stay. But state this positively (i.e. it's always possible to come back).
• If you feel that you and the client cannot form a productive working relationship, suggest alternatives. For example, someone else might help this client rather than you. You should not see this as a failure, but as a way of achieving a step forward for the client.

Resistant clients

Positive responses increase their ability to take action and move on. Negative responses can lead to a loss of confidence, inability to set goals and priorities.
Individuals interact with other individuals and systems. This is a two way process in the sense that clients are both active agents and recipients of actions from other individuals and systems. Interactions with individuals and systems can be positive and/or negative.

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A problem-solving approach

Identifying the problem

• What is stopping the client achieving what she/he want and where she/he want to be? If there are a number of factors, discuss with clients how they see the most important one(s) of these.
• How do the blocks relate to the way clients interact with others and with systems? How is this revealed in their thoughts, feelings behaviours? What patterns emerge from this? Share views with client. Be prepared to change/adjust your interpretation in your discussion.
• What change(s) do clients want to achieve? This needs to be described in clear very specific terms. Is there a clear relationship between this and the identification of the problem? Clarify if there is any uncertainty.
• What are the implications for change? What effect will any changes have on others or other systems? For example, if a client is to change a daily routine, he/she will need to think how others' response(s) might help or hinder achievement of this.

Ways of achieving goals

There are always alternative ways of solving problems. One is using a problem-solving approach in the interview. This could mean turning problems into goals so clients achieve changes in their lives, or rewarding constructive behaviour. For example:

• Helper offers: Praise, encouragement, reinforcement for any areas where client shows development and achievement. Encourage client even if all action has not been implemented.
• Client: Encouraged to give reward(s) to him/herself.
• External rewards:Giving treats when goal has been achieved.
• Internal rewards: Positive self-talk , acknowledge achievement, self praise, self reinforcement. For example, if a client keeps to a timetable, or succeeds in writing a letter, he/she can reinforce this achievement by giving a reward.
• Evaluating alternatives: Helping clients see there maybe other ways of dealing with a situation, and generating alternative approaches. This is particularly important with clients who maintain they have no choice. Brainstorming other possibilities helps client see alternative perspectives.
• Selecting easy goals: Try to identify something which is easily managed and more likely to be within clientsí reach. Goals, which have a more immediate pay-off, are likely to encourage clients to preserver.
  
• Develop client self-monitoring skills: Becoming more aware of their behaviour helps clients achieve greater independancy and sense of responsibility. For example complete a diary of daily tasks achieved. Record how many times they put off doing something.
• Rehearsing in preparation for an event: Going through anticipated responses and planning how client would react in these situations. Particularly helpful when client is fearful of new situations or would like to implement change to their actions but are not confident of how this will work. For example, rehearse how to make a telephone call to someone they don't know.
• Confrontation/challenging: Helper must take care not to blame or tell-off client but to confront them with the effects of their actions. This helps client understand consequences of actions.
• Redefining the situation/problem: Helpful for clients who only see blocks to change. Define problem in terms of how client thinks about a particular situation and how they act in a particular situation. Identify that the way we define a situation could be changed. For example, difficult, challenging situations could be seen more positively as offering a chance to overcome a difficulty and gain a sense of achievement.

References

• Egan, G. (1994) The Skilled Helper: a problem-management approach to helping, (5th Ed) Belmont, California: Brooks Cole.
• Egan, G. (1997) The Skilled Helper: a problem-management approach to helping, (6th Ed) Belmont, California: Brooks Cole.
• Ford, M.E. (1992) Motivating humans: goals, emotions and personal agency beliefs, Newbury Park, CA: Sage.
• Munro, A., Manthei, R. & Small, J. (1988) Counseling: the skills problem solving, London: Routledge.
• Okun, B.F. (1997) Effective Helping: interviewing and counseling techniques, (5th Ed) Brooks Cole.

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