How to deal with the patient's resistance to treatment

A therapist sits in the limelight, listening to a man discussing his disappointments.Have you ever met those customers who are resistant to change? Do you have customers that do not comply with your recommendations and never complete the assignment? Or do you find that your work with one of your clients is delayed and stagnant?

Many clinical experts face resistance from customers. In general, a therapist will have one of two answers: (1) blame the client. or (2) blame myself. Nor is it suitable. Mistreatment never produces any positive effect – especially in the mental health profession. Instead, a clinician is recommended to address the following six reasons for the patient's resistance:

1) Therapist's inability to develop relationships with the client.

Many times a therapist will assume that customer resistance is 100% based on something within the client. In fact, the healer's inability to build a strong healing relationship with the client can contribute.

Building the relationship requires:

  • Keep eye contact properly.
  • Helping customers feel a sense of affinity with you. You can do this by trying to match the original behavior, mood and rhythm of the customer.
  • Keeping negative issues neutral – avoid making statements with negative undermines.
  • Using the customer's name.
  • Adjust the sound.
  • Leaving customers to meet you – that is, to be a real person.
  • It is affordable and dedicated.
  • Interested. Even if you feel bored, go to the customer and help him to feel, see and be important.

2) Therapist imposes their agenda on the client.

Treatment should be conducted by developing client goals based on collaboration between the client and the therapist. If a client is resilient or otherwise "non-compliant," then the issue needs to be discussed promptly and honestly. If a client does not perform certain tasks in the treatment, then these may not be important to the client and the therapist simply imposes his / her own agenda on the client.

3) The lack of flexibility of the therapist.

If a therapist lacks a customer-based approach, then the client will notice (if not consciously, then unconsciously) that his therapist is rigid or rigid. If a client has childhood problems from a parent who controls or has problems with the elements of power, then they can unconsciously resist what is considered as external control by the therapist.

4) They do not realize that non-compliance is part of the "pathology" that needs to be addressed.

If treatment goals have reached a therapist and client relationship and there is still a non-compliance, then resistance can be treated as part of what should be focused on the treatment. Resistance must be actively discussed with the customer, without judgment or surprise. Issues that contribute to customer resistance may include fears of failure or fear of termination of treatment. A question a therapist can use to deal with these types of fears is: "What would happen if you were successful?" or something else on these lines. Always explore issues of resistance with curiosity and encouragement.

5) Need to process fears and "shapes" or experiences from early life.

A therapist can explore customer fears and early life experiences using Socratic questioning. Identify the underlying beliefs of the client for life. For example, does the client have a strong need to manipulate others or have power over them? By revealing and revealing the underlying unadjusted shapes, together with the treatment of their protective agents, they should be addressed in the treatment plan.

6) Healers fear the jam.

The therapist must be willing to commit fully to his clients, even if he / she takes them out of their comfort zone. When a therapist tries to keep the relationship with his clients away from fears, such as the fear of counter-transfer problems, customers may feel this distancing. The effectiveness of the treatment can then be reduced. A therapist can benefit from taking emotional risks with his clients. Customer relationships are not so fragile that mistakes can not be overcome and overcome.

To address the concerns of therapists, a therapist needs a good support system, including people with whom they can discuss their fears. It is also good for a therapist to redefine his fears with anxiety reduction strategies, such as:

  • Causing unrealistic performance expectations set on themselves
  • Recalling that it is okay to make mistakes
  • Focusing on the client rather than on himself
  • Realizing that no error is deadly and that part of good treatment includes the concept of "rupture and repair". When disruptions occur in the healing relationship, the restoration of the relationship can be treated by itself.

It is always useful for therapists to realize that everyone has limitations – including therapists and clients. It is important for therapists to understand when they put unrealistic expectations on clients based on the therapist's experiences. Remember that customers have their own personal experiences that can or can not lead to some treatment results.

Plan of treatment

The best way to ensure effective treatment is for clinicians to formulate a well-designed model and treatment plan, including:

  • Specify the key problem (s) of the customer.
  • Consider the factor (s) that contributes to customer development on key issues.
  • Assess the customer / customer relationship in the treatment relationship:
    • What does the customer want from me or others?
    • What does the customer expect from me or others?
    • What is the client's experience with others?
    • What are the basic beliefs of the client?
    • What are the recurring issues in customer relationships?
  • Establish better treatment interventions for integration into treatment.
  • Treat the customer's self-reputation.
  • Evaluates and evaluates the effectiveness of existing strategies and adjusts as needed. Remind yourself that treatment is supposed to be a wet business rather than a stagnant one.

Final remarks

The best approach to addressing the patient's resistance or non-compliance is for the therapist to look in the mirror. If all treatment efforts apparently fail, then the therapist can go back, reconstruct and evaluate the problem (s) in the treatment protocol. In fact, if a therapist finds himself frustrated by the client's effort, he may be better served to "leave" expectations, as this is an indication that the therapist's personal agenda is not respected.

Indeed, most of the "work" is in the hands of the client between the sessions. The therapist is simply a "tool" in the "toolbars" and the time spent in the treatment is limited. Ultimately, the customer is the one responsible for his own recovery.

Bibliographical references:

  1. Lang, E. (2012). A better patient experience through better communication. Journal of Nursing Radiology, 31(4): 114-119.
  2. Shapiro, F. (2018). Epidemic treatment of eye movement and treatment of reprocessing, third edition: Basic principles, protocols and procedures. New York, New York: The Guilford Press.
  3. Smith, A. (N.d.) Creating (and maintaining) a relationship in the classroom. Retrieved from:
  4. Teybor, E., McClure, F. H. (2011). Interpersonal process in therapy: A totalitarian model. Belmont, CA: Resource Learning.

© Copyright 2018 All rights reserved. Publishing permission is granted by Sharie Stines, PsyD, a therapist at La Mirada, California

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