Engaging Resistant Clients

When I started my career as a therapist in 1986, I actually believed all of my clients would want to work with me, would make the most of that time, and would be appreciative of my efforts. You can stop laughing now. I quickly was brought back to earth by teenagers who were dragged in kicking and screaming by their parents, people who were required by the courts to attend counselling but were just going through the motions, and husbands who had their wife's hand attached to their earlobe. So how do you engage with someone who has their arms crossed, doesn't want to be there, and is reluctant to talk? Here is my advice for those who work with non-voluntary clients.

1. Make them as comfortable as possible. You can try to put them at ease by introducing yourself, being personable, reassuring them of confidentiality, and explaining, in an appealing way, how your role works. You could say that your job was simply helping people to get what they want. I don't suggest you say to resistant clients, "I help people with problems" as they will feel, quite rightly, labeled. If people are reluctant to talk about the matter at hand, they may be more open to first speaking about their interests and passions - a type of a 'get to know you before I talk to you' approach.
2. Acknowledge their perspective. It also helps if you acknowledge how they are seeing things and how strongly they are feeling about this. For those who are not talkative, you may have to guess how they are feeling. Perhaps they don't see the need to be there or are mad as hell at being compelled to attend. Acknowledgement for how they are feeling will help to ease strong negative emotions. At the very least, they will at least appreciate that you understand how they are seeing things. You can also reduce resistance by overstating their position, "You feel that the other person is being totally unreasonable, are 100% to blame for the difficulties, and there is absolutely nothing you can do". When people's position is overstated, there is often a temptation to correct you with a more moderate position. You could also reframe someone's resistance in a positive light, "You don't want to be told by anyone what to do. You have your own ideas on what will help". A double-sided reflection can also help. Eg. "On the one hand, you think your parents are being very unfair and you are not the problem. But on the other hand, you can't go on putting up with things as they presently are". Although they have not actually said the more positive part, you are at least helping them to consider if they do indeed feel that way. Most people are reluctant to correct a position that helps to paint them as reasonable.
3. Find out what they want. Everyone wants something. It might be to get their parents off their back, for example. But the challenge is you also have other parties whose wants you also need to consider. Parents, for example, might want their child's behaviour to improve. Here the strategies required to achieve the parents' goal are likely to be the same as the teenager's. Oh, if people were only this easy. Sometimes clients choose unworthy goals (to kill themselves, for example) or unachievable (for others to leave them alone). Your job is to negotiate goals that are worthy and achievable - to be less stressed or to influence change in others, for example. Other times, people simply say what they think you want to hear. They might say they want to address their problem drinking even when they really do not see their drinking as a problem at all. Here we need to double-check with people that they are really meaning what they are saying. Finding out what people want is further complicated by the fact that some people have a hidden agenda. I often used to work with parents who presented concerned about how their child was going with their mother and father's separation. Invariably, many of these parents also wanted a report supportive of their court actions around the child's living arrangements. Here you may need to guess what the client is possibly also wanting and to check this with them and to clarify what you can or cannot do. Where clients have a number of wants, your task is to clarify which of these wants need to be worked on first.
4. Use what they find motivating. Most human beings are motivated by either pleasure or pain, sometimes both. It could be the benefits associated with the change that needs to occur. Or it could be change to avoid a negative consequence that they deeply care about. It should not be this way, but some people are only motivated to consider or explore change when the status quo becomes very uncomfortable for them. Men going through relationship difficulties, for example, are often reluctant to attend counselling. I have found, however, that when their partner is commencing separation, that many will move heaven and earth to do what it takes. We can find out what is motivating for an individual by asking why or what questions. "Why do they need to change?" or "What makes them think they need to work hard on this?" Although we might already have an idea as to what the reasons are, people tend to become more motivated by that which they voice themselves. Whenever we hear such 'change language' we need to literally turn the volume up, asking questions to elicit more talk that is supportive of change. Others, through their resistant behaviour, are saying they are motivated by power and control. We can harness this need by giving clients control. For example, "You're in control of your life. I can't make you do anything. What are your ideas for helping the situation?" Alternatively, you could take up the anti-change side of the argument which will often provoke them to argue for all the reasons they should change.

There is a certain order to the above which needs to be considered although not stuck to strictly. It is no good trying to find out what a client is wanting if they do not feel comfortable at all in talking with you. Most people can be made to feel comfortable, though there is always a possibility that you are just the wrong person to work with a particular client. Resistance is also strongly influenced by your approach. So, if resistance continues, this is a signal that you need to stop what you are doing and change your approach. Changing the environment is also an option - seeing couples separately or involving others in your meeting. I have found some teenagers who were initially reluctant to talk became more open as we walked and talked in a park with their parents nearby. If you want to work more effectively with difficult clients, then check out my On-line Course: Effectiveness Training for Helping Professionals.