Motivational Interviewing

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

2. Chapter 5 – Change and Resistance – Opposite Sides of the Same Coin Resistance is a result of two people interacting with each other

3. Chapter 5 – Change and Resistance – Opposite Sides of the Same Coin Traditionally, resistance is used to describe the behavior of only one person, (the client) however it is a two-way street

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

5. Chapter 5 – Change and Resistance – Opposite Sides of the Same Coin Client resistance behavior is, at most, a signal of dissonance in the relationship Dissonance: lack of agreement or consistency

6. 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

7. What Causes Dissonance? There are many other possible sources of dissonant communication, besides the two parties having different goals. 

8. What Causes Dissonance? 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.

9. What Causes 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

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

11. What Causes Dissonance? 4. A misunderstanding of the other's intent can yield dissonance

12. What Causes Dissonance? 5. Lack of agreement about roles in the relationship (adolescent/parent)

13. Change Talk and Resistance Client resistance behavior can be increased or decreased depending on how the counselor responds to it

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

15. Change Talk and Resistance 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.

16. Resistance Behavior • Box 5.1 Four Process Categories of Client Resistance Behavior • 1. Arguing • 2. Interrupting • 3. Negating • 4. Ignoring

17. Advocacy Counselor responses that tend to elicit and reinforce resistant behavior

18. 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