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As a chaplain and psychotherapist serving in a correctional setting I am challenged to provide a consistently supportive response to individual presentations involving concurrent mental health and addiction disorders, as well as complex trauma exacerbated by the effects of incarceration and its antecedents. Problem management represents the primary focus of my work as every client, without exception, is in a heightened state of disorientation or transitional crisis and has limited access to supportive resources to help themselves.
As a responder to those who are experiencing personal problems, I find that most are motivated to be collaborative and engage in the solution-seeking process. However, some clients do exhibit a lack of incentive or assume an antagonistic posture in the initial stages of the helping dialogue, which affects not only the helping process but also the development of a therapeutic relationship. I must admit that I tend to feel more engaged with (and subconsciously committed to)clients who exhibit positive interpersonal cooperation than those who don’t. In a correctional context, it is common to encounter disgruntled individuals who attract negative rather than supportive attention. Though I am careful not to withhold support from those who display reluctance or resistance behavior, it can be a challenge to invest therapeutic time and resources in them when so many eager and contemplative candidates are impatiently waiting in the queue.
A client who exhibits reluctance in the helping process may be wary or cautious for many reasons. Egan and Schroeder (2009) suggest several possibilities for consideration including: fear of intensity, lack of trust, fear of disorganization, shame, stigma, the cost of change, loss of hope and values conflict (pp. 225-227). Anyone of these can represent a valid explanation for a client who may not yet have the capacity to engage in a formal change process without some reservations. Until a client’s reluctance to engage fully in the helping process is understood, responders may be prone to incorrectly interpret such behaviour as disinterest, resistance, or some other form of uncooperativeness. I often encounter individuals who are reticent to disclose how personal struggles are affecting them. In the masculine culture of a male correctional environment, emotional expressions are generally withheld (except for anger and aggression). I often wonder, what manner of dysregulated emotional despondency lies beneath the defensive non-disclosure? Perhaps a therapist proverb is called for: Beware your preliminary impressions of a reluctant client, for it rarely reflects an accurate assessment based on presentation. It is prudent therefore when engaging with clients that exhibit reluctance behaviour that the behaviour not be viewed as a barrier to treatment, but rather an indicator that further assessment and exploration is needed to formulate a client-validated case conceptualization.
Resistance, as compared to reluctance, represents a more defensive posture that Egan and Schroeder (2009) describe as “the push-back from clients when they feel they are being coerced” (p. 224). A client may have misgivings (i.e., a passive reluctance) about engaging in a helping process (based on internal cues), or may respond uncooperatively (i.e., active resistance) to what is perceived as a threat originating from the helper or the intervention process. If expressed resistance is not responded to in a way that clarifies the motivation for the client’s presentation and affirms an understanding of the client’s position, the potential for intensified resistance behaviour or premature termination of the helping process increases. Mandated clients within a supervised support system, like a correctional setting, often exhibit behaviours indicative of resistance, such as avoidance, withdrawal, non-compliance, defiance, non-disclosure, or even hostility. Keeping in mind that resistance behaviour may actually represent defence mechanisms that “serve to maintain our self-esteem and keep our sense of self intact” (Egan & Schroeder, 2009, p. 231), the responder’s role must begin with an examination of his or her own expectations of therapy to determine whether they are reasonable and client-compatible or not. Helper responses to reluctance and resistance behaviour would be more productive by first recognizing these behaviours as existing within the helper,viewing them as normal, accepting and working with them, understanding low motivation factors, enhancing awareness of helper competence and interpersonal communication styles,having realistic expectations regarding client participation and outcomes, developing a client-empowering therapeutic relationship, exploring for incentives that reduce resistance, expanding helping resources (e.g., family) and when possible “employ the client as a helper” (Egan & Schroeder, 2009, pp. 234-5).
Applying these and other creative strategies may help address the challenges inherent in working with clients who seem to repel the very support they need to address prevailing life-limiting challenges.In the correctional setting, I am inundated with clients who are motivated to seek treatment and supportive resources; however, many others fervently resist what, to them, is an unwelcomed intrusion, for reasons that may actually be contextually and philosophically sound –a learned distrust of those who are responsible for maintaining their involuntary incarceration. Personally, I operate on the theory that unmotivated or actively resistant clients are intimately and intrapsychically engaged in managing their problematic issues (successfully or not) and are generally aware of supportive options if and when they are ready to access them. With this in mind, resistance is not futile (to the defensive client). It’s survival.
Egan, G. & Schroeder, W. (2009).The skilled helper: A problem-management and opportunity-development approach to helping. Toronto, Canada: Nelson Education Ltd.