[Table], Figure 3-2: Four Types of Client Resistance - Enhancing Motivation for Change in Substance Abuse Treatment

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Center for Substance Abuse Treatment. Enhancing Motivation for Change in Substance Abuse Treatment. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1999. (Treatment Improvement Protocol (TIP) Series, No. 35.)

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Enhancing Motivation for Change in Substance Abuse Treatment.

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Figure 3-2: Four Types of Client Resistance

Figure 3-2 Four Types of Client Resistance
*Arguing* The client contests the accuracy, expertise, or integrity of the clinician. Challenging. The client directly challenges the accuracy of what the clinician has said. Discounting. The client questions the clinician's personal authority and expertise. Hostility. The client expresses direct hostility toward the clinician.
*Interrupting* The client breaks in and interrupts the clinician in a defensive manner. Talking over. The client speaks while the clinician is still talking, without waiting for an appropriate pause or silence. Cutting off. The client breaks in with words obviously intended to cut the clinician off (e.g., "Now wait a minute. I've heard about enough").
*Denying* The client expresses unwillingness to recognize problems, cooperate, accept responsibility, or take advice. Blaming. The client blames other people for problems. Disagreeing. The client disagrees with a suggestion that the clinician has made, offering no constructive alternative. This includes the familiar "Yes, but...," which explains what is wrong with suggestions that are made. Excusing. The client makes excuses for his behavior. Claiming impunity. The client claims that she is not in any danger (e.g., from drinking). Minimizing. The client suggests that the clinician is exaggerating risks or dangers and that it really isn't so bad. Pessimism. The client makes statements about himself or others that are pessimistic, defeatist, or negative in tone. Reluctance. The client expresses reservations and reluctance about information or advice given. Unwillingness to change. The client expresses a lack of desire or an unwillingness to change.
*Ignoring* The client shows evidence of ignoring or not following the clinician. Inattention. The client's response indicates that she has not been paying attention to the clinician. Nonanswer. In answering a clinician's query, the client gives a response that is not an answer to the question. No response. The client gives no audible verbal or clear nonverbal reply to the clinician's query. Sidetracking. The client changes the direction of the conversation that the clinician has been pursuing.
Source: Miller and Rollnick, 1991. Adapted from a behavior coding system by Chamberlain et al., 1984. Reprinted with permission.

From: Chapter 3—Motivational Interviewing as a Counseling Style

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Center for Substance Abuse Treatment. Enhancing Motivation for Change in Substance Abuse Treatment. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1999. (Treatment Improvement Protocol (TIP) Series, No. 35.) [Table], Figure 3-2: Four Types of Client Resistance.
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