Rolling Out the Rug

Rolling Out the Rug of Resistance

Abstract: To increase awareness of the concept and presence of resistance in client-counselor exchanges

Overview: An interactive discussion in which participants consider the nature of resistance, and what counselor responses are likely to increase or decrease it. It particularly highlights the counselor’s very active role in responding to and managing resistance.

Materials: Whiteboard or flip chart, handout with the chart below can be helpful for the participants. On the flipchart, list three columns, Increase, Expresses resistance, Decrease

Structure: Allow about 30 minutes, including taking inventory of participants' suggestions of resistance utterances.

Guidelines:
1. Depending on the mix of background within the participants in the group, it may be helpful to begin the exercise with a short presentation of the concept of resistance in MI and how this in some ways differs from how resistance is viewed in other fields such as psychotherapy, psychoanalysis, physics, economics or whatever area you feel comfortable in comparing.
2. Once the scene is set you can begin by requesting from the participants how "resistance" tends to be expressed. Most likely things like anger, disappointment, fear, shame and the likes will come up in the discussion. These aspects are noted in the center field of the chart below. Summarize, elicit more examples, until the list seems to be complete.
3. The next step is to ask the participants what in the client/counselor exchange could lead to increasing the level of resistance. These aspects are noted in the left field. Elicit, summarize, complete.
4. The next step is to ask the participants what in the client/counselor exchange could lead to decreasing the level of resistance. These aspects are noted in the right field. Elicit, summarize, complete.
5. The final step is asking the participants to recall and write down maybe two or three examples o f utterances from their clients that may be seen as expressing resistance. Depending on the size of the group, these utterances may perhaps be written on a flip chart. These sheet(s) of resistance utterances may be used in a number of ways in further exercises.

Thanks to: Stefan Sanner and Timothy Van Loo