What Strategies Help Patients Who Resist Treatment?

What Strategies Help Patients Who Resist Treatment?

In the complex terrain of mental health, resistance to treatment can be a significant hurdle. We've gathered insights from psychologists and therapists, who share five strategies ranging from reframing resistance as a protective measure to employing the 4 Rs approach. Their collective wisdom is distilled here to guide professionals in enhancing patient engagement and therapeutic outcomes.

• Reframe Resistance as Protective
• Build a Strong Therapeutic Alliance
• Offer the Right Treatment Modality
• Create a Nonjudgmental Treatment Pace
• Employ the 4 Rs Approach

Reframe Resistance as Protective

I find it helpful to reframe how we think about 'resistance.' Instead of seeing it as a barrier, a problem, or something that the client is doing wrong, I see resistance as more of a protective posture. I help my clients see that ambivalence about change is a normal part of the process, and it is natural to have parts of oneself that are protective of old response patterns because they needed those responses at one time in order to cope. I remind my clients that if a protective response is there, it must be there for a very good reason.

Build a Strong Therapeutic Alliance

One effective strategy for helping patients resistant to treatment involves building a strong therapeutic alliance. This begins with establishing trust and rapport, understanding the patient's concerns, and collaborating on achievable treatment goals. Flexibility in the therapeutic approach and psychoeducation about their condition can help alleviate resistance. It is also essential to explore ambivalence and address practical barriers while empowering the patient to recognize their strengths. By pacing therapy appropriately and celebrating progress, therapists can gradually overcome resistance and foster meaningful change in their patients. — Kim Feeney, LISW, RPT-S

Offer the Right Treatment Modality

I don't believe anyone is 'treatment-resistant'; I believe we haven't offered them the right modality. We need to acknowledge the limitations of the traditional mental health systems and the paradigm in which we operate. Our clients deserve better, and so do we.

Create a Nonjudgmental Treatment Pace

A strategy that I utilize the most to assist clients who may be hesitant about treatment is creating a nonjudgmental atmosphere and allowing them to initially set the pace of treatment. It is crucial to go at the client's pace, and it might take time for them to build trust and feel secure enough to share deeper thoughts and feelings. A client’s level of trust and safety directly impacts many clients' ability to begin to share more vulnerable feelings. Respecting their needs and honoring their process is crucial in gaining a strong level of trust. After trust and safety have been established, a therapist can begin to challenge the client to understand deeper feelings and/or tackle behaviors that are negatively impacting themselves or their relationships. Through building a relationship with clients in this way, most become less resistant to treatment.

Employ the 4 Rs Approach

Never force a patient who is resistant. Most providers try to sell their skills, which gives clients the impression that this is something commercial rather than healing or therapeutic. I prefer to make the first session itself very impactful, explaining to them the 4 Rs approach of Relief, Root cause reversal, Rebalance, and Regeneration that we follow. This approach sets us apart from others and treats not just their symptoms but also promotes well-being.