With today ‘s article we address a rather debated topic in the field of psychotherapy , namely that of the client’s resistance to change and how this concept is addressed in relation to Single Session Therapy (Cannistrà & Piccirilli, 2018).
Let’s start from the beginning, what do we mean by resistance to change?
In the context of psychoanalysis or some forms of psychotherapy such as cognitive-behavioral therapy or systemic therapy , just to name a few, resistance to change beyond the peculiar definitions that derive from it based on the reference approach, is considered as a more or less conscious obstacle that the person or the system of which they are part implements to oppose the change introduced by the therapist (Hoyt, 2018).
According to this perspective, what does the presence of resistance presuppose in the relationship between therapist and client?
Seen in this sense, resistance appears to be a difficult factor to manage for the therapist , who tends to attribute mostly to the client/patient/system the responsibility for the slow change in the therapeutic path, if not even the failure of the therapy itself.
But is this the case for all approaches?
There are forms of brief therapy that do not necessarily consider resistance as an obstacle put in place by the person to avoid the change or anguish that could result from it, but rather, as in the case of the famous psychiatrist M. Erickson and strategic therapy , it is considered as a form of collaboration by the customer. The latter, in fact, if accepted and used by the therapist from the beginning of the intervention, can be circumvented through specific strategies (e.g. prescription of the symptom) and become the resource itself for change (Haley, 1973).
How is this concept addressed in Single Session Therapy?
As we know, in the context of SST it is essential to use the person’s motivation , create the therapeutic alliance and respect the client’s Theory of Change (Duncan & Miller, 2000). All
elements which, as it is possible to imagine, take us away from the traditional concept of resistance, to instead approach de Shazer’s model of solution brief therapy (de Shazer et al. , 1986) which proposes an overcoming of this concept (de Shazer, 1984) in favor of a vision of the therapeutic relationship based on cooperation between therapist and client.
What is the assumption underlying this vision?
Underlying this view of the therapeutic relationship is the idea that the client is always motivated to change . Any resistance expressed by the client is nothing more than a more or less conscious signal of the inability to collaborate in the ways proposed by the therapist . It will therefore be the therapist who will have to find the most suitable way to meet the client’s needs and not the client who will have to adapt to the proposed therapy model (Cannistrà & Piccirilli, 2018).
Conclusions
We can conclude by using the following words from de Shazer (1986):
We had long been baffled by the notion of “resistance” in therapy. As we watched each other work, we became more and more convinced that the clients really wanted change. Certainly some of them found that our ideas about how change should happen didn’t fit very well. Rather than seeing this as “resistance” we saw it more as customers taking action to let us know how to help them (p. 2).
Angelica Giannetti
Psychologist, Psychotherapist
Team of the Italian Center
for Single Session Therapy
Bibliography.
Cannistrà, F., & Piccirilli, F. (2018). Single Sitting Therapy: Principi e pratiche . To the editor.
de Shazer, S. (1984). The death of resistance. Family Process, 23: 11–17.
de Shazer, S., Kim Berg, I., Lipchik, E., Nunnally, E., Molnar, A., Gingerich, W., Weiner-Davis, M., (1986). Brief Therapy: Focused Solution Development. Family Process, 14: 79-93.
Hoyt M. F. (2018). Brief psychotherapies: Principles and practices. CISU Publisher