Academic journal article The Behavior Analyst Today

Assisting the Client/consultee to Do What Is Needed: A Functional Analysis of Resistance and Other Forms of Avoidance

Academic journal article The Behavior Analyst Today

Assisting the Client/consultee to Do What Is Needed: A Functional Analysis of Resistance and Other Forms of Avoidance

Article excerpt

Skinner (1945) discussed the importance of analyzing psychological terms. One commonly used term needing deconstruction is "resistance." While the study of "resistance" is not novel to a behavioral approach (e.g. DeVoge & Beck, 1978), it has certainly been given less attention than it deserves in the behavior analytic literature. First, it is important to recognize that when behaviorists speak of "resistance" it is not a characteristic of the client. Instead it is conceptualized as a description used by either the consultant or therapist of a relationship in which the client/consultee does not do what is expected or desired by the therapist or the consultant. For example, Dr. John said "Mary, please use this new form to collect data on Sam's aggressive behaviors." Mary has not followed through three days later when Dr. John returns to see how treatment is going; Mary has not come under instructional control of Dr. John's mand. Behavioral consultants and therapists often encounter this problem of performance. As a performance problem, resistance is a complex issue that warrants a comprehensive functional analysis. A comprehensive functional analysis of behavior not being displayed was conducted by Daly, Witt, Martens, & Dool (1997). In this paper, we apply their model to consulting and therapeutic relationships. It can be applied to the supervisory process as well.

Before launching into the model of these relationships, it is important to understand that much of what is termed "resistance" in the psychotherapeutic relationship can be avoided with proper setting of the consulting context. A proper setting requires giving the consultee or client accurate information about the process at the start of the consulting or therapeutic relationship. The therapeutic relationship is complex (Kohlenberg and Tsai, 1998). It allows for shaping of client behavior (Kohlenberg & Tsai, 1994) and the giving (Kohlenberg & Tsai, 1994) or disruption (Hayes, Strosahl, & Wilson, 1999) of instructions or rules to clients to change their behavior. When giving rules, we are presenting clients with information. Etymologically, the word "information" comes from the Latin word "informare." This word means, "to put into form;" things that help us put what we know into form, (i.e., structure and simplify what was previously complex), can be reinforcing (Foxall, 1988). If consultant utterances fail to do this, or do it in a way that requires high levels of work output, then they can be aversive instead of reinforcing, and thus people will seek less information in the future.

Six informational setting factors that a consultant can implement to increase compliance are: (1) prepare the consultee or client for what consultation/therapy is about (i.e., provide direct instruction of what is about to occur); (2) explain responsibilities of all parties involved (i.e., contract consent); (3) explain how this process can help (i.e., talk about the reinforcers); (4) explain the risk factors involved (i.e., talk about any punishers that may occur); and (5) avoid early overuse of demands, imperatives, and questions which tend to evoke "resistance." When the initial contact is approached in this manner using language that is meaningful to the listener, much of what is often termed "resistance" can be avoided.

With the above said, it is important to recognize that with some populations such as those diagnosed with oppositional defiant disorder, conduct disorder, borderline personality disorder, or substance abuse, "resistance" to performance may be very high and can have very pronounced effects on therapeutic outcomes (Patterson & Chamberlain, 1993; Stoolmiller, Ducan, Bank, & Patterson, 1993). However, some methods exist which can help the therapist or consultant to change their behavior to increase the probability of client or consultee compliance (Patterson & Forgatch, 1985).

The model presented here is based on interventions designed to overcome students' failure to perform academic tasks developed by Daly, Witt, Martens, & Dool (1997). …

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