Rolling With Resistance
If you were using the Motiviational Interviewing principles how does one deal with a client who maintains that he/she didn’t do the crime? Or seems to skirt accountability? And therefore the conversation gets stuck there. How might we apply our MI skills to this scenerio? I asked Brad Bogue and Fleet Maull to reply to this question.
Fleet Maull: It is clearly difficult working with a client who presents strong denial. Of course we may encounter a few situations where a person is innocent, but as we know in most cases this is simply denial. Such denial presents clear barriers to any kind of effective treatment. There have been some efforts to set up specific sex offender treatment programs for this category of “deniers,” who categorically deny the offense with limited success. I suspect the most important this is to create an effective relationship and keep the person talking through the use of open questions, affirmations, reflections and summaries (OARS). Over time this will create an environment in which the client may be more likely to come clean and find relief in doing so. Directly challenging or confronting the client around their denial is not likely to be helpful, but consistently reflecting their denial statements back to them in a non-confrontational manner and asking open ended questions about related behaviors or behavior patterns may evoke a breakdown in their wall of denial over time. I have attached two intersting articles here dealing with this issue.
I look forward to Brad’s response to this question of how best to work with denial from an MI perspective.
Brad Bogue: I basically agree with what Fleet has posted. One of the MI techniques for working with conflict and discord such as this is to Shift the Focus, you can always return to the topic later, hopefully when your rapport is in less jepardy – and maybe you have a more clear and different tact for exploring with the client their high risk behavior and related consequences.
This video of Miller & Rollnick also goes into this topic:
Attached here is a chapter from Brad’s book on MI about “resistance.”