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"You Can't Make Me!" - Effective Techniques for Managing Highly Resistant Clients - Test
by Clifton Mitchell, Ph.D.

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1. The author asserts that therapists should develop their own philosophy for managing resistance and that this philosophy should include:	Help
An understanding of what resistance represents psychologically. Theories for conceptualizing resistance. Techniques and approaches for managing resistance. All of the above.

2. When should you develop your strategies for dealing with resistance?	Help
Within the first few minutes of a session Before you encounter it in a counseling session Approximately half way through a session You do not need to develop approaches.

3. Most conventional definitions of resistance are based on Freudian theory and view resistance as:	Help
A result of poor therapeutic skills. Something that emerges from the client or that resides in the client. Opposition to the therapist's agenda. Both 2 and 3 above.

4. The social interaction theorists view resistance as:	Help
Reluctance to change on the part of the client. An attempt to avoid anxiety provoking memories and insights. Something that resides in the unconscious. A result of a negative interaction style between the client and the therapist.

5. The author presents a model that asserts that resistance is created by the therapist:	Help
When the client's inner conflicts are clarified. When the client's cognitive distortions are pointed out. When the method of delivering influence is mismatched with the client's current propensity to accept the manner in which influence is delivered. In all cases where confrontation is utilized as a therapeutic technique.

6. When the underlying dynamics of what is commonly labeled "resistance" are examined, it becomes evident that what appears to be resistant behavior could be a sign of:	Help
Social fear. Passive-aggressive behavior. A desire for individuality. All of the above.

7. One of the primary therapist errors that fosters resistance is a failure to:	Help
Clearly explain the therapist's credentials. Establish mutually agreed upon objectives. Establish a set and limited time for therapy to occur. Clarify the diagnosis and likely future outcome (prognosis).

8. With resistant clients, the more of an expert the therapist becomes regarding the situation, the more likely the client will feel the need to be:	Help
Receptive to the therapist's ideas. Needy in the therapeutic relationship. Resistant to the ideas presented. Knowledgeable also.

9. ________ provides the socially acceptable, surface reason for change, while _________ provides the underlying motivation to initiate and implement the change.	Help
Logic, emotion Logic, insight Support, emotion Emotion, logic

10. In order to avoid creating resistance, a good rule of thumb is for therapists to continually focus at the current moment in the session on:	Help
The ultimate goals that clients desire. Saving time by maximizing insights into problems. Moving clients the smallest step possible toward their goals. Moving clients the largest step possible toward their goals.

11. In order to circumvent resistance when problem solutions appear to be obvious and your client does not accept them, your displayed attitude should be one of:	Help
Uncertainty. Experience and confidence. Leadership. Exasperation.

12. When a client offers you an "invitation to take his or her pain," it is best to:	Help
Politely refuse the "invitation" while expressing empathy. Confront the client about what is occurring. Avoid all discussions about their pain for the moment. Move the discussion of the issues to a more logical level of understanding.

13. The author asserts that the primary factor that results in change is for clients to have:	Help
A logical reason for changing. Support from others for changing. An emotionally compelling reason to change. Psychodynamic insight into their problems.

14. Prochaska labels the stage in which people are aware that a problem exists and are intending to change in the next six months as the stage of:	Help
Precontemplation. Contemplation. Preparation. Action.

15. The most highly resistant clients usually fall into which two of Prochaska's stages of change?	Help
Precontemplative and Action Action and Maintenance Precontemplative and Contemplative Preparation and Contemplative

16. In order to avoid the pitfalls of responses provided by most lay people desiring to help, it is advised that you consistently strive to avoid:	Help
Direct discussion of problems. An emphasis on the emotional components of issues. An excessive focus on details. Commonplace lay responses and typical reactions to client statements.

17. Which one of the following statements is NOT true?	Help
When you become naive and puzzled with regard to client's problems you are likely to lose the client's respect. With resistant clients, the more you become an expert the greater the chance of creating resistance. Most of what we communicate is received by the listener through paralanguage. One of the best predictors of therapeutic success is the client's experience of the counselor's acceptance.

18. In order to maximize effectiveness, goals and problem solutions should both be:	Help
Specific and measurable. Not too difficult or too easy. Prioritized. All of the above.

19. When resistance is encountered, it is advised to do all of the following except:	Help
Slow the pace. Focus on details. Talk more in order to keep the conversation moving. Process the client's feelings relative to their meaning.

20. With highly resistant clients, when considering a balance between direction of therapy and speed of progress, one should keep in mind that:	Help
Direction and speed must constantly be balanced. With resistant clients in particular, speed of progress is more important than direction. Direction is more important than speed. None of the above.

21. When contradictions emerge in a client's logic, your safest initial response is to:	Help
Point out the contradiction. Remain passive. Express confusion about your understanding of what your client is stating. Directly pursue a logical resolution of the contradictory comments.

22. From the overall perspective presented by the author, in order to circumvent resistance, when clients are ambivalent toward change the best initial response from therapists would be to:	Help
Subtly push the client toward change. Help the client realize the need for change. Give the client reassurance that the change will be beneficial. Fully accept, understand, and discuss the client's ambivalence.

23. Dr. Mitchell's position on words and language is that:	Help
We should avoid being manipulative with our language. It is unethical and deceptive to use hypnotic language without the client's permission and understanding. All language is hypnotic, and we cannot, not manipulate. The specific words used by the therapist are not important as long as the client gets the message and it is spoken from the heart.

24. Clients almost invariably present and discuss their problems:	Help
From a position of what they want (positive connotation). From a position of what they do not want (negative connotation). From a position of finding fault with themselves. In no set discernible pattern.

25. In describing the concept of "dominant thoughts," Dr. Mitchell asserts that:	Help
A lack of understanding and improper use of dominant thoughts is detrimental to the therapeutic process. There is greater influence when dominant thoughts describe what is desired as opposed to what is not desired. Clients with negative dominant thoughts will have a difficult time reaching their goals. All of the above

26. "Priming" is a broad overarching term that is used to describe:	Help
The use of leading questions with known answers. Instances where therapists frankly tell clients the truth about their situation. Any type of statement that directly or indirectly introduces new ideas to clients. Instances where clients are told difficult information only when the time is right.

27. Dr. Mitchell's position is that the primary tool that therapists have for promoting client change is:	Help
Endless patience and repeated efforts. Research based knowledge of mental health problems and diagnoses. Their position and degree. The precise use of words and paralanguage.

28. Dominant Thought Theory states that the tense of the mental programming statement is:	Help
Not a critical factor. Not a critical factor if the dominant thought is correctly presented. Very important to consider. Automatically adjusted by the subconscious mind because it already knows what is needed to reach objectives.

29. The first step in creating mental programming statements is to:	Help
Defeat all negative thoughts regarding the desired change. Define the positive opposite of what you are currently doing. Create a statement that you will do the new behavior. Describe what you are currently doing.

30. The most difficult step in mental programming is:	Help
Describing what you are currently doing. Defining the positive opposite of what you are currently doing. Making a present tense statement that you are doing what you want to do. Consistently repeating the new dominant thought statement.

31. Dr. Mitchell asserts that the primary way that therapists get drawn into the client's stuckness is through:	Help
Avoiding questions. Asking questions. Avoiding confrontation. The excessive use of empathy.

32. From a Dominant Thought Theory perspective, which of the following would be an effective mental programming statement for those wanting to stop smoking?	Help
"I need to get healthy." "I am a nonsmoker." "I smell clean." "My lungs are free of smoke."

33. Dominant Thought Theory contends that consistent repetition of the mental programming statement is critical because:	Help
There is a tremendous amount of interference from previously formed mental and environmental associations that must be overcome. Most of us suffer from "monkey mind" in which our thoughts constantly jump from one topic to another never allowing time for a focused effort. The negative voice that emerges and attempts to sabotage efforts must be overwritten. All of the above.

34. Dr. Mitchell asserts which of the following should be the first step in the process of effective goal creation?	Help
Clearly determine how the problem is a problem from the client's perspective. Make sure all goals are written down. Clearly explain how the presenting problem may result in additional psychological ramifications. Directly ask what is desired by the client.

35. When creating viable goals, which of the following are important for success?	Help
Proper timing in the therapeutic process Careful positive wording Client participation All of the above

36. Counselors who remain flexible and open with what clients view as worthwhile goals, even when such goals appear of little value, are more likely to:	Help
Decrease rapport with the client. Increase resistance from the client. Increase the possibility of beneficial client changes in the future. Increase feelings of confrontation with the client.

37. Which of the following is a therapeutically correct and useful example of an empathic response that includes recognition of the deficit present?

Help

"You are very distraught over the divorce from your husband and you are searching for a way to make some sense of what has occurred."
"You are experiencing much anger at your husband and you are very irritated with your relatives."
"Your situation is quite irritating to you and you currently lack the self-discipline required to make needed changes."
"You are very lonely in your present situation and this is leading to feelings of depression."

38. Which statement is true?	Help
Goal intentions and implementation intentions are synonymous. Once goals are established, goal intentions should be the primary focus in therapeutic discussions. Once goals are established, implementation intentions should be the primary focus in therapeutic dialogue. None of the above

39. According to Dr. Mitchell when therapists accept and empathize with a "not knowing" response from clients,the therapist is:	Help
Aware that clients' internal mental dynamics are moving him towards knowing. Allowing clients to avoid facing their issue. Inadvertently reinforcing "I don't know ..." responses. Admitting that he is just as stumped as they are.

40. Which one of the following is a true statement?	Help
Questions will always hinder progress in the therapeutic relationship. Questions are a readily accepted form of communication in all societies. Questions are likely to foster resistance in reluctant clients. Clients always appreciate a caring therapist's inquiries.

41. When therapists recognize in themselves the urge to ask a question, the first thing they should do is:	Help
Ask immediately from the heart before the idea is lost. Slow down, "go inside," and further assess your motivation for asking. Change the subject to diminish the urge. Ask permission of the client to ask the question.

42. Most questions can be converted to statements or commands by:	Help
Avoiding common introductory phrases. Avoiding common closing phrases. Only changing the inflection in one's voice. A and B above.

43. Which of the following paralanguage styles has the most likely possibility of conveying to the client that the therapist truly does not know what the client's response to a question will be?	Help
A slow, thoughtful, curious manner of speaking A brisk, inquisitive manner of speaking A neutral, nonchalant, manner of speaking A smiling, friendly manner of speaking

44. A statement that is grammatically a command, yet conveys puzzlement and naivete from the accompanying paralanguage is referred to by Dr. Mitchell as a:	Help
Demanding statement. Curious command. Exaggerated hypotheses. Interrogating question.

45. In order to prevent resistance, the safest way to respond to an "I don't know" answer from a client is to:	Help
Point out that the client is deflecting, and push for a response. Tell the client that you know the client knows the answer and is holding back. Directly state that you will not allow the client to play "I don't know" games. Empathize with the meaning behind the "I don't know."

46. If you have just asked a question or if you are in the process of asking a question and, in your mind, you hear an "I don't know" response as the most likely response from your client, Dr. Mitchell recommends that you:	Help
Stop what you are doing, signal your client not to respond, and provide an empathic response to the assumed "I don't know" response. Be resolved to receiving an "I don't know" response and accept that this is what clients do. Tell your client in advance that an "I don't know" response is not acceptable. Answer the question for the client in order to prevent hearing "I don't know."

47. An example of a response that attempts to use the "pretend technique" in response to an "I don't know" answer might be:	Help
"Go inside and listen to your inner voice, what do you hear it saying?" "Right now, it is difficult to imagine doing something different." "What would you say if you did know?" "It is very difficult for you to see a way to deal with this, currently."

48. Dr. Mitchell asserts that the danger(s) of using the "pretend technique" in response to an "I don't know" answer from a client is that:	Help
It can appear disrespectful. It may appear to be a "trick" question to clients and, thus, diminish rapport. The questioning style of dialogue may be asking for an answer outside of the client's current insights. All of the above.

"You Can't Make Me!" - Effective Techniques for Managing Highly Resistant Clients - Test by Clifton Mitchell, Ph.D.

"You Can't Make Me!" - Effective Techniques for Managing Highly Resistant Clients - Test
by Clifton Mitchell, Ph.D.