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

Course content © copyright 2008 by Clifton Mitchell, Ph.D.. All rights reserved.

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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. 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
12. 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
13. 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
14. Which one of the following statements is not true? Help
When you become naïve 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
15. 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
16. 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
17. Those who confront resistant clients early in the counseling process are likely to: Help
create an atmosphere that prevents future confrontations
avoid discovering underlying, deeper issues with which the client is struggling
enhance resistance
both 2 & 3 above
18. 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
19. 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
20. 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
21. 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
22. 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
23. "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
24. 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
25. 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
26. 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
27. 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
28. 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."
29. 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
30. 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
31. 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
32. 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
33. A statement that is grammatically a command, yet conveys puzzlement and naiveté from the accompanying paralanguage is referred to by Dr. Mitchell as a Help
demanding statement
curious command
exaggerated hypotheses
interrogating question
34. Most questions can be converted to statements or commands by simply avoiding common introductory or closing phrases. Help
True
False
35. 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"
36. 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"
37. 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."
38. 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

 

 

 
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