Understanding Motivational Interviewing and the Roll with Resistance Technique

Introduction

Motivational interviewing is a client-centered approach that focuses on helping individuals explore and resolve their ambivalence towards change. This technique is widely used in various fields, including therapy, coaching, and healthcare, to facilitate behavior change and increase motivation.

What is Motivational Interviewing?

Motivational interviewing is a collaborative conversation style that aims to strengthen a person’s motivation and commitment to change. It recognizes that individuals may have mixed feelings about making changes and that they are ultimately responsible for their own decisions.

This approach is rooted in four core principles:

1. Express empathy: Practitioners must show genuine empathy and understanding towards the client’s perspective, fostering a safe and non-judgmental environment.
2. Develop discrepancy: The therapist helps the client explore the discrepancy between their current behavior and their desired goals, highlighting the importance of change.
3. Roll with resistance: Rather than confronting resistance head-on, the therapist aims to understand and explore it, working collaboratively with the client to overcome it.
4. Support self-efficacy: The therapist encourages the client to believe in their ability to make positive changes and reinforces their self-confidence.

What is Roll with Resistance?

Rolling with resistance is a key technique used in motivational interviewing. It involves avoiding direct confrontation or arguments with the client when they express resistance or reluctance to change. Instead, the therapist acknowledges and explores the client’s concerns, allowing them to express their thoughts and feelings without judgment.

This technique recognizes that resistance is a natural part of the change process and that attempting to force or persuade someone to change is often counterproductive. By rolling with resistance, the therapist can maintain a collaborative and non-confrontational approach, fostering a trusting relationship with the client.

How to Handle Resistance from the Client

When faced with resistance from a client, it is important for the therapist to respond in a way that encourages open dialogue and exploration. Here are some strategies for handling resistance:

1. Show empathy: Begin by expressing empathy and understanding towards the client’s concerns. This helps create a safe space for the client to express their resistance without fear of judgment.
2. Reflective listening: Use reflective listening techniques to actively listen to the client’s concerns and reflect them back in a non-judgmental manner. This demonstrates that their perspective is valued and understood.
3. Explore ambivalence: Help the client explore their ambivalence towards change by discussing the pros and cons of both changing and staying the same. This allows them to gain insight into their own motivations and encourages self-reflection.
4. Ask open-ended questions: Use open-ended questions to encourage the client to elaborate on their thoughts and feelings. This helps deepen their understanding of their resistance and can lead to insights or new perspectives.
5. Reframe resistance: Instead of viewing resistance as a barrier, reframe it as a normal part of the change process. Emphasize that the client has the power to make their own decisions and that the therapist is there to support them.

Example for Roll with Resistance

Imagine a client who is struggling with weight loss and expresses resistance to exercise. Instead of arguing or trying to persuade the client to exercise, a therapist using the roll with resistance technique might respond as follows:

Therapist: “I understand that exercise can be challenging and that you may have concerns about starting an exercise routine. Can you tell me more about what makes exercise difficult for you?”

By acknowledging the client’s resistance and inviting them to share their concerns, the therapist creates an opportunity for the client to explore their thoughts and feelings. This approach fosters a collaborative relationship and encourages the client to take ownership of their own decision-making process.

Conclusion

Motivational interviewing, with its emphasis on collaboration and empathy, is a powerful approach for facilitating behavior change. The roll with resistance technique allows therapists to effectively address client resistance by acknowledging and exploring it, rather than trying to overcome it through confrontation. By using this technique, therapists can create a safe and supportive environment that encourages clients to explore their ambivalence and make positive changes.