Module 9: working with young people on AOD issues: learner's workbook

4.3 Working with resistance in young people

Page last updated: 2004

Resistance in young people
Responding to resistance
Sources of resistance in your work with young AOD users
Summary

Resistance in young people

Resistance in young people can be one of the most challenging and frustrating issues to deal with and often occurs when freedom of choice is being threatened. In the Juvenile Justice context, for example, coercion into treatment can be a clear source of resistance! Where possible, encourage the young person to reflect on the choices they have and involve them as much as possible in the decision-making process. Reflection and expression of empathy can also help the young person to talk about their loss of choice.

Resistance can be an expression of the young person thinking, 'Hey hang on, I'm not with you, I don't agree'. One of the defining characteristics of motivational interviewing is the way a worker views and deals with resistance. A young person's resistance is viewed as an interpersonal, contextual dynamic rather than a personality trait or the result of a disease state. The reframing of a young person's resistance is one of the key factors in the motivational interviewing model.

Key issues in working with resistance

  • The worker's style can be a powerful determinant of the young person's resistance and motivation to change
  • Argument tends to provoke resistance
  • Young people may respond to confrontation by presenting the reasons against change
  • When resistance is provoked, young people tend not to change
  • Resistance may be a message from the young person that you do not understand them or their situation
  • Motivation emerges from the interaction between the young person and the worker
  • Motivation can be increased by using a variety of strategies.
One of the goals of motivational interviewing is to avoid eliciting and reinforcing any resistance or reluctance a person may express. This is known as 'rolling with resistance'. Research suggests that the approach taken with a young person can either increase or decrease resistance. There is also good evidence to suggest that levels of a young person's resistance can predict outcomes (See Miller and Rollnick, 1991).
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Reflection can be used to reduce resistance and can also be employed as a way to work with, rather than against, the energy of resistance.

Some examples are:
  • Simple acknowledgement of the young person's disagreement, emotion or perception can permit further conversation rather than defensiveness.

  • Reflecting back what the young person has said, exaggerating the point but with a quiet, understated tone. If successful, the young person may back off a bit and might articulate the other side of the ambivalence.

  • Acknowledge what the young person has said and include the other side of the issue, with the aim of increasing ambivalence.
In relation to AOD issues, resistance is most likely to occur when there is a mismatching between the young person's stage of change and the approach being taken by the worker. One of the worst ways to work with someone who is not ready to look at the issues at hand is to confront them.

Responding to resistance

Task

For each of the statements below, spend a few moments considering the possible sources of the resistance. Based on what you have just learned about working with resistance, generate two responses to each of the following statements.
  • 'Who are you to tell me what to do? What do you know about smack? You've probably never even tried dope!'

  • 'I don't have to talk to you. I'm only here 'cause I have to be!'

  • 'I couldn't change even if I wanted to. My father always said I'd be no good.'

  • 'I don't use any more than my friends. They aren't being hassled!'

  • 'The law sucks! Everyone knows that alcohol causes far more problems than marijuana. Besides, they're trying to legalise it now.'

  • 'Things are different now than when you were a kid. There's nothin' else to do except smoke cones!'

  • The person responds to any question with either silence or 'I dunno'.

Sources of resistance in your work with young AOD users

Workplace learning activity

Question - Why might you encounter resistance as a worker with young people who use AOD?

Question - List three examples of resistance that has arisen in your interactions with young people who use AOD.

Question - What aspects of your role and the way young people may view it might contribute to resistance?

Question - Are there any aspects of your own work style that may contribute to a young person's resistance?Top of page

Summary

  • Motivational interviewing is an intervention technique that purposefully creates a conversation about change, without attempting to convince the person of the need to change or instructing them about how to change.

  • Working with ambivalence, rather than ignoring or denying it, can assist young people in moving through the change process.

  • Reflection can be a useful technique to work with resistance.