It happens all the time. We sit down with a client and find ourselves talking to someone who’s fighting everything and is not ready to do anything. 

The frustration that can come up for us during these kinds of counseling sessions can be very intense. But by doubling down on why you’re the authority in the room, we unintentionally set up a situation where our patient’s experiences no longer matter. 

What we know is now more important than what our patient is experiencing. 

When faced with someone who’s simply not interested in change, it can be very easy to try to get them interested by going into expert fix-it mode.

• Just try this!
• This is what I do
• You can just
• All you’ve got to do is
• When I do this…and this happens

Each of these statements give the impression that change is easy. And for someone who’s not ready to accept that change is either easy or necessary, this kind of language can make a client’s resistance flair up even brighter.

A Better Way to Respond to Resistance

We are not here to fix problems. And we aren’t here to pour all of our clinical nutrition education into someone who doesn’t care to know it. 

We’re here to support our patients in discovering what information they need to get them to where they want to be. 

We do this by:

• Promoting choice (ie: Would you rather talk about X or Y?)
• Not pushing change (ie: Is there something you’d like to work on?)
• Acknowledging and explore the resistance (ie: Oh yea? How did that happen? I can see that.)

Curiosity combined with open-ended questions, active listening and some judgement free patience can be highly effective. These motivational interviewing techniques reinforce our patient’s right to decide when they want to make a change and what that change will be. 

Steps for showing empathy during resistance:

At the heart of all of this is showing empathy, even as someone is pushing back hard on the things you know can help them. To do this, you can start by:

1. Acknowledge the problem (as they’ve stated it) AND the emotion that comes with it
2. Learn what your client already knows, find out what they’ve already tried
3. Acknowledge the effort
4. Ask if your client wants more information, how you can help, what kind of extra information they’d like to learn about

Remember

Focusing the conversation on our client’s autonomy and their ability to have personal choice is our best tool for reducing resistance. 

Offering choice whenever possible can set a clear tone right from the moment you walk in the room that your patient is the one in control of the conversation. It can start off pretty basic and doesn’t even have to directly relate to nutrition education. 

When you give your patient choice every step of the way, you’re priming them to believe that their wants matter. This might look like asking: 

• Where they’d like to sit
• What to talk about first
• If they want to answer your question or change the subject
• What goal they’d like to set
• When they’d like to talk again

This may not lead to an immediate shift in a client’s readiness to change. However when personal choice is emphasized, it can be empowering and open our client up to brainstorming what might be possible.