Resistance is a common reaction to change. And people who are hesitant or adverse to taking part in a change process are often called resistant. In service provision, the label of “resistant” carries negative connotations, and people who are resistant are often met with animosity. The label “resistant” can also be persistent, staying in a person’s file throughout their case and even into subsequent interactions.
Labeling a person as resistant is easy. It is a ready explanation for why services aren’t working for them, why they aren’t a success of the program. If a person is resistant, that’s just how they are.
MiiWrap doesn’t see resistance as a trait; a trait is a static characteristic, a part of a person. Instead, we see resistance as a state, something that can be changed. The skills used in MiiWrap directly address resistance and help a person to leave it behind.
The place of resistance in behavior change is best understood within a brief discussion of MiiWrap’s theory on behavior change. The two primary factors that impact behavior change are motivation and self-efficacy — the belief in one’s skills and abilities to make change. How a person feels about the change impacts their motivation and self-efficacy, and often people feel conflicted about change. In MiiWrap, having arguments both for and against change is called ambivalence. Ambivalence is a normal part of change. In fact, avid list makers are very good at exploring ambivalence. The sentiments for change are heard as change talk. Those against change are sustain talk. Both change talk and sustain talk provide insight into ambivalence and motivation.
Part of the way we talk about change
MiiWrap does not use the word resistant to identify people who are not ready to make a change. Instead, resistance to change is seen as sustain talk, and sometimes discord. Sustain talk is the not-wanting-to-change side of ambivalence. It is the discussion that rationalizes avoiding change. Sustain talk can be one of four types, each of which requires a different approach to address. The four types of sustain talk and related approach are:
- Reluctance is expressed as thinking the change will not work, or they will not be able to make the change. Respond to this type of sustain talk by exploring concerns and building self-efficacy.
- Rebellion is perhaps the most readily called to mind when thinking of traditional resistance. It is people who do not want to be told what to do. Addressing rebellion involves helping the person understand they have ownership over the MiiWrap process and creating their own goals.
- Resignation is an overall hopelessness, thinking the change will not matter in the scheme of things. MiiWrap staff must build hope and self-efficacy in response to this type of sustain talk.
- Rationalization is the presentation of, “I know, but…” as a person gives reason for not wanting to make a change. With this type of sustain talk, it is important to avoid persuading or arguing.
The other part of traditional resistance is discord. As opposed to sustain talk, which comes from the person’s unwillingness and desire to change, discord is a relational problem. It is the conflict, friction, or hostility that appears between people during the change process. Because MiiWrap is a team-based approach, there are many people between which discord may arise. It may be between the MiiWrap staff and the person, within the family, or between any other team members. Building the collaborative relationship and increasing engagement are key activities in overcoming discord.
Here is an example of discord often recalled by Jim Rast. He was meeting with an adolescent who was shut down and not engaging. After multiple failed attempts to increase engagement through questioning, Jim started using reflections. After a while, the adolescent began to open-up. At the end of their time together, Jim asked why he decided to start sharing. The adolescent responded when he asked him so many questions, he thought Jim was a cop. The way Jim approached the situation created discord, which resulted in reluctance for the adolescent to engage in the process. But changing his tactics, Jim was able to turn things around. It’s not that his first approach was wrong, but it was his responsibility to figure out why the adolescent wasn’t engaging and see what he could do to fix it. For this adolescent, questions felt like an interrogation. But reflections felt more like listening.
Resistance to the label resistant
The relational skills in MiiWrap are informed by Motivational Interviewing, as is the process of behavior change. Ambivalence and sustain talk are also described as the sources of traditional resistance in that discipline. In the 3rd edition of Motivational Interviewing, authors Miller and Rollnick note their resistance to the label “resistant.” Labeling a person instead of their behavior puts the blame on them. It places the responsibility of overcoming reluctance solely on the person, and divorces failure from the process. We are here to help people understand their goals and how to reach them, no matter their attitude towards and stage of change. Therefore, the use of a term such as resistance may be harmful to the process. It is hard to respond to resistance as a static trait. But MiiWrap provides the tools to respond to sustain talk and discord, ever changing characteristics in the process of change.
Using MiiWrap skills to soften sustain talk and overcome discord
One of the core beliefs of MiiWrap is that everyone can make positive change. Resistance, then, must be a changeable thing. Understanding the process of change and how to guide a person through it is MiiWrap. Viewing resistance as a natural part of change and a relational problem presents many avenues for increasing engagement and helping a person create lasting change.