Understanding Client Resistance as Pathological Ambivalence

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  • February 1, 2019
  • 9:00 a.m. - 3:30 p.m.
  • 5 Core Continuing Education Clock Hours (Related Hours for MFTs)
  • Location: Hilton Garden Inn (3045 Windy Hill Road, Atlanta, GA 30339)
  • Cost: $105 before January 18, $120 after

Presented by: Linda Buchanan, Ph.D.

Dr. Linda Buchanan founded Atlanta Center for Eating Disorders in 1993 which was acquired by Walden Behavioral Care in 2017. She is now Senior Director of Clinical Services with Walden which provides Intensive Outpatient, Partial Hospitalization and Residential care for individuals with eating disorders in Dunwoody, Alpharetta and Decatur.  Dr. Buchanan received her Master’s degree Georgia State University and a Diploma from the Psychological Studies Institute (now known as Richmont University) in Christian Counseling from which she received the Distinguished Alumnus Award for her work in founding ACE. Dr. Buchanan then went on to receive her Ph.D. from Georgia State University doing a residency at the Medical College of Georgia. She currently has a book in publication titled A Clinician’s Guide to Dealing with Pathological Ambivalence: How to be on Your Client’s Side Without Taking a Side the content of which she has presented at multiple national conferences. She has published two chapters on her model of treatment of eating disorders which have been used as texts in a local doctoral program for Clinical Psychology students.  Additionally, she has published four research articles on the treatment of eating disorders including two outcome studies of the treatment provided at Atlanta Center for Eating Disorders.  She has been married for over 30 years and is the mother of two teenaged boys.

 

Workshop Description:

As a therapist, you have undoubtedly had the experience of working with a patient who will spend a lot of money and time coming to therapy while doing little that you suggest. These patients are often labeled resistant, oppositional, or borderline because of the frustration they create in those who want to help them.  Therapists concurrently may label themselves as ineffective or unskilled when working with these patients. This workshop will focus on relabeling resistance as Pathological Ambivalence (PA). When dealing with someone with PA, a specific type of approach and strategies need to be utilized which empower these patients to identify and manage their own ambivalence.Ambivalence occurs primarily as the result of the cognitive scripts, narratives or schemas which individuals form in childhood and, which when operating, can slow down, confuse or even halt the therapeutic process.   A brief review of theoretical perspectives of resistance will be presented with a focus on integrating the concepts into a theory about Pathological Ambivalence. PA and its common forms will be described so that therapists can improve their skills for staying out of power struggles and empower their clients to resolve ambivalence. Also presented will be strategies for assessing scripts and avoiding common pitfalls such as prematurely discounting client beliefs, and unknowingly participating in, or becoming the target of, projections.

Educational Objectives:

  1. Conceptualize resistance as Pathological Ambivalence (PA).
  2. Understand why some individuals are more prone to developing PA than others.
  3. Quickly identify common expressions of PA in therapy and not mislabel it as resistance.
  4. Utilize strategies to skillfully side-step power struggles and splitting and empower clients to resolve ambivalence from within.
  5. Understand and help clients identify narratives and their projections while avoiding participating in the schemas or being the object of the projections.

Agenda:

  • 8:30 - 9:00 Registration (Coffee, Tea, and Granola Bars Served)
  • 9:00 - 10:30 Welcome and Morning Session
  • 10:30 - 10:45 Break
  • 10:45 - 12:00 Morning Session (Cont.)
  • 12:00 - 1:00 Lunch Break (Lunch is on Your Own)
  • 1:00 - 2:00 Afternoon Session
  • 2:00 - 2:15 Break
  • 2:15 - 3:30 Afternoon Session (Cont.)
  • 3:30 - 3:45 Continuing Education Certificates Distributed

Workshop Outline :

  1.   Understanding Resistance as Ambivalence
  2. Relabel resistance as ambivalence
  3. Ambivalence is normal
  4. Brain functioning
  5.  Etiology of Pathological Ambivalence
  6. Working Definition
  7. Sensitivity vs learning
  8. Serotonin and biology
  9. Development of Narratives and scripts

III.  Theoretical Perspectives On Resistance

  1. We all have parts
  2. Psychoanalytic
  3. Object Relations
  4. Transactional Analysis
  5. Gestalt
  6. Dialectics
  7. Dissociation
  8. Family Theories
  9. We all create narratives
  10. Cognitive
  11. Adlerian
  12. Narrative
  13. Humanistic,Rogerian
  14. Social Interaction Theory
  15. Behavioral Viewpoint and ACT
  16. Common Forms of Ambivalence
  17. Ambivalence Continuum
  18. Splitting
  19. Manipulation
  20. Power Struggles
  21. Avoidance and maintaining status quo
  22. Denial
  23. Treatment Strategies
  24. Education
  25. Emotional triggers
  26. Function of symptoms
  27. Brain functioning
  28. Shame/regret continuum
  29. Ego states
  30. Assessment of Scripts or narratives
  31. Function of behavior
  32. Rewriting the script
  33. Avoiding Power Struggles
  34. Integrating internal splits
  35. Acceptance and Commitment therapy
  36. Working with ego states,
  37. Empty chair
  38. Inner child metaphor
  39. Identifying that the client has dilemmas
  40. Split column journaling
  41. Acceptance of dialectics (DBT)
  42. Imbalance in status quo
  43. Concept of multiple motives
  44. Acknowledging alternatives
  45. Acknowledging exceptions to the rules
  46. Working with ego states
  47. Identifying and Avoiding projections
  48. Acknowledging the script
  49. Seeking wisdom from within
  50. Accessing client’s wisdom
  51. Combining wisdom
  52. Second order change
  53. Paradoxical interventions
  54. Reframing and relabeling
  55. Ordeal therapy
  56. Prescribing the symptom
  57. Group Therapy
  58. Experiential Training
  59. Case Consultation
  60. Empty Chair
  61. Role Play
  62. Sidestepping Projections
  63. Exploring Therapist Narratives

VII. Questions

5 Core CE Clock Hours by:

  • APA:  The Anxiety & Stress Management Institute (ASMI) is approved by the American Psychological Association to sponsor continuing education for psychologists.  ASMI maintains responsibility for this program and its content.
  • NBCC:  The Anxiety & Stress Management Institute has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 6502. Programs that do not qualify for NBCC credit are clearly identified. The Anxiety & Stress Management Institute is solely responsible for all aspects of the programs.
  • GSCSW:  This workshop is approved for 5 core CE hours through the Georgia Society for Clinical Social Work.
  • MFTs:  Related hours.

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For information about our Continuing Education Workshops, please contact our Continuing Education

Workshop Coordinator at:

770.953.0080 Ext. 333

Workshops@StressMgt.net