Resistance Is Not Futile: An experimental analogue of the effects of consultee "resistance" on the consultant's therapeutic behavior in the consultation process: A replication and extension

Abstract In the school system, school psychologist serves a role as consultant to teachers in regard to children's behavioral problems (Bergan & Kratchowill, 1990). The defining feature of children's success is plan implementation (Bergan & Kratochwill, 1990). For school psychologists, ensuring consistent and accurate implementation of behavior strategies and tactics is the defining feature of successful treatment (Piersel & Gutkin, 1983). Failure to implement is commonly referred to as treatment integrity. Based on our previous review of the research (Cautilli, Tillman, Axelrod, & Hineline, 2005), we concluded that treatment integrity goes beyond successful training procedures to the need for a behavioral analysis of the consulting relationship--in particular the area referred to as resistance. We propose that effective consultation consists of a repertoire of skills based on principles of behavior analysis for promoting effective action within the consultation relationship. However, this model is seriously hindered by the lack of such a functional analysis. This study presents an experimental analogue of resistance in the consultation process. Using an ABAB reversal design, the experimenter measured the ecological effects of teacher resistant behaviors on consultant therapeutic behavior. The results of the study found that participants decreased therapeutic questioning in response to consultee's resistance. In addition, teacher resistance also led to increased missed sessions by the consultant and greater negative perceptions of the consultee by the consultant. Key Words: Consulting relationships, functional analysis, resistance, treatment integrity. Introduction Resistance can be defined as anything that a client or consultee does that impedes progress (Wickstrom & Witt, 1983). What is termed resistance in consultation can have serious implications for treatment integrity (Wickstrom, Jones, LaFleur & Witt, 1998). Resistance to change in verbal therapies and consultation is a phenomenon that has substantial representation (Cautilli & Santilli-Connor, 2000; Patterson & Chamberlain, 1994) with some early representation within the behavioral literature (e.g., DeVoge & Beck, 1978; Skinner, 1957). Resistance appears to interest a broad spectrum of clinicians both behavioral (e.g., Lazurus & Fay, 1982; Munjack, & Oziel, 1978; DeVoge & Beck, 1978) and nonbehavioral (e.g., Mandanes, 1981) in orientation. In one study, Patterson and Forgatch (1985) explored the impact of therapist behavior (the independent variable) on client resistance (dependent variable). These researchers used an ABAB experimental design and observed the resistance displayed by parents in parent training for two conditions. The baseline involved the therapist using verbal behavior to convey "support" or "facilitate" (short statements indicating attention or agreement). In the treatment phase, the behavior of the therapist was to "confront" and "teach. " Resistance was measured by a coding system developed by Patterson and colleagues (Chamberlain, Patterson, Reid, Kavanagh, & Forgatch, 1984) which identified as resistant such behaviors as talking over/interrupting, challenging / confronting, negative attitude, "own agenda," not tracking as resistant. As was predicted by the model, teaching and confronting led to increases in resistance, while facilitate and support led to decreases in resistance. In Patterson's model, resistance serves three main functions: (a) it reduces the amount of confrontation and teaching the consultee receives; (b) it increases the number of sessions needed to bring about therapeutic change; and (c) it reduces the therapists' "liking" for the consultee. Patterson and Chamberlain (1994) found in cases where the mother's resistance decreased, greater gains were evident in parental discipline. In addition, regression analysis showed that decreasing "resistance" lead to more teaching of the parents and, in turn, decreases in future arrests of the child. …