Accept or Change
Out of frustration, invalidation, or exasperation, some patients come to the clinical appointment venting and complaining without committing to treatment. The clinician cannot help but grow similarly frustrated—with the patient! This impasse is a threat to the success of the therapeutic alliance. This chapter describes a technique for challenging the patient to either accept their situation or commit to change. Achieving a clarity of purpose resolves much of the pressure that underlies both parties’ frustrations. This technique may exacerbate tension if not preceded by sufficient validation of the patient’s perspective.