Client Pushback Isn't Resistance (and the Field Already Knows It)
Somewhere along the way, a lot of us picked up "resistant" as clinical shorthand for a client who pushes back. Declines a topic. Says an intervention didn't work. Asks for something different than what we planned. The word shows up in notes, in case consults, in supervision, almost always describing the client and never describing the moment between two people.
Here's what's worth knowing: the field that arguably relies most heavily on this concept has already abandoned the word.
Motivational Interviewing already made this move
In the third edition of Motivational Interviewing, Miller and Rollnick did something clinicians don't talk about enough. They removed "resistance" from the model entirely. Their own glossary describes it plainly: a term previously used in the field, now deconstructed into its actual components, sustain talk and discord (Miller & Rollnick, 2013).
The reasoning matters as much as the change itself. "Resistance" placed all responsibility for friction in the therapeutic relationship on the client, and none on the clinician. Discord, by contrast, names something that happens between two people: a mismatch in pace, in approach, in what each person thinks should happen next. Sustain talk names something that isn't pathological at all, a normal, human ambivalence about change that shows up in essentially everyone who's ever tried to change something hard.
This isn't a fringe reframe. It's a correction made inside the model most associated with addressing exactly this kind of client behavior, and it's been the standard for over a decade.
What this looks like in an actual session
"I don't want to talk about that today" often gets filed as avoidance. It's frequently just accurate pacing, a client managing what they can handle in a given session better than their clinician is.
"That didn't work" often gets filed as non-compliance. It's actually the clearest, most useful feedback a clinician will get on their own intervention, delivered directly instead of through six more sessions of quiet disengagement.
"Can we do something different?" often gets filed as resistance to treatment. It's self-advocacy, and depending on how you think about the actual goal of therapy, it might be the outcome you were working toward the whole time.
Whose comfort the label protects
Here's the part worth sitting with in supervision. When friction gets labeled resistance, the clinician's approach is protected from scrutiny by default. The chart says the client wasn't ready, wasn't engaged, wasn't motivated. It rarely says the clinician moved too fast, missed the client's actual goal, or kept pushing an intervention past the point it was working.
Discord doesn't protect either party by default. It asks a genuinely harder question: what's happening between the two of us right now, and whose pace, whose approach, whose definition of progress is currently running the session.
What to do differently
When you feel the pull to write "resistant" in a note, pause and ask what actually happened. Did the client decline, redirect, or give feedback, or did something else occur?
Treat direct pushback as data about the fit between your approach and this specific client, not as a trait belonging to the client.
In supervision, ask whether "resistance" language in a case presentation is describing the client's behavior or protecting the clinician's approach from examination.
None of this means every difficult moment in a session is secretly your fault as the clinician. It means the field's own most rigorous thinking on this already moved past a word that assumed exactly that split, before assuming anything else.
If you want a deeper framework for examining where clinical discomfort gets mislabeled as client pathology, that's part of what Responsive Boundaries walks through.
[Explore Responsive Boundaries →]
References
Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd ed.). Guilford Press.