Dealing with a patient's resistance to care plans. Can you effectively navigate their objections?

I wonder if building trust comes first before being able to understand why, as patients may be reluctant to share the truths until they can determine their trustworthiness. Also understanding the circumstances and situations are important before making calls about the resistance. If the patient has built mistrust from other healthcare entities, it is hard for one to trust. Easier said than done, as we often rely on others’ data for our own judgement when we are preparing for a conversation with patients. But wait...the data already have judgment from others in them… Another important thing to remember is the trust between/among providers who are in the care team.

I have come to understand some intricacies of holding back information by patient as lack of trust in treatment, lack of motivation, past trauma, ambivalence, attachment to the me and fear of the unknown. This needs to be addressed early in treatment it can interfere with treatment and it’s efficacy.

Trust is earned and this is a gradual process. Most patients with past trauma, paranoid personality, suspicious individuals may struggle with establishing therapeutic alliance as a way of protecting themselves, thus getting in the way of the treatment. One way to deal with this is to address their negative thoughts about their view of others and help them check the fact as well as educate on how this can be an hindrance to therapeutic goals.

I agree to educating clients early in treatment as to clear doubt, fear and misunderstanding about treatment and it outcome. This way the client I’ll be aware of the rise and fall, manage their expectations as well as give clear direction to empowering them to achieve their therapeutic goals.

Instead of reading unfavorable patient responses as “resistance to care,” I have often considered the potential multi-factorial complexity at play. Rather than resisting care, the individual may be embracing comfort with what is familiar, known, and stable in their life (even if dysfunctional or unhealthy) as opposed to what is uncertain, unknown, and uncomfortable. What if we are interpreting the unconscious fear of the unknown as the conscious rejection of hope? Could that misreading trigger our own bitter response, subsequently dulling motivation to go the extra mile needed in offering treatment and assistance to those in need? These are all important thoughts to explore as we shape our care-giving efforts and programs.