Intervention
Paradox Selection Guide
Match a client's specific resistance pattern to the appropriate paradoxical technique before selecting or designing an intervention.
This worksheet helps therapists select the right paradoxical technique for a specific client’s resistance pattern — from the fifteen techniques covered in the book — before designing the intervention. A paradoxical technique selected without a specific rationale is a guess; one selected after a careful fit analysis is a clinical decision.
Complete this worksheet after mapping the resistance function and before designing the intervention. Do not select a technique without first identifying what function the resistance serves. The technique must match the function, not just the symptom.
Paradox Selection Guide
Client (initials or identifier): _______________ Date: _______________
Description of the current resistance What does it look like, when does it appear, how long has it been present?
Apparent function of the resistance What is the resistance organized around? (Mark the most applicable.)
- Maintaining relational control — the resistance manages the therapist’s influence
- Avoiding specific material — the resistance is organized around one or more specific topics
- Symptom maintenance — the resistance protects the symptom’s function in the relational system
- Hierarchy management — the resistance is about the terms of the therapeutic relationship
- Other: _______________________________________________
Technique fit assessment Review the fifteen techniques. Note Strong fit / Possible / Not indicated for each.
| Technique | Fit | Notes |
|---|---|---|
| Symptom prescription — prescribe the symptom deliberately | ||
| Prescribing the relapse — assign a setback before next session | ||
| Restraining change — advise against changing too fast | ||
| Therapeutic double bind — present two options, both therapeutic | ||
| Positive connotation — attribute positive motive to symptom and system | ||
| The ordeal — assign disagreeable but acceptable task until symptom resolves | ||
| Prescribing the resistance — assign the resistant behavior as official task | ||
| Go-slow — express clinical doubt that change is advisable at this pace | ||
| Positioning technique — suggest problem is intractable to motivate defiance | ||
| Therapeutic surrender — declare genuine uncertainty, invite partnership | ||
| Benevolent sabotage — introduce small disruption to symptom pattern | ||
| Paradoxical homework — assignment useful whether completed or not | ||
| Symptom scheduling — assign the symptom to specific regulated times | ||
| Paradoxical reframe — shift the symptom’s meaning to serve client’s values | ||
| Resistance-as-alliance — build the working agreement from client’s objections |
Selected technique
Rationale — why this technique fits this client’s specific resistance function
Next-session plan
Delivery language (write out the specific phrasing): _______________________________________________
What to watch for: _______________________________________________
How to respond to the most likely client reactions: _______________________________________________
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