Learning to Identify Errors in Managing Resistance & Ambivalence in Therapy: A Video Analysis Workshop
Teaching therapists to ‘code’ therapy process - to explicitly tune in to and pick up on these signals (or process ‘tells’), is a new direction in training to help therapists become ‘process experts’ on a moment-by-moment basis as therapy is unfolding. These process markers, especially of unproductive process (at times of resistance, noncompliance, stuckness, criticism, etc.) are often hidden and difficult to spot without training. As a result, therapists inadvertently make responsiveness errors because they don’t recognize the signs and are not taught how to use them to steer the process back on a productive track.
In this workshop, we will use in depth analysis of video examples and lots of practice with feedback. You will learn how to identify the classic observable signs of unproductive, repetitive cycles that we all fall into that keep therapy from moving forward. You will learn to become adept at quickly identifying / diagnosing the quality of the collaboration on a moment-by-moment basis in real time during therapy; and then learn how to get it back on track when it’s off. These skills cut across therapy approach and diagnosis. Westra and Di Bartolomeo (2024) underscore the importance of being attuned to micro-moments in session as a way to track client progress in real time (i.e., Process Coding) and improve therapist responsiveness. Similarly, the method of Deliberate Practice (i.e., thoughtful and systematic continuous practice with expert feedback) has continued to demonstrate superiority to more passive training models in psychotherapy workshops (e.g., Chow et al., 2024; Westra et al., 2021). This workshop will harness both methods (i.e., Process Coding and Deliberate Practice) to improve your recognition and responsiveness to challenging therapeutic moments.
As part of this workshop, you will complete a pre- and post-workshop test of your skills (follow the YouTube link to complete the first half of the test). This will give you a sample of the kinds of difficult situations we will consider in the workshop and you will learn how to score your responses in the workshop (as well as how to generate effective responses).
Objectives. In this workshop you will:
- Learn to differentiate productive from unproductive therapy process
- Learn to decode and detect typically hidden signals of disengagement, noncollaboration, rupture & reluctance (the ‘tells’)
- Re-engage clients by responding effectively in empirically supported ways to signals of negative process
- Hone your attention to the ‘tells’ of negative process & improve your nonverbal sensitivity
- Identify therapist errors in managing resistance and ambivalence
- Practice and receive feedback on your responses to and management of ambivalence, resistance, and negative process
- Build nonreactivity and resilience to difficult interpersonal situations and impasses
Dates & Locations
One Day Workshop (9 – 4:30 pm):
- In-person version of this workshop on Monday, April 14, 2025 at York University
- Online version on Friday, May 16, 2025
Presenters:
Dr. Henny Westra is a professor at York University, with a particular interest in training process sensitivity, especially learning to recognize and work with resistance and ambivalence. For over 30 years, she has researched, published and presented widely on Motivational Interviewing, CBT, and Psychotherapy Process. She is the author of "Motivational Interviewing in the Treatment of Anxiety" and the upcoming book (2025) with Boritz & Eubanks titled “Developing Process Sensitivity: A Transtheoretical Path to Improving Psychotherapy Training”
Dr. Jordan Harris is lead author of the book Deliberate Practice in Multicultural Therapy. Dr. Harris is also co-developer of the Private Practice Incubator, a coaching program teaching therapists how to leave community-based work and start their own solo counseling practices. You can follow him at JordantheCounselor.com.
Alyssa Di Bartolomeo is a PhD Candidate in Clinical Psychology at York University. Her research focuses on psychotherapy training, with a particular focus on harnessing novel training practices (e.g., process coding and deliberate practice) to improve therapist responsiveness to challenging interpersonal moments.
Links to the 2 Pre-tests:
Resistance Vignette Task (RVT): https://youtu.be/5bcHq_Z3Y-E
Therapist Errors in Managing Resistance (TERM): https://youtu.be/ASWDBJ1pfMU
Readings and Podcast:
Westra, H.A. & Di Bartolomeo, A. (2024). Developing expertise in psychotherapy: The case for process coding as clinical training. American Psychologist, 79(2), 163-174. (Selected as “Editors’ Choice” - papers that represent the best science, reflecting science that is exceptionally important, impactful, and deserves additional visibility for the whole field.)
Podcast: The Future of Therapy Training, https://podcasts.apple.com/us/podcast/the-future-of-therapy-training-exploring-process/id1427537186?i=1000655188660