The term ‘confrontation’ often gets a bad wrap.

Read on to learn what therapeutic confrontation is, and how it can be an effective strategy in a counseling session.

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What is Therapeutic Confrontation?

When you think of confronting someone, it rarely sounds like the path you want to take to keep the situation from becoming violent or hostile. Luckily, therapeutic confrontation can be incorporated into counseling strategy to identify behaviors or trends, talk through an issue, and bring about a realistic solution.Confrontation is beneficial to your client or patient for a number of reasons. It can effectively:

  • Promote insight and awareness
  • Reduce resistance
  • Promote open communication
  • Lead to changes in behaviors, emotions, and actions (MacCluskie, 2010)

How Confrontation is Used

Confrontation can be a great intervention, or it can create communication barriers that shut down the client with slim hope of addressing the topic. Talk about walking a thin line! Consider that you are applying therapeutic confrontation to your first client of the day, Frank.

You are asking him to evaluate his reality compared to what he verbalized to you in last week’s session. In other words, you are hoping to sort out the difference between Frank’s stated emotions and his behaviors.

Frank’s Situation

In this morning’s session, you are hoping to identify and address the gap between Frank’s stated desire to abstain from illicit drug use and his strong connection to his friends from the past.Throughout the session, Frank states his willingness to attend meetings and his strong emotional stance against drug use.

Ever since he’s gotten clean, he explains, he has been a better father to his two young kids.You begin to probe Frank about his social support systems, and you ask who he is able to talk to on a regular basis. Frank mentions that he doesn’t really have anyone he can trust except for his old friends. You know from previous sessions that Frank’s old friends were heavily involved in his bad habits. Frank tells you that his old friends were always there for him, and even though they still use drugs, he relies on them for emotional support.

Using Therapeutic Confrontation to Help Frank

You start by repeating some of what Frank has said to confirm that you have received his intended message.

Next comes the confrontation, and you have the power to make this an effective or ineffective session.

  • Bad Confrontation: ‘You are putting yourself at risk. Hanging out with your old friends does not help your situation.

    I know too many people who got caught up in their old circles. Aren’t you thinking about your children at all?’

  • Good Confrontation: ‘Frank, I’m hearing that you feel focused on your recovery, yet you are still leaning on your old crowd quite a bit for support. I know you have had a tight bond with them for many years. But, don’t you think that you might fall back into old habits by remaining associated with them?’

Lesson Summary

By therapeutically confronting Frank, you have raised a serious, yet important topic. Frank may not even realize that what he is saying (that he is strongly against falling back into old habits) is conflicting with his behaviors (hanging out with old friends).

Even though confrontation is not the easiest technique to use, it is an essential and effective strategy for many counseling situations.


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