| Course | PAC 240 Helping Skills |
|---|---|
| Module | Module 4 |
| Paper type | Ambivalence and resistance paper |
| Length | About 1,075 words, 6 pages |
| Format | APA 7 student paper |
| School | Aspen University |
| Program | Psychology and Addiction Studies |
| Updated | October 2026 |
Free sample paper for PAC 240 Module 4
"CPS Is Overreacting": Ambivalence, Reactance and Motivational Responses to a Mother Mandated to Treatment
Student Name
Psychology and Addiction Studies Program, Aspen University
PAC 240: Helping Skills
Instructor Name
Month Day, Year
"CPS Is Overreacting": Ambivalence, Reactance and Motivational Responses to a Mother Mandated to Treatment
Marisol is twenty-eight and the mother of a six-year-old and a three-year-old. Two months ago, a child protective services worker visiting after a neighbor's report found methamphetamine in her kitchen. Her children stayed with her under a safety plan that requires treatment and drug testing. At her first session at Riverside Recovery Services, the invented program used in this course, she said she uses only on weekends, when the children are with their grandmother, that meth helps her get through double shifts as a home health aide and that CPS is overreacting. Her previous counselor, at another agency, had told her she was in denial, and she stopped going. This paper examines how to respond to Marisol's resistance. She and the program are composites built for teaching; the research is real.
Resistance Reconsidered
Resistance has often been treated as a trait of people with addictions, part of a supposed personality marked by denial. Motivational interviewing offers a different view. In this view, most people with substance use problems are ambivalent: they see reasons to change and reasons to stay the same. What looks like resistance is often sustain talk, statements in favor of the status quo, and it is shaped by the interaction. When a counselor argues for change, the client tends to argue the other side.
Marisol's statements fit this view. She defends her use, but she also took a job that requires her to be reliable, kept her children with her and came to her first session. Her stance is ambivalent, not simply defiant.
How Counselor Behavior Shapes Client Language
Moyers et al. (2009) studied recorded sessions from a trial of motivational interviewing for drinking. They coded counselor behaviors and client language and followed clients' drinking afterward. Counselor behaviors consistent with motivational interviewing, such as reflections, open questions and emphasizing autonomy, were followed by more client change talk, statements about desire, ability, reasons or commitment to change. Behaviors inconsistent with motivational interviewing, such as confronting or warning, were followed by more sustain talk. Client language in turn predicted drinking outcomes. The authors described a causal chain: counselor behavior shapes client language, and client language shapes later behavior.
Magill et al. (2018) tested these links across many studies in a meta-analysis. Counselor skills consistent with motivational interviewing were associated with more client change talk, and inconsistent skills with more sustain talk. Client language was associated with later outcomes, with sustain talk in particular linked to worse results. The meta-analysis supported the idea that what clients say in session matters, and that counselors influence what clients say.
Reactance
Some clients are especially sensitive to threats to their freedom. Beutler et al. (2011) conducted a meta-analysis of studies examining how clients' level of reactance, a tendency to resist when they feel controlled, affects their response to directive and nondirective therapy. Clients high in reactance did better with less directive approaches, while clients low in reactance did better with more directive ones. The effect was substantial.
Marisol shows signs of high reactance. Her experience with CPS, a previous counselor who called her in denial and a lifetime of authorities telling her what to do have left her alert to control. A directive approach, telling her what she must do, would likely increase her pushback.
Two Responses
The first response is the kind she received before.
The second response follows motivational interviewing.
| Speaker | Words | Effect |
|---|---|---|
| Marisol | "I only use on weekends when the kids are at my mom's. CPS is overreacting." | Sustain talk |
| Counselor A | "Using meth on weekends is still dangerous, and you're in denial if you don't see that. You need to stop completely." | Confrontation and warning |
| Marisol | "You sound just like them. I'm not an addict. I work, I take care of my kids." | More sustain talk; defensive |
| Speaker | Words | Effect |
| Marisol | "I only use on weekends when the kids are at my mom's. CPS is overreacting." | Sustain talk |
| Counselor B | "You've been careful to keep it away from the kids, and it feels like CPS isn't seeing that." | Reflection; acknowledges her care |
| Marisol | "Yeah. I'd never use around them." | Shows her values |
| Counselor B | "Being a good mom matters a lot to you. What worries you most about all this?" | Reflection of meaning; open question |
| Marisol | "That they'll take them. And honestly, the double shifts, I can't do them without it anymore." | Change talk: fear, and admission of dependence |
Why the First Counselor Failed
Marisol's first counselor was not wrong that weekend methamphetamine use is risky. The problem was the response. By naming denial and insisting on complete abstinence in the first meeting, the counselor took the side of change, which left Marisol to take the side of staying the same. In Moyers and colleagues' terms, the counselor's confrontation produced sustain talk; in Beutler and colleagues' terms, a directive approach met a highly reactant client. Marisol's decision to stop attending was a predictable outcome of that exchange, not proof that she was unwilling to change.
Guidance for the Next Sessions
Several practices follow from the research. First, avoid arguing for change, which tends to produce sustain talk. Second, emphasize Marisol's autonomy: the choices about her use are hers, even though CPS has requirements. Third, be clear and honest about those requirements, such as drug testing, without using them as threats. Fourth, explore what matters to her, especially her role as a mother and her worry about the double shifts. Fifth, use reflections that highlight change talk when it appears, such as her admission that she cannot work double shifts without meth. Finally, given her reactance, offer options rather than directives, for example asking whether she would like to hear about how others manage fatigue on long shifts.
The children's safety remains a fixed point. A motivational approach does not mean ignoring risk; it means engaging Marisol in a way that makes change more likely, which is the best protection for her children.
Conclusion
Marisol's statement that CPS is overreacting is sustain talk within ambivalence, not simply denial. Moyers and colleagues and Magill and colleagues show that counselor behavior shapes whether clients voice change or sustain talk, and that this language predicts outcomes. Beutler and colleagues show that clients high in reactance, like Marisol, do better with less directive help. Responding with reflections, respect for her autonomy and curiosity about what matters to her allowed Marisol to name the problem herself.
References
Beutler, L. E., Harwood, T. M., Michelson, A., Song, X., & Holman, J. (2011). Resistance/reactance level. Journal of Clinical Psychology, 67(2), 133-142. https://doi.org/10.1002/jclp.20753
Magill, M., Apodaca, T. R., Borsari, B., Gaume, J., Hoadley, A., Gordon, R. E. F., Tonigan, J. S., & Moyers, T. (2018). A meta-analysis of motivational interviewing process: Technical, relational, and conditional process models of change. Journal of Consulting and Clinical Psychology, 86(2), 140-157. https://doi.org/10.1037/ccp0000250
Moyers, T. B., Martin, T., Houck, J. M., Christopher, P. J., & Tonigan, J. S. (2009). From in-session behaviors to drinking outcomes: A causal chain for motivational interviewing. Journal of Consulting and Clinical Psychology, 77(6), 1113-1124. https://doi.org/10.1037/a0017189
Reading the PAC 240 Module 4 assignment instructions
Resistance is a classic topic in addiction counseling, and PAC 240's fourth module typically asks you to analyze how a counselor responds to a client who pushes back and what research says about better responses. Take the Module 4 page in your Aspen course as the authority, with Marisol standing in as a composite. Reframe resistance in terms of ambivalence and the relationship. Present research on how counselor behavior affects client language and outcomes. Consider individual differences such as reactance. Analyze an actual exchange, contrasting less and more helpful responses. Plan next steps, and cite the research behind each response in APA 7. Where safety rules apply, as with children in the home, explain how you will state them without using them as threats.
How this PAC 240 Module 4 example is built
Marisol says she uses only on weekends when the children are with their grandmother and that CPS is overreacting. The paper reframes her statements as sustain talk within ambivalence. Moyers and colleagues' coded-session study shows counselor behaviors shaping client change and sustain talk, which in turn predicted outcomes. Magill and colleagues' later meta-analysis confirms the links across many studies. Beutler and colleagues' Journal of Clinical Psychology meta-analysis explains why a directive approach would likely backfire with her. A two-part exchange contrasts a confrontational response with a motivational one. Guidance covers emphasizing autonomy, stating CPS requirements honestly and exploring her goals as a mother and her exhaustion from double shifts.
Where the marks sit in the PAC 240 Module 4 rubric
Resistance papers earn credit for reframing resistance accurately, for reporting research on counselor behavior and for demonstrating better responses in dialogue. This example shows both versions of the exchange, so the reader can see how counselor words change client words. Research is reported at the level of mechanism, explaining why sustain talk matters. Reactance is applied to Marisol's history with authorities, which makes the individual difference concrete. The guidance protects her autonomy while keeping her children's safety in view, a balance mandated cases require. The analysis treats Marisol with respect throughout, which is the stance the research recommends. Her children's safety stays fixed while the approach stays collaborative.
PAC 240 Module 4 help from the desk
Students often describe resistance as a client trait, calling clients resistant or in denial. Research suggests resistance arises in the interaction and reflects ambivalence and the relationship. Present research on how counselor behavior affects client language. Consider individual differences, such as reactance, that call for a less directive approach. Show exchanges in dialogue, contrasting responses. Avoid arguing with clients, even when they minimize; arguing tends to strengthen sustain talk. In mandated cases, keep safety requirements clear while respecting autonomy. Plan concrete next steps. Count the client's change and sustain statements in your exchange if you can; numbers make the analysis sharper. Keep the client's exact words in the transcript.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Aspen University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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PAC 240 Module 4 questions, answered
What does PAC 240 Module 4 usually ask for?
Aspen's PAC 240 addresses ambivalence and resistance in this module, so analyzing responses to a client who pushes back, with research on better responses, is typical. Review your Module 4 prompt.
Is resistance a client trait?
Research suggests it arises in the interaction; Moyers and colleagues found counselor behaviors shaped whether clients voiced change or sustain talk.
What is reactance?
A tendency to resist perceived threats to one's freedom; Beutler and colleagues found highly reactant clients do better with less directive approaches.
Where can I find a free PAC 240 Module 4 sample paper?
The complete paper is above: ambivalence and resistance with a mandated mother, with an annotated exchange and guidance for the next sessions.
What is sustain talk?
Client statements in favor of keeping the current behavior; Magill and colleagues found it linked to counselor behaviors and to outcomes.