Confrontation increases the counselor's level of understanding as well as helping the client form a more realistic perspective of incongruous perceptions. Ultimately, this counseling skill helps to "identify and process discrepancies that may resolve with clarification" (Knapp, 2008, p. 139). Leaman (1978) defines confrontation as "an open, honest identification of the client's self-defeating patterns or manipulations" (p. 630). Gadgila, Nokes-Malacha, and Chib (2011) believe that when individuals are forced to compare their flawed perceptions with a realistic model, it can work as a self-explanation toward changing misconstrued beliefs and ideas. Used as a device in counseling, it must be implemented carefully and consciously to "point out the contradictions of their self-defeating thoughts, actions, and feelings" (Spadero, 2012, para. 9).
The following hypothetical situation demonstrates the appropriate use of confrontation in counseling. In this case, the counselor has been working with a woman who was consistently sexually abused by her father from age three through 15. Although she understands, from a logical perspective, that her father was wrong and his abuse continues to cause her severe distress, she maintains that she and her father had a very good relationship. After several sessions the counselor believes the relationship with the client is strong and decides to confront the client regarding the inconsistency with which she refers to her father. The counselor says she hears her client say she understands the victimization she suffered because of her father's abuse, yet she continues to refer to the good relationship she and her father had. The counselor adds that it must be confusing sometimes to integrate both those feelings. After a few moments of silence the counselor asks how she feels about what the counselor just said.
As reasoning for this confrontation, the counselor believes until her client can grasp the dysfunction in her relationship with her father, she will continue to blame herself and take responsibility for his actions. As explained by Zinzow, Seth, Jackson, Niehaus, and Fitzgerald (2010), blaming oneself, even as an adult who can clearly understand the spurious nature of the childhood abuse, is common. Women continue to blame themselves even though they realize logically that children are not consenting players in their abuse. Zinzow et al. (2010) contend in many cases, girls take blame for their abuse, perhaps to maintain some consistency between their experiences and their expectations for the father's role. During confrontation, the counselor may identify and explain how compensatory behavior, such as blaming oneself rather than the perpetrator, causes continued negative consequences such as illness, depression, and misplaced anger (Murtagh, 2010).
The confrontation, in this case, may help the client begin to replace the maladapted thoughts with a more appropriate, logical, adult perspective, in essence, giving the client an opportunity to free herself from the constraints of guilt related to her abuse. Leaman (1978), however, believes confronting maladaptive behavior is a difficult task in counseling. Furthermore, the challenge of integrating new information with the old may be difficult for the client, and the counselor must be sensitive to the client's ability. This type of confrontation would not take place until the counselor is confident in the strength of the client/counselor relationship. Until the relationship is strong, confrontation may not be effective. Worse, it can make clients defensive or cause undue emotional stress (Knapp, 2008).
Degree of Comfort Using Confrontation
Although I have not had the opportunity to use confrontation under any circumstances except for mock counseling sessions, I believe I would be comfortable using this counseling skill with clients when appropriate. The perceptive observation and acknowledgment of inconsistencies with clients is critical; it forces reflection and makes constructive corrections in their belief systems. It can also help to extinguish belief perseverance, which is a common human inaccuracy that surfaces in healthy individuals as well as those struggling with challenges. Furthermore, confrontation helps the counselor better understand the genuine effects of the client's history and experience, thereby contributing to the effectiveness of the therapeutic alliance (Knapp, 2008).
Supporting my personal level of comfort with using this skill, is understanding the purpose and value of facing oneself realistically as an integral part of the therapeutic process (Leaman, 1978). Confrontation awakens the client to personal inconsistencies and contradictions that may contribute to ongoing issues, but involves acknowledging the often harsh realizations of one's inaccurate perceptions. "Counselors sometimes forget how difficult it is to face oneself honestly and how painful vulnerability can become" (Leaman, 1978, p. 631). As a counselor, I intend to support my clients as they move from vulnerability to the strength and empowerment that comes with honest self-evaluation and self-acceptance.
Confrontation in counseling, as in life, is not always comfortable. Like acknowledging or reporting abuse or suicidal behavior, the comfort lies in knowing the action or the process is ultimately beneficial to the client. Although caveats for its use exist, confrontation in counseling has profound purpose and its knowledgeable and deliberate use can benefit the therapeutic alliance and contribute to the forward movement of clients.
Gadgila, S., Nokes-Malacha, T. J., & Chib, M. T. (2011). Effectiveness of holistic mental model confrontation in driving conceptual change. Learning and Instruction, 22(1), 47-61. doi: 10.1016/j.learninstruc.2011.06.002
Knapp, H. (2007). Therapeutic communication: Developing professional skills. Thousand Oaks, CA: Sage Publications, Inc.
Leaman, D. R. (1978). Confrontation in Counseling. Personnel & Guidance Journal; Jun78, 56(10), 630-633.
Murtagh, M. P. (2010). The Appropriate Attribution Technique (AAT): A new treatment technique for adult survivors of sexual abuse. North American Journal of Psychology, 12(2), 313-334.
Spadero, N. (2012, July 16). Welcome to Week 7 From Dr. Nina [E-mail to the author]
Zinzow, H., Seth, P., Jackson, J., Niehaus, A., & Fitzgerald, M. (2010). Abuse and Parental Characteristics, Attributions of Blame, and Psychological Adjustment in Adult Survivors of Child Sexual Abuse. Journal of Child Sexual Abuse, 19(1), 79-98. doi: 10.1080/10538710903485989