The author's viewpoint is understandable however he/she sounds frustrated by the power struggle with the patient for control. I suggest that the best way to win is not to play. I will talk about myself and my feelings about the situation (sad, mad, scared,glad) and ask the "magic question"-"How can I help you?" Once the patient commits to their own request, the patient will be less likely to be non-compliant as they are making the rules. In these situations,the more I talk about me and the less about them, the less defensive or oppositional the patient is. I tell the patient what I can and cannot do in case they have unrealistic expectations or a hidden agenda.