Resistance.

Abstract

This article reviews extant literature on how patient resistance has been defined and its effects on psychotherapy. Resistance has been considered as both a patient-in-treatment state and as an enduring trait. In either form, patient resistance seems to interfere with treatment outcome. Resistance also Junctions as a moderating variable in determining the effectiveness of different levels of therapist directiveness. The evidence that patients who enter treatment with high levels of traitlike resistance will benefit most from nondirective interventions is moderately strong. Conversely, those who enter treatment with low levels of traitlike resistance benefit most from therapist directed interventions. Therapeutic practices associated with the research evidence are advanced.While some experts (e.g., Lambert, 1992;Wampold, 2001) assert that specific techniques offer little advantage over the experience of being understood and affirmed in an environment of safety, in the past decade, evidence has begun to accumulate that there are specific factors that affect psychotherapy (Chambless & Ollendick, 2001;Nathan & Gorman, 1998). Thus, while many authors conclude that highly specialized

A Theoretical Model of Common Process Factors in Youth and Family Therapy

“…Hill and Knox (2002) suggest that therapist self-disclosure should depend on client characteristics but there is no research that documents what these characteristics should be. Not surprisingly, when therapist behavior has not been responsive to pretreatment client characteristics (e.g., being directive with a resistant client), this has often resulted in poor treatment outcomes (Beutler, Rocco, Moleiro, & Talebi, 2001). However, as important as this probably is, a literature search revealed that very little work has examined the impact of client characteristics on therapist behavior in youth mental health treatment research.…”

Mental Health Care Providers’ Views of Their Work with Consumers and Their Reports of Recovery-Orientation, Job Satisfaction, and Personal Growth

“…Specifically, directiveness may occur when providers initially listen to consumers' goals, but ultimately make decisions and direct consumers in ways that are inconsistent with consumers' stated goals. Previous studies suggest that providers' directiveness can result in increased client resistance to treatment (Beutler et al 2001) and that less directiveness by therapists resulted in outcomes for reactant clients in treatment for alcoholism (Karno and Longabaugh 2005). For example, in a study of 51 consumers involved with mental health courts, Pratt et al (2013) found that consumers' perceptions of negative pressures (i.e., perceived injustices during court proceedings) from professionals statistically predicted their future involvement with the criminal justice system.…”

Limited Motivation, Patient-Therapist Mismatch, and the Therapeutic Alliance

“…However, some patients may be reactant, where they feel as if a didactic approach can be an authoritative stance, which can lead to resistance (Brehm, 1976 ) , and some research has indicated that people with a propensity for such reactance do not fare as well with CBT (Beutler, Rocco, Moleiro, & Talebi, 2001 ) . Therapist behavior has been indicated to increase or decrease resistance (Patterson & Forgatch, 1985 ) , and a therapist's relational style can indeed impact patient motivation (Norcross, 2002 ) .…”