Despite the efforts of therapists and patients, many patients in cognitive-behavioral therapy--or any therapy--do not improve. This unique book is designed to help the clinician better understand and work with patients who seem unable or unwilling to make needed changes. Integrating ideas from a range of psychotherapeutic approaches, the book presents a multidimensional model of resistance. It enumerates the specific impediments to change that may arise in the cognitive therapy context and brings each one to life with realistic clinical illustrations. Clinicians learn practical strategies and interventions to deal with a number of types of resistance, from reluctance to comply with basic cognitive procedures to risk-aversion and self-handicapping. Also addressed are countertransference issues, including workable ways that clinicians can modify their own responses to patients to overcome impasses in treatment.
"This book fills a major gap in the cognitive therapy literature, one that may often account for failure to attain therapeutic goals. The author, while committed to a cognitive model, shows a willingness to mine other therapeutic traditions for ideas that cognitive therapists can use. He has developed a well-thought-through typology of types of resistance, and provides a richness of clinical example and precise formulations of actions the therapist can take to help the patient overcome each type. This book will be an excellent text in courses in all the therapeutic disciplines. It will be especially useful for students in such professions as social work, who will encounter many clients who are induced by environmental and socialization influences to erect barriers to change."--Charles Garvin, PhD, School of Social Work, University of Michigan
"For any cognitive-behavioral clinician who has ever asked, 'Why am I having such a difficult time helping my client change?', Leahy has provided an engaging, thought-provoking, integrative text that addresses this question most effectively. The text will appeal to therapists at all levels of experience, offering interesting variations on conceptual themes about why clients think and act in ways that maintain their problematic status quo in life, and in therapy. The book also succeeds in guiding therapists to assess and manage their own unwitting contributions to their clients' resistance, and thus become more adept in helping clients to progress."-Cory F. Newman, PhD, ABPP, Director, Center for Cognitive Therapy, University of Pennsylvania School of Medicine
"Every so often, a clinical text is written that offers an innovative, rich perspective on a previously neglected problem of immense clinical importance. This volume achieves such heights. A 'must read' for any clinician who has been challenged by resistance in the therapy session, the volume is full of practical insight and treatment suggestions presented in a scholarly, thoughtful, and yet pragmatic fashion. Leahy addresses a significant gap in the cognitive-behavioral literature, integrating his clinical experience with psychoanalytic, behavioral, developmental, social, and cognitive theory and research on the topic. Whether a novice or expert in cognitive therapy, the reader will find this a stimulating and thought-provoking text with immediate application to the therapy session. It will be a valuable resource for graduate courses or professional workshops on cognitive therapy."-David A. Clark, PhD, Department of Psychology, University of New Brunswick, Canada
"This volume fills an important gap. In his inimitable style, Robert Leahy addresses a topic that has been neglected by cognitive-behavioral therapists: how to work effectively with the client who is reluctant to embrace the many technical interventions the therapy offers. The book is easy to read and immediately useful to all cognitive-behavioral therapists, from students to experienced clinicians. This book will serve as an excellent supplementary text for graduate courses in cognitive-behavioral therapy. It is thought-provoking and rich, with dozens of clinical examples of effective work by an experienced and masterful therapist."-Jacqueline B. Persons, PhD, San Francisco Bay Area Center for Cognitive Therapy, and University of California, Berkeley