Resistance is an unfortunate term for the manifestation of defense mechanisms in the treatment situation. Use of the word to a psychoanalytically unsophisticated patient may evoke undesired consequences because to a patient, it implies deliberate intent and thus, blame. From the patient's unconscious, or at time conscious, point of view, these defenses protect the individual from a variety of intrapsychic or interpersonal dangers. As long as these defenses are in play, the process of exploration and discovery comes to a halt. They must be understood and carefully analyzed for they are at the heart of the treatment impasse. This book is written for the professional psychotherapist who may be puzzled why work with a particular patient or client is going nowhere. It brings to the therapist's attention a wide variety of these defenses, these resistances, so that they can be addressed and resolved.

This practical guide presents Leahy's multidimensional model of resistance in cognitive therapy. Richly illustrated with case examples and session vignettes, the book addresses a variety of ways that clients may resist basic therapeutic procedures: noncompliance with agenda setting and homework assignments, splitting transference with other therapists, inappropriate behavior, and premature termination. Underlying processes of resistance are explored, from the desire for validation to risk aversion and self-handicapping. Also highlighted are ways that the therapist's own responses may inadvertently impede change. Provided are innovative tools for getting treatment back on track, including targeted interventions, in-session "experiments," and questionnaires and graphic models to share with clients.

Working with Resistance is about heartache, grieving, letting go and moving on - as the patient's resistances are worked through and her defences are overcome. It is, therefore, a book about hope that arises in the context of discovering that it is possible to survive the experience of heartbreak, sadder perhaps but certainly wiser and more realistic.

A mixture of theory and practice, this study of individual and group resistance in psychotherapy is illustrated by numerous clinical vignettes. Offering techniques for handling and resolving resistance within the group setting, it should appeal to clinicians and group therapists.

A growing number of adolescents arrive in the therapist's office beyond adult control. Their behavior is outrageous, they use drugs heavily, and their moods fluctuate wildly. Nothing seems to work. If they stay in treatment, they make a shambles of the process. If they terminate prematurely, therapists may feel they never really got hold of the case; worse, they are not sure how they could have done so. Therapists looking at their interactions with patients will usually notice distinct patterns. The out-of-control patient usually shows a preference for one of five pathological patterns: narcissism, masochism, the paranoid stance, the schizoid defense, and affective lability. This book studies the five patterns of interaction typical of out-of-control adolescents, showing therapists how to recognize each and introducing interventions to interrupt them. When patients are forced into new, less comfortable experiences of themselves and their therapists, more honest exchanges become possible and more conventional treatment approaches become feasible.

Tough Kids, Cool Counseling offers creative techniques for overcoming resistance, fostering constructive therapy relationships, and generating opportunities for client change and growth. This edition includes a new chapter on resistance busters and updated and fresh ideas for establishing rapport, carrying out informal assessments, improving negative moods, modifying maladaptive behaviors, and educating parents. Suicide assessment, medication referrals, and therapy termination are also discussed. John and Rita Sommers-Flanagan clearly enjoy working with kids—no matter how tough—and their infectious spirit and proven techniques will help you bring renewed energy into the counseling process. *Requests for digital versions from ACA can be found on www.wiley.com. *To purchase print copies, please visit the ACA website *Reproduction requests for material from books published by ACA should be directed to [email protected]

With a new foreword by Raymond DiGiuseppe, PhD, ScD, St. John's University "Albert Ellis has written many books on his favorite topic Rational Emotive Behavior Therapy. Although he writes on that topic very well, he often does not write about generic psychotherapy. REBT is an integrative form of psychotherapy. Following this model, psychotherapists can incorporate many diverse techniques and strategies to change clients' dysfunctional behaviors and emotions . Much of what Al identifies as good REBT in this book is just good psychotherapy. Because people so universally identify Al with REBT, people may generally overlook his wisdom as a clinician. Having worked with Al for more than thirty years, I have been fortunate enough to learn from him. Much of the knowledge I learned from Al and cherish the most is not necessarily about REBT theory. They concern wise ways of thinking about clinical problems. That is why, out of all Al's books, this is my favorite. This is Al Ellis, the clinician." -- From the Foreword by Raymond DiGiuseppe, PhD, ScD, Director of Professional Education, Albert Ellis Institute; Professor and Chair, Department of Psychology, St. John's University Now available in an affordable paperback, this edition takes a look at the underlying causes of resisting cognitive-emotional-behavioral change and the methods used to overcome them. Written in present-action language, Ellis gives an overview of the basic principles of Rational Emotive Behavior Therapy and Cognitive Behavior Therapy. Ellis charts the changes in the field that have taken place in the 20 years leading up to 2002, when this edition was originally published. The book also integrates recent therapies into REBT, including psychotherapy, solution-focused therapy, and recent findings of experimental psychology.

Compassionate Therapy explores the characteristics of difficult clients and the nature of client resistance. Arguing that conflict can be a constructive force, it shows how practitioners can use the struggle to examine their own abilities, deepen their compassion, and improve therapeutic flexibility and effectiveness. It offers proven approaches to working through therapeutic impasses with difficult clients and blAnds professional development with personal growth.

RESISTANCE AND THE PROCESS OF THERAPEUTIC CHANGE Paul L. Wachtel Psychotherapy, whether practiced from a psychodynamic or a behavioral point of view,! is rarely as straightforward as textbooks and case reports usually seem to imply. More often the work proceeds in fits and starts (and often does not seem to be proceeding at all, but rather unraveling or moving backward). The "typical" case is in fact quite atypical. Almost all cases present substantial difficulties for which the therapist feels, at least some of the time, quite unprepared. Practicing psychotherapy is a difficult-if also rewarding-way to earn a living. It is no profession for the individual who likes certainty, predictability, or a fairly constant sense that one knows what one is doing. There are few professions in which feeling stupid or stymied is as likely to be a part of one's ordinary professional day, even for those at the pinnacle of the field. Indeed, I would be loath to refer a patient to any therapist who declared that he almost always felt effective and clear about what was going on. Such a feeling can be maintained, I believe, only by an inordinate amount of bravado and lack of critical self-reflection. But the therapist trying to get some ideas about how to work with 1 These are, of course, not the only two points of view in psychotherapy; nor do I believe they are the only two of value.