ABSTRACT
Just as therapists treat clients' therapy-interfering behaviours, so too must they treat their own behaviours that stop or reverse the progress of the treatment. Examples of such therapyinterfering behaviours include invalidating the valid, failing to target properly, not engaging the client in active problem solving, treating the client as overly fragile or reinforcing suicidal behaviour. These behaviours may result from some combination of the therapist's personal issues, clinical skills de®cits, strong emotions or cognitive distortions during the session, or contingencies imposed by the system. Often, the prompt for the therapist's problematic behaviour is the client's therapy-interfering behaviour. One therapist who had a habit of lecturing clients analysed this pattern of behaviour and discovered that it tended to occur when a client had remained unresponsive for a prolonged time. The therapist identi®ed the assumption that she had not explained things clearly enough as the intervening link. Once the therapist recognized this pattern, she mindfully let go of the assumption and focused instead on using DBT to treat the client's unresponsiveness. Just as the therapist shapes the client's behaviour, so the client shapes the therapist's behaviour. With some clients, in particular, the transaction between client and therapist may be such that the client punishes therapeutic behaviour and rewards iatrogenic behaviour. For example, one can easily imagine that if a client became verbally aggressive every time the therapist tried to address a presenting problem, the therapist may become less likely to target that problem.
