ABSTRACT
This chapter discusses an approach to addressing therapeutic difficulties. Problems in the therapeutic alliance, either with the parent or the child, deserve some additional consideration. As mentioned, there are common factors that can interfere with this alliance, such as competing demands on people's time, ambivalence about therapy, shifting intensity of symptoms, and unexpected crises in the life of the child or family. Some people relate better to boys, others to girls. Similar cultural background can facilitate the therapeutic alliance, while cultural differences can result in miscommunication and unintended rifts in the alliance. Many problems addressed in Cognitive Behavioral Therapy (CBT) relate to facing something new, whether it is facing a fear, facing a situation where one normally engages in rituals. A good analogy for challenges in CBT is that of a car radio. Listening to music on the car radio, there are two possible problems. One problem is the presence of weather patterns, other is strength of the signal.
