ABSTRACT
Recent findings (Zeiss, Breckenridge, Gallagher, Silven, Schmit, & Thompson) indicate that client noncoopera-tiveness is characteristic of a sizable proportion of depressed elders receiving short-term outpatient psychotherapy. That is, even among those clients whose depressive symptoms remit by the end of therapy, pervasive failure to cooperate with the treatment procedures appears to be an extremely common phenomenon. In psychodynamic therapy, resistance to treatment might be regarded by the therapist as a natural and perhaps even welcome opportunity to examine the client’s dysfunctional behavior and internal dynamics. In more structured cognitive-behavioral approaches, however, client noncooperativeness would seem to limit the client’s opportunity to practice and thereby learn the cognitive and behavioral coping skills which the therapy attempts to provide. The following is a description of the course of short-term cognitive-behavioral therapy with a minimally cooperative elderly depressed client. This client’s noncooperativeness presented serious challenges to the establishment of a collaborative therapeutic relationship.
