ABSTRACT
Cognitive behavioral therapy (CBT) presents many opportunities for noncompliance or resistance to change. Whereas psychodynamic therapy “requires” openness to the stream of thoughts and emotions but places the patient in a relatively passive role, with CBT the patient is expected to actively engage in challenging negative thoughts and behavioral exposure to anxiety-provoking situations. A number of points of noncompliance or resistance as “procedural resistance”—where the noncompliance focuses on the specific procedures or interventions implicit in the cognitive model-have been discussed elsewhere (i.e., Leahy, 2001). The clinician can anticipate the possibility of noncompliance by relying on psychoeducation, clarifying homework assignments, shaping, modeling, utilizing rewards, increasing contingency, or using response cost (Leahy, 2001).
