ABSTRACT
This chapter outlines behavioral strategies to maximize the potential for compliance and offers specific techniques based on these strategies for managing the noncompliant patient. Compliance behavior cannot be predicted from demographic and socioeconomic characteristics. Noncompliance results from social variables over which the patient has little or no control. Zifferblatt specified two steps in the enhancement of compliance behavior. The first, determining the problem, requires special attention to specific patient behavior. The second step in affecting compliance behavior consists of teaching the patient to take responsibility for the management of the problem. Early attempts to facilitate compliance consisted of operant conditioning procedures, including reinforcement, shaping, and contingency contracting. To increase compliance, the patient's psychological resistance must be reduced. The physician or other health care professional should detail the desired behavior to the patient and collaborate with the patient in working out a stepwise approach to accomplish the goal.
