2,138
Views
5
CrossRef citations to date
0
Altmetric
EMPIRICAL PAPERS

The impact of resistance on empathy in CBT for generalized anxiety disorder

, , &
Pages 606-615 | Received 21 Aug 2015, Accepted 22 Sep 2016, Published online: 19 Oct 2016

References

  • Ahmed, M., Westra, H. A., & Constantino, M. J. (2012). Early therapy interpersonal process differentiating clients high and low in outcome expectations. Psychotherapy Research, 22, 731–745. doi:10.1080/10503307.2012.724538
  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
  • Aspland, H., Llewelyn, S., Hardy, G. E., Barkham, M., & Stiles, W. (2008). Alliance ruptures and rupture resolution in cognitive-behavior therapy: A preliminary task analysis. Psychotherapy Research, 18, 699–710. doi:10.1080/10503300802291463
  • Aviram, A., & Westra, H. A. (2011). The impact of motivational interviewing on resistance in cognitive behavioral therapy for generalized anxiety disorder. Psychotherapy Research, 21, 698–708. doi:10.1080/10503307.2011.610832
  • Aviram, A., Westra, H. A., & Eastwood, J. (2011, September). Patterns of early resistance and client outcome in cognitive behavioral therapy. Paper presented at the meeting of the North American Society for Psychotherapy Research, Banff, Canada.
  • Barrett-Lennard, G. T. (1962). Dimensions of therapist response as causal factors in therapeutic change. Psychological Monographs: General and Applied, 76, 1–36. doi:10.1037/h0093918
  • Beck, J. S. (2005). Cognitive therapy for challenging problems: What to do when the basics don’t work. New York, NY: Guilford Press.
  • Behar, E., Alcaine, O., Zuellig, A. R., & Borkovec, T. D. (2003). Screening for generalized anxiety disorder using the Penn State Worry Questionnaire: A receiver operating characteristic analysis. Journal of Behavior Therapy and Experimental Psychiatry, 34, 25–43. doi:10.1016/S0005-7916(03)00004-1
  • Beutler, L. E., Harwood, T. M., Michelson, A., Song, X., & Holman, J. (2011). Resistance/reactance level. Journal of Clinical Psychology, 67, 133–142. doi:10.1002/jclp.20753
  • Beutler, L. E., Moleiro, C., & Talebi, H. (2002). Resistance in psychotherapy: What conclusions are supported by research. Journal of Clinical Psychology, 58, 207–217. doi:10.1002/jclp.1144
  • Beutler, L. E., Rocco, F., Moleiro, C. M., & Talebi, H. (2001). Resistance. Psychotherapy: Theory, Research, Practice, Training, 38, 431–436. doi:10.1037/0033-3204.38.4.431
  • Biesanz, J. S., Falk, C. F., & Savalei, V. (2010). Assessing mediational models: Testing and interval estimation for indirect effects. Multivariate Behavioral Research, 45, 661–701. doi:10.1080/00273171.2010.498292
  • Binder, J. L., & Strupp, H. H. (1997). “Negative process”: A recurrently discovered and underestimated facet of therapeutic process and outcome in the individual psychotherapy of adults. Clinical Psychology: Science and Practice, 4, 121–139. doi:10.1111/j.1468-2850.1997.tb00105.x
  • Bischoff, M. M., & Tracey, T. J. G. (1995). Client resistance as predicted by therapist behavior: A study of sequential dependence. Journal of Counseling Psychology, 42, 487–495. doi:10.1037/0022-0167.42.4.487
  • Brown, T. A., Antony, M. M., & Barlow, D. H. (1992). Psychometric properties of the Penn State Worry Questionnaire in a clinical anxiety disorders sample. Behaviour Research and Therapy, 30, 33–37. doi:10.1016/0005-7967(92)90093-V
  • Button, M. L., Westra, H. A., Hara, K. M., & Aviram, A. (2015). Disentangling the impact of resistance and ambivalence on therapy outcomes in cognitive behavioral therapy for generalized anxiety disorder. Cognitive Behaviour Therapy, 44, 44–53. doi:10.1080/16506073.2014.959038
  • Castonguay, L. G., Goldfried, M. R., Wiser, S., Raue, P. J., & Hayes, A. M. (1996). Predicting the effect of cognitive therapy for depression: A study of unique and common factors. Journal of Consulting and Clinical Psychology, 64, 497–504. doi:10.1037/0022-006X.64.3.497
  • Chamberlain, P., Patterson, G., Reid, J., Kavanagh, K., & Forgatch, M. (1984). Observation of client resistance. Behavior Therapy, 15, 144–155. doi:10.1016/S0005-7894(84)80016-7
  • Constantino, M. J., Westra, H. A., & Antony, M. M. (2015, June). Mediators of treatment effects in a RCT: Testing the efficacy of augmenting CBT with MI for severe GAD. Paper presented at the meeting of the Society for Psychotherapy Research, Philadelphia, PA.
  • Coté, G., & Barlow, D. H. (1992). Combined treatment for generalized anxiety disorder: Albany comparative treatment study of generalized anxiety disorder. Unpublished manuscript.
  • Coutinho, J., Ribeiro, E., Hill, C., & Safran, J. (2011). Therapists’ and clients’ experiences of alliance ruptures: A qualitative study. Psychotherapy Research, 21, 525–540. doi:10.1080/10503307.2011.587469
  • Craske, M. G., & Barlow, D. H. (2006). Mastery of your anxiety and worry (2nd ed. Workbook). New York, NY: Oxford University Press.
  • Edwards, J. R. (2009). Seven deadly myths of testing moderation in organizational research. In C. E. Lance, & R. J. Vandenberg (Eds.), Statistical and methodological myths and urban legends: Doctrine, verity and fable in the organizational and social sciences (pp. 143–160). New York, NY: Routledge.
  • Elliott, R., Bohart, A. C., Watson, J. C., & Greenberg, L. S. (2011). Empathy. Psychotherapy, 48, 43–49. doi:10.1037/a0022187
  • Enders, C. K., & Tofighi, D. (2007). Centering predictor variables in cross-sectional multilevel models: A new look at an old issue. Psychological Methods, 12, 121–138. doi:10.1037/1082-989X.12.2.121
  • Eubanks-Carter, C., Muran, J. C., & Safran, J. D. (2010). Alliance ruptures and resolution. In J. C. Muran, J. P. Barber, J. C. Muran, & J. P. Barber (Eds.), The therapeutic alliance: An evidence-based guide to practice (pp. 74–94). New York, NY: Guilford Press.
  • First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1996). Structured clinical interview for DSM-IV Axis I Disorders – Patient edition (SCID-I/P, version 2.0). New York, NY: New York Psychiatric Institute, Biometrics Research Department.
  • Fleiss, J. L. (1981). Statistical methods for rates and proportions (2nd ed.). Hoboken, NJ: John Wiley and Sons.
  • Francis, N., Rollnick, S., McCambridge, J., Butler, C., Lane, C., & Hood, K. (2005). When smokers are resistant to change: Experimental analysis of the effect of patient resistance on practitioner behavior. Addiction, 100, 1175–1182. doi:10.1111/j.1360-0443.2005.01124.x
  • Fremont, S. K., & Anderson, W. (1988). Investigation of factors involved in therapists’ annoyance with clients. Professional Psychology: Research and Practice, 19, 330–335. doi:10.1037/0735-7028.19.3.330
  • Hara, K. M., Westra, H. A., Aviram, A., Button, M. L., Constantino, M. J., & Antony, M. M. (2015). Therapist awareness of client resistance in cognitive-behavioral therapy for generalized anxiety disorder. Cognitive Behaviour Therapy, 44, 1–8. doi:10.1080/16506073.2014.998705
  • Henry, W. P., & Strupp, H. H. (1994). The therapeutic alliance as interpersonal process. In A. O. Horvath, & L. S. Greenberg (Eds.), The working alliance, theory, research, and practice (pp. 51–84). New York, NY: John Wiley and Sons.
  • Hollenbeck, G. P. (1965). Conditions and outcomes in the student parent relationship. Journal of Consulting Psychology, 29, 237–241. doi:10.1037/h0022104
  • Horvath, A. O., Del Re, A. C., Flückiger, C., & Symonds, D. (2011). Alliance in individual psychotherapy. Psychotherapy, 48, 9–16. doi:10.1037/a0022186
  • Horvath, A. O., & Greenberg, L. S. (1989). Development and validation of the working alliance inventory. Journal of Counseling Psychology, 36, 223–233. doi:10.1037/0022-0167.36.2.223
  • Jungbluth, N. J., & Shirk, S. R. (2009). Therapist strategies for building involvement in cognitive-behavioral therapy for adolescent depression. Journal of Consulting and Clinical Psychology, 77, 1179–1184. doi:10.1037/a0017325
  • Kazantzis, N., & Shinkfield, G. (2007). Conceptualizing patient barriers to adherence with homework assignments. Cognitive and Behavioral Practice, 14, 317–324. doi:10.1016/j.cbpra.2006.08.003
  • MacKinnon, D. P., Lockwood, C. M., Hoffman, J. M., West, S. G., & Sheets, V. (2002). A comparison of methods to test the significance of the mediated effect. Psychological Methods, 7, 83–104. doi: 10.1037/1082-989X.7.1.83
  • Mamedova, M., Westra, H. A., Constantino, M. J., & Antony, M. M. (2016, June). The impact of resistance on client and therapist’s outcome expectations in cognitive-behavioural therapy. Paper presented at the meeting of the Society for the Exploration of Psychotherapy Integration, Dublin.
  • Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28, 487–495. doi:10.1016/0005-7967(90)90135-6
  • Miller, W. R., Benefield, G., & Tonigan, J. S. (1993). Enhancing motivation for change in problem drinking: A controlled comparison of two therapist styles. Journal of Consulting and Clinical Psychology, 61, 455–461. doi:10.1037/0022-006X.61.3.455
  • Miller, W. R., & Rollnick, S. (2002). Motivational interviewing: Preparing people for change (2nd ed.). New York, NY: Guilford Press.
  • Miller, W. R., & Rollnick, S. (2012). Motivational interviewing: Helping people change (3rd ed.). New York, NY: Guilford Press.
  • Moyers, T. B., & Martin, T. (2006). Therapist influence on client language during motivational interviewing sessions. Journal of Substance Abuse Treatment, 30, 245–251. doi:10.1016/j.jsat.2005.12.003
  • Moyers, T. B., & Miller, W. R. (2013). Is low therapist empathy toxic? Psychology of Addictive Behaviors, 27, 878–884. doi:10.1037/a0030274
  • Moyers, T. B., & Rollnick, S. (2002). A motivational interviewing perspective on resistance in psychotherapy. Journal of Clinical Psychology, 58, 185–193. doi:10.1002/jclp.1142
  • Newman, C. F. (1994). Understanding client resistance: Methods for enhancing motivation to change. Cognitive and Behavioral Practice, 1, 47–69. doi:10.1016/S1077-7229(05)80086-0
  • Patterson, G. R., & Chamberlain, P. (1994). A functional analysis of resistance during parent training therapy. Clinical Psychology: Science and Practice, 1, 53–70. doi:10.1111/j.1468-2850.1994.tb00006.x
  • Patterson, G. R., & Forgatch, M. S. (1985). Therapist behavior as a determinant for client noncompliance: A paradox for the behavior modifier. Journal of Consulting and Clinical Psychology, 53, 846–851. doi:10.1037/0022-006X.53.6.846
  • Rhodes, R. H., Hill, C. E., Thompson, B. J., & Elliot, R. (1994). Client retrospective recall of resolved and unresolved misunderstanding events. Journal of Counseling Psychology, 41, 473–483. doi:10.1037/0022-0167.41.4.473
  • Ribeiro, A. P., Ribeiro, E., Loura, J., Gonçlaves, M. M., Stiles, W. B., Horvath, A. O., & Sousa, I. (2014). Therapeutic collaboration and resistance: Describing the nature and quality of the therapeutic relationship within ambivalence events using the therapeutic collaboration coding system. Psychotherapy Research, 24, 346–359. doi:10.1080/10503307.2013.856042
  • Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting and Clinical Psychology, 60, 827–832. doi:10.1037/0022-006X.60.6.827
  • Safran, J. D., & Muran, J. C. (1996). The resolution of ruptures in the therapeutic alliance. Journal of Consulting and Clinical Psychology, 64(3), 447–458. doi:10.1037/0022-006X.64.3.447
  • Safran, J. D., & Muran, J. C. (2000). Negotiating the therapeutic alliance: A relational treatment guide. New York, NY: Guilford Press.
  • Stöber, J. (1998). Reliability and validity of two widely-used worry questionnaires: Self-report and self-peer convergence. Personality and Individual Differences, 24, 887–890. doi:10.1016/S0191-8869(97)00232-8
  • Strupp, H. H., & Williams, J. V. (1960). Some determinants of clinical evaluations of different psychiatrists. Archives of General Psychiatry, 2, 434–440. doi:10.1001/archpsyc.1960.03590100074
  • Tompkins, M. (2004). Using homework in psychotherapy: Strategies, guidelines and forms. New York, NY: Guilford Press.
  • Waters, A. M., & Craske, M. G. (2005). Generalized anxiety disorder. In M. M. Antony, D. R. Ledley, & R. G. Heimberg (Eds.), Improving outcomes and preventing relapse in cognitive behavioral therapy (pp. 77–127). New York, NY: Guilford Press.
  • Watson, J. C. (2002). Re-visioning empathy. In D. J. Cain, & J. Seeman (Eds.), Humanistic psychotherapies: Handbook of research and practice (pp. 452–478). Washington, DC: American Psychological Association.
  • Watson, J. C., Steckley, P. L., & McMullen, E. J. (2014). The role of empathy in promoting change. Psychotherapy Research, 24, 286–298. doi:10.1080/10503307.2013.802823
  • Westra, H. A. (2011). Comparing the predictive capacity of observed in-session resistance to self-reported motivation in cognitive behavioral therapy. Behaviour Research and Therapy, 49, 106–113. doi:10.1016/j.brat.2010.11.007
  • Westra, H. A. (2012). Motivational interviewing in the treatment of anxiety. New York, NY: Guilford Press.
  • Westra, H. A., Arkowitz, H., & Dozois, D. J. A. (2009). Adding a motivational interviewing pretreatment to cognitive behavioral therapy for generalized anxiety disorder: A preliminary randomized controlled trial. Journal of Anxiety Disorders, 23, 1106–1117. doi:10.1016/j.janxdis.2009.07.014
  • Westra, H. A., Aviram, A., Kertes, A., Ahmed, M., & Connors, L. (2009). Manual for rating interpersonal resistance. Unpublished manuscript.
  • Westra, H. A., Constantino, M. J., & Antony, M. A. (2015). Integrating motivational interviewing with cognitive-behavioral therapy for severe generalized anxiety disorder: An allegiance-controlled clinical trial. Unpublished manuscript.
  • Westra, H. A., Constantino, M. J., & Aviram, A. (2011). The impact of alliance ruptures on client outcome expectations in cognitive behavioral therapy. Psychotherapy Research, 21, 472–481. doi:10.1080/10503307.2011.581708
  • Zickgraf, H. F., Chambless, D. L., McCarthy, K. S., Gallop, R., Sharpless, B. A., Milrod, B. L., … Barber, J. P. (2015). Interpersonal factors are associated with lower therapist adherence in cognitive-behavioral therapy for panic disorder. Clinical Psychology and Psychotherapy, 1–13. doi:10.1002/cpp.1955
  • Zinbarg, R. E., Craske, M. G., & Barlow, D. H. (2006). Mastery of your anxiety and worry, (2nd ed., Therapist guide). New York, NY: Oxford University Press.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.