title: Therapist awareness of client resistance in cognitive-behavioral therapy for generalized anxiety disorder.
abstract: Clients' resistance relates negatively to their retention and outcomes in psychotherapy; thus, it has been increasingly identified as a key process marker in both research and practice. This study compared therapists' postsession ratings of resistance with those of trained observers in the context of 40 therapist-client dyads receiving 15 sessions of cognitive-behavioral therapy for generalized anxiety disorder. Therapist and observer ratings were then examined as correlates of proximal (therapeutic alliance quality and homework compliance) and distal (posttreatment worry severity) outcomes. Although there was reasonable concordance between rater perspectives, observer ratings were highly and consistently related to both proximal and distal outcomes, while therapist ratings were not. These findings underscore the need to enhance therapists' proficiency in identifying important and often covert in-session clinical phenomena such as the cues reflecting resistance and noncollaboration.
authors.affiliation: a Department of Psychology , York University , 4700 Keele Street, Toronto , ON M3J 1P3 , Canada.
authors.forename: Kimberley M
authors.initials: KM
authors.lastname: Hara
authors.forename: Henny A
authors.initials: HA
authors.lastname: Westra
authors.forename: Adi
authors.initials: A
authors.lastname: Aviram
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Button
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Constantino
authors.forename: Martin M
authors.initials: MM
authors.lastname: Antony
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000523:psychology* / Q000628:therapy*; D002983:Clinical Competence; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance / Q000523:psychology*; D011369:Professional-Patient Relations; D016896:Treatment Outcome; D055815:Young Adult
keywords: CBT; client resistance; generalized anxiety; therapist awareness