Resistance in Cognitive Behavioral Therapy and Motivational Interviewing Techniques

Abstract

As is valid for each psychotherapy method, the factors such as whether the therapy is appropriate and sufficient, whether the client is ready to therapy, duration and frequency of the therapy shall determine the success of the treatment also for clients whom are treated with cognitive-behavioral therapy. However, while considering these factors, the concept of resistance should not be ignored. The aim of this article is to understand the underlying causes of the resistance for cognitive-behavioral therapy and to make suggestions on how to manage it. In this context, motivational interviewing techniques will also be explained in detail.

Keywords

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Bilişsel Davranışçı Terapide Direnç ve Motivasyonel Görüşme Teknikleri

Öz

Her psikoterapi yöntemi için geçerli olduğu gibi, bilişsel davranışçı terapi ile izlenen danışanlar için de terapinin uygun ve yeterli olup olmadığı, danışanın terapiye hazır olup olmadığı, terapinin süresi ve sıklığı gibi faktörler tedavinin başarısını belirler. Ancak bu faktörleri ele alırken direnç kavramı göz ardı edilmemelidir. Bu makalenin amacı, bilişsel-davranışçı terapiler için direncin altında yatan nedenleri anlamak ve direncin nasıl yönetileceği konusunda önerilerde bulunmaktır. Bu kapsamda motivasyonel görüşme teknikleri de detaylı olarak anlatılacaktır.

Anahtar Kelimeler

• Direnç, bilişsel davranışçı terapi, motivasyonel yöntemler

References

1. Aviram A, Westra HA (2011) The impact of motivational interviewing on resistance in cognitive behavioural therapy for generalized anxiety disorder. Psychother Res, 21:698-708.
2. Borkovec TD, Roemer L (1995) Perceived functions of worry among generalized anxiety disorder subjects: distraction from more emotionally distressing topics? J Behav Ther Exp Psy, 26:25–30.
3. Burke BL, Arkowitz H, Menchola M (2003) The efficacy of motivational interviewing: a metaanalysis of controlled clinical trials. J Consult Clin Psychol, 71:843–861.
4. Burns DB (1989) The Feeling Good Handbook. New York, Penguin.
5. Burns DB, Spangler DL (2000) Does psychotherapy homework lead to improvements in depression in cognitive-behavioral therapy or does improvement lead to increased homework compliance? J Consult Clin Psychol, 68:46–56.
6. Butler AC, Chapman JE, Forman EM, Beck AT (2006) The empirical status of cognitive behavioral therapy: a review of meta- analyses. Clin Psychol Rev, 26:17-31.
7. Dozois DJA, Westra HA, Collins KA, Fung TS, Garry JKF (2004) Stages of change in anxiety: psychometric properties of the University of Rhode Island Change Assessment (URICA) scale. Behav Res Ther, 42:711-729.
8. Engle DE, Arkowitz H (2006) Ambivalence in Psychotherapy: Facilitating Readiness to Change. New York, Guilford Press.

9. Freeston MH, Rheaume J, Letarte H, Dugas MJ, Ladouceur R (1994) Why do people worry? Pers Indiv Differ, 17:791– 802.
10. Haugaard C, Sandberg K (2008) Resistance in cognitive therapy: an analysis of paradigm and contemporary practice. Nord Psychol , 60 :24-42.
11. Huppert JD, Baker-Morissette SL (2003) Beyond the manual: the insider’s guide to panic control treatment. Cogn Behav Pract, 10:2–13.
12. Kemp R, Kirov G, Everitt B, Hayward P, David A (1998) Randomised controlled trial of compliance therapy. Br J Psychiatry, 172:413–419.
13. Kingdon D, Hansen L, Finn M, Turkington D (2007) When standard cognitive-behavioural therapy is not enough. Psychiatr Bull, 31:121-123.
14. Leahy RL (2001) Overcoming Resistance in Cognitive Therapy. New York, Guilford Press.
15. Martino S, Carroll KM, O’Malley SS, Rounsaville BJ (1999) Motivational interviewing with psychiatrically ill substance abusing patients. Am J Addiction, 9:89– 91.
16. Miller WR, Rollnick S (2002) Motivational Interviewing: Preparing People for Change. New York, Guilford Press.
17. Miller WR, Rose GS (2009) Toward a theory of motivational interviewing. Am Psychol, 64:527-537.
18. Moyers TB, Rollnick S (2002) A motivational interviewing perspective on resistance in psychotherapy. J Clin Psychol, 58:185– 194.
19. Newman CF (2002) A cognitive perspective on resistance in psychotherapy. J Clin Psychol, 58:165–174.
20. Papageorgiou C, Wells A (2001) Positive beliefs about depressive rumination: development and preliminary validation of a self- report scale. Behav Ther, 32:13–26.
21. Schmidt NB, Wollaway-Bickel K (2000) The effects of treatment compliance on outcome in cognitive-behavioral therapy for panic disorder: quality versus quantity. J Consult Clin Psychol, 68:13–18.
22. Swanson AJ, Pantalon MV, Cohen KR (1999) Motivational interviewing and treatment adherence among psychiatric and dually diagnosed patients. J Nerv Ment Dis, 187:630–635.
23. Van Deurzen E, Adams M (2011) Skills in Existential Counselling and Psychotherapy. New Tork, Sage Publishing.
24. Westra H (2004) Managing resistance in cognitive behavioural therapy: The application of motivational interviewing in mixed anxiety and depression. Cogn Behav Ther, 33:161-175.
25. Nurcihan Alpaydın, Klin. Psik., İstanbul Medipol Üniversitesi, İstanbul; Meliha Çimen, Öğr.Gör., İstanbul
26. Medipol Üniversitesi, İstanbul; Büşra Tarçalır Erol, Klin. Psik, Arkabahçe Psikolojik Gelişim ve Danışma
27. Merkezi; Oya Mortan Sevi, Klin. Psk. Dr. İstanbul Psikiyatri Enstitüsü , İstanbul.