Helping the clinician understand and manage frequently encountered obstacles in treatment, including but not limited to resistance, this volume brings together leading contributors representing a range of cognitive-behavioral perspectives. Each research-based chapter addresses a specific kind of "roadblock," exploring how and why it arises and suggesting effective, practical solutions. A section on specific populations examines difficulties that occur in treating such complex disorders as psychosis, bipolar disorder, PTSD, and binge eating. Other sections cover new directions in case conceptualization; working with emotional and metacognitive processes in cognitive therapy; approaches to engaging angry patients and dealing with alliance ruptures; and ways to overcome impasses in couple and family work.
* Practical: shows not only how roadblocks arise, but spells out strategies for dealing with them.
* Covers challenges that all therapists grapple with but that are not often addressed in the CBT literature.
* Contributor panel includes high-profile, leading lights in the field.
Table of Contents
I. Case Conceptualization
1. Case Conceptualization in Preventing and Responding to Therapeutic Difficulties, Needleman
2. Impediments to Effective Psychotherapy, Freeman and McCloskey
3. Effective Homework, Tompkins
II. Metacognition and Emotion
4. Anxiety Disorders, Metacognition, and Change, Wells
5. Emotional Schemas and Resistance, Leahy
6. Avoidance of Emotion as an Obstacle to Progress, Holland
III. Specific Populations
7. Psychosis, Haddock and Siddle
8. Bipolar Disorder, Newman
9. Posttraumatic Stress Disorder: A New Algorithm Treatment Model, Smucker, Grunert, and Weis
10. Binge-Eating and Other Eating Disorders, Schaffer
IV. Couples and Families
11. Couple Therapy, Epstein and Baucom
12. Family Therapy, Dattilio
V. Psychotherapy Processes
13. Difficult-to-Treat Patients: The Approach from Dialectical Behavior Therapy, Foertsch, Manning, and Dimeff
14. Obstacles or Opportunities?: A Relational Approach to Negotiating Alliance Ruptures, Stevens, Safran, and Muran
15. Angry Patients: Strategies for the Beginning Phase of Treatment, Tafrate and Kassinove
16. Medication Compliance with Difficult Patients, Marcinko
17. Conclusions, Leahy
"Roadblocks in Cognitive-Behavioral Therapy provides a rich and multifaceted exploration of the many obstacles that can arise in the treatment process. It does a marvelous job of explaining why and how roadblocks occur in therapy with diverse individuals, as well as couples and families, and provides a coherent set of principles for turning obstacles into what Leahy calls windows of opportunity. Filled with clinical wisdom and specific strategies, this volume should be of use to both beginning and experienced clinicians. It could well become a mainstay of professional training programs at all levels."
-Steven D. Hollon, PhD, Vanderbilt University
"Leahy, one of cognitive therapy's most prolific and creative writers, has brought together leading therapists in the field to address the important issue of impasses and disruptions in therapeutic progress. With coverage of such areas as case conceptualization, the relationship of cognition to emotion, and the therapeutic relationship, the volume provides a wealth of insights and practical solutions to clinical difficulties. I highly recommend this book and I am sure that, like me, other readers will learn much from it."
-Paul Gilbert, FBPsS, Mental Health Research Unit, Kingsway Hospital, Derby, UK
"This book will suffer a lot of abuse from being pulled from your office shelf again and again to be pored over for ideas and inspiration. Leahy has pulled together some of the greatest CBT minds to share their thoughts, feelings, and strategies for working with some of our most difficult-to- treat disorders and populations."
-Peter J. Bieling, PhD, St. Joseph's Hospital and McMaster University, Hamilton, Ontario, Canada