The Clinical Implementation of Behavior Change Techniques

A Cognitively Oriented Conceptualization of Therapeutic “Compliance” and “Resistance”
  • Roy Cameron


Consider the following situation: Two clients present what appear to be highly similar problems related to interpersonal anxiety. The assessment suggests that each of the two clients is experiencing anxiety in a wide variety of situations, and it seems appropriate to train anxiety-management skills. To accomplish this, stress-inoculation training (Meichenbaum, 1975a; Meichenbaum and Cameron, 1973) is initiated with both clients. We have, then, two dients who present with highly similar problems, both of whom receive the same sort of therapy. One of the clients quickly masters the anxiety-management skills. He gradually begins to report enthusiastically that he is no longer experiencing debilitating anxiety and, in due course, terminates treatment with his problem resolved. You have, no doubt, already anticipated what happens with the second client. Although the specific intervention that was employed has worked successfully with other similar clients in the past, in this instance it fails miserably. The client does not do homework assignments, begins to miss appointments, and eventually disappears altogether (frequently to the great relief of the therapist).


Therapeutic Alliance Therapeutic Process Homework Assignment Behavior Change Technique Referral Process 
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  1. Bem, D.J. Self-perception theory. In L. Berkowitz (Ed.), Advances in experimental social psychology (Vol. 6). New York: Academic Press, 1972.Google Scholar
  2. Brehm, J.W. A theory of psychological reactance. New York: Academic Press, 1966Google Scholar
  3. Brehm, S.S. The application of social psychology to clinical practice. New York: Wiley, 1976.Google Scholar
  4. Davidson, P.O. Therapeutic compliance. Canadian Psychological Review,1976, 17, 247–259.Google Scholar
  5. Davison, G.C. Counter-control in behavior modification. In L.A. Hamerlynck, L.C. Handy, and E.J. Mash (Eds.), Behavior change: Methodology concepts and practice. Champaign, Ill.: Research Press, 1973.Google Scholar
  6. Davison, C.C., Tsujimoto, R.N., and Claros, A.G. Attribution and the maintenance of behavior change in falling asleep. Journal of Abnormal Psychology, 1973, 82, 124–133.PubMedCrossRefGoogle Scholar
  7. Davison, G.C., and Valins, S. Maintenance of self-attributed and drug-attributed behavior change. journal of Personality and Social Psychology, 1969, 11, 25–33PubMedCrossRefGoogle Scholar
  8. Egan, G. The skilled helper. Monterey, Calif.: Brooks/Cole, 1975.Google Scholar
  9. Farber, I. The things people say to themselves. American Psychologist, 1963, 18, 185–197.CrossRefGoogle Scholar
  10. Frank, J.D. Persuasion and healing. Baltimore: Johns Hopkins University Press, 1961Google Scholar
  11. Frank, J.D. Psychotherapy and the sense of mastery. In R.L. Spitzer and D.F. Klein (Eds.), Evaluation of psychological therapies. Baltimore: Johns Hopkins University Press, 1976.Google Scholar
  12. Gentry, W.D., and Cameron, R. Psychodiagnostic evaluation of pain and disability. In J.C. Davis and J.P. Foreyt (Eds.), Mental examiner’s source book. Springfield, Ill.: Charles C Thomas, 1975.Google Scholar
  13. Goldfried, M.R., and Davison, G.C. Clinical behavior therapy. New York: Holt, Rinehart and Winston, 1976.Google Scholar
  14. Goldstein, A.P. Therapist-patient expectancies in psychotherapy. New York: Pergamon, 1962.Google Scholar
  15. Goldstein, A.P. Relationship-enhancement methods. In F.H. Kanfer and A.P. Goldstein (Eds.), Helping people change: A textbook of methods. New York: Pergamon, 1975.Google Scholar
  16. Goldstein, A.P., Heller, K., and Sechrest, L.B. Psychotherapy and the psychology of behavior change. New York: Wiley, 1966.Google Scholar
  17. Gottman, J.M., and Leiblum, S.R. How to do psychotherapy and how to evaluate it: A manual for beginners. New York: Holt, Rinehart and Winston, 1974.Google Scholar
  18. Hackett, T.P. The surgeon and the difficult pain problem. In H.S. Abram (Ed.), Psy-chological aspects of surgery. Boston: Little, Brown and Co., 1967.Google Scholar
  19. Lazarus, A.A. Behavior therapy and beyond. New York: McGraw-Hill, 1971Google Scholar
  20. Lazarus, A.A. Multi-modal behavior therapy. New York: Springer, 1976.Google Scholar
  21. Lefcourt, H.M. Locus of control: Current trends in theory and research. Hillsdale, N.J.: Erlbaum, 1976.Google Scholar
  22. Meichenbaum, D. A self-instructional approach to stress management: A proposal for stress inoculation training. In C. Speilberger and I. Sarason (Eds.), Stress and anxiety in modern life. New York: Winston, 1975a.Google Scholar
  23. Meichenbaum, D. Self-instructional methods. In F.H. Kanfer and A.P. Goldstein (Eds.), Helping people change: A textbook of methods. New York: Pergamon, 1975b.Google Scholar
  24. Meichenbaum, D. Toward a cognitive theory of self-control. In G.E. Schwartz and D. Shapiro (Eds.), Consciousness and self-regulation: Advances in research (Vol 1). New York: Plenum, 1976.Google Scholar
  25. Meichenbaum, D. Cognitive-behavior modification: An integrative approach. New York: Plenum, 1977.Google Scholar
  26. Meichenbaum, D., and Cameron, R. Stress inoculation: A skills training approach to anxiety management. Unpublished manuscript, University of Waterloo, 1973Google Scholar
  27. Seligman, M.E.P. Helplessness. San Francisco: Freeman, 1975.Google Scholar
  28. Shapiro, A.K. A contribution to the history of the placebo effect. Behavioral Science, 1960, 5,109–135.CrossRefGoogle Scholar
  29. Shapiro, A.K. Placebo effects in medicine, psychotherapy, and psychoanalysis. In A.E. Bergin and S.L. Garfield (Eds.), Handbook of psychotherapy and behavior change. New York: Wiley, 1971.Google Scholar
  30. Truax, C.B., and Carkhuff, R.R. Toward effective counseling and psychotherapy: Training and practice. Chicago: Aldine, 1967.Google Scholar
  31. Wachtel, P.L. Psychoanalysis and behavior therapy. New York: Basic Books, 1977.Google Scholar

Copyright information

© Plenum Press, New York 1978

Authors and Affiliations

  • Roy Cameron
    • 1
  1. 1.Department of PsychologyUniversity of SaskatchewanSaskatoonCanada

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