Development of the Client Resistance Scale.

Abstract

This study examines (a) the psychometric properties of the Client Resistance Scale (CRS) and (b) how client manifests as a function of client, therapist, and therapist response mode. The CRS is composed of 5 subscales that are based on R. R. Greenson's (1967) formulation of client (i.e., Opposing Expression of Painful Affect, Opposing Recollection of Material, Opposing Therapist, Opposing Change, and Opposing Insight). Master's-level judges rated client speaking turns for 6 sessions with 6 expert therapists (i.e., Beck, Ellis, Meichenbaum, Perls, Rogers, and Strupp). Results indicated that (a) the CRS subscales were reliable with 3 and 4 judges, (b) the 5 subscales were significantly positively correlated with each other, and (c) client differed as a function of client, therapist, and therapist response mode. Client is a central concept in analytic psychotherapy (Greenson, 1967), and it is important in other psychotherapy models such as cognitive-behavioral (Goldfried, 1982; Meichenbaum & Gilmore, 1982), gestalt (Breshgold, 1989), and rational-emotive therapy (Ellis, 1985). Arguably, the most lucid and thorough discussion of client has been presented by Greenson. Greenson detailed the purposes of resistance, described its manifestation in therapeutic work, and discussed several strategies for working with client resistance. Specifically, Greenson (1967) observed that resistance opposes the analytic procedure, the analyst, and the patient's reasonable ego. Resistance defends the neurosis, the old, the familiar, and the infantile from exposure and change (p. 77). In this article, Greenson's (1967) language is recast to be inclusive of nonanalytic approaches and to incorporate the motivation for (i.e., the avoidance of painful affect; Freud, 1901/1960; Greenson, 1967). As such, the following formulation of is presented: With its motivation being the avoidance of painful affect, opposes the client's recollection of therapeutic material, as well as the therapist's efforts, change, and insight. A survey of the literature on client supports the five dimensions identified in this formulation.