Therapist behavior as a determinant for client noncompliance: A paradox for the behavior modifier.

Abstract

G. R. Patterson and M. S. ForgatchOregon Social Learning Center, Eugene, OregonThe immediate impact of therapist behavior on client noncompliance was examinedin two studies. Observation systems describing client and therapist behavior wereused to code videotaped therapy sessions. In the first study, the therapist behaviorsteach and confront were associated with significant increases in the likelihoodof client noncompliant reactions. Therapist behaviors facilitate and supportwere followed by reliable decreases in client noncompliance. In the second study,the therapist behaviors teach and confront were manipulated in a series ofsingle-subject ABAB reversal designs. The experiment demonstrated that changesin therapist behaviors produced increases in client noncompliance.For the present studies, noncompliance waspresumed to be a ubiquitous behavior for chil-dren and adults alike. It is paradoxical thatcertain situations (e.g., parent training) de-signed to help the client may actually stimulatethe client to work against the therapist. Anal-yses of videotaped parent training sessions byChamberlain, Patterson, Reid, Kavanagh, andForgatch (1984) showed that the average rateof parent noncompliant behavior was .17 re-sponses per minute during the initial stages oftreatment. This increased significantly to morethan .30 responses per minute during the mid-stages of treatment. These findings led to thehypothesis that therapists' efforts to changeparent behavior may function as an importantdeterminant for parent noncompliance duringtreatment. The present studies tested this hy-pothesis.