Exploring the Resistance Factors within Cognitive Behavioral Therapy (CBT) and Strategies to Overcome them among Therapist: An Exploratory Study

The efficacy of CBT is now well-established, and CBT is recommended by multiple academic societies. However, not every patient responds well to CBT and little is known about the resistance factors of the therapy. This study aims to identify predictive factors of CBT success and failure and the techniques used by clinicians to overcome resistance. We recruited 43 French therapists (31 women) who filled out sociodemographic information and answered open questions related to the predictive factors of CBT and the way they overcome resistance in therapy. Thematic analysis was used to treat the data. Six themes related to the predictive factors were identified as follows, “Influence of motivation on the therapy”; “Influence of certain psychopathological processes”; “Influence of patient/therapist match”; “Certain psychopathological profiles are harder to treat”; “Influence of environmental and biological factors”; “Other factors of influence” and three themes related to the strategies to overcome resistance, namely “Adaptation of therapy content to overcome difficulties”, “Adaptation of the therapeutic framework”, “Environmental intervention to overcome the difficulties”. Multiple factors influence the success or the failure of CBT such as motivation, alliance, negative beliefs about the therapy or complex symptomatic profiles. Some solutions have already been identified by the therapists to overcome such difficulties. However, it would be useful to conduct further research on CBT resistance and ways to overcome it.