Predictors of Skill in Resistance Management in Psychotherapy

Appropriately responsive management of resistance in psychotherapy remains a foundational skill that is associated with positive client outcomes (Westra & Norouzian, 2018). Despite this, little is known about which individual differences contribute to successful management of resistance. Findings suggest that psychotherapy performance does not improve with experience (Goldberg et al., 2016), that psychotherapists lack humility due to positively biased self-assessment (Walfish et al., 2012), and that difficult moments in psychotherapy may dysregulate therapist emotions (Grecucci & Sanfey, 2014). This thesis therefore had two primary aims: 1) to identify whether psychotherapy training experience (n = 98 untrained participants and n = 76 trained participants) was associated with resistance management, and 2) to identify whether humility and difficulties regulating emotions in trained individuals (n = 76) were associated with resistance management (i.e., as operationalized using the Resistance Vignette Task – RVT; Westra et al., 2021). Results indicated that trained individuals performed significantly better on the RVT than untrained individuals, however, years of experience within the trained sample were not associated with RVT scores. Furthermore, humility and difficulties regulating emotions were each independently associated with resistance management in the trained group. These findings suggest the possibility of improving training to focus on key skills, such as resistance management, through supporting humility and emotion regulation in training. By identifying ways to improve therapist skill in resistance management (i.e., by introducing skill training and promoting humility and emotion regulation in therapists), client outcomes may subsequently improve.