Includes bibliographical references (p. 312-315) and index.

Identifying problems in treatment -- Conceptualizing patients who present challenges -- When a personality disorder challenges treatment -- Developing and using the therapeutic alliance -- Therapeutic relationship problems: case examples -- When therapists have dysfunctional reactions to patients -- Challenges in setting goals -- Challenges in structuring the session -- Challenges in solving problems and in homework -- Challenges in identifying cognitions -- Challenges in modifying thoughts and images -- Challenges in modifying assumptions -- Challenges in modifying core beliefs.

Where can clinicians turn when "standard" cognitive therapy just doesn't seem to work? Why do some patients appear unable or unwilling to collaborate or grasp basic techniques? And how can therapists deal effectively with their patients'--and their own--emotional responses? In this groundbreaking volume, Judith S. Beck builds on her acclaimed Cognitive Therapy: Basics and Beyond to help clinicians learn to recognize and solve problems ranging from common clinical missteps to complex treatment challenges. Written in a lively, accessible style, the book provides a clear framework and step-by-step suggestions for identifying and overcoming therapeutic obstacles. Beck emphasizes the need to base intervention on a systematic yet flexible conceptualization of the individual patient. She shows how revisiting the case conceptualization can illuminate why progress may be getting derailed at any given point, as well as how to get back on track. Strategies are presented for remediating difficulties in the fundamental elements of cognitive therapy: the therapeutic relationship, goal setting, structuring sessions, solving problems, cognitive and behavioral change, and homework. While the recommendations presented are applicable to a variety of difficult situations, particular attention is given to addressing the longstanding distorted beliefs and self-defeating coping strategies associated with personality disorders. Throughout, vivid case examples and transcripts illustrate specific techniques and facilitate their immediate implementation in the reader's own practice. Helpful appendices include a reproducible assessment tool, the Personality Belief Questionnaire.