Reactance and engagement in integrative group psychotherapy for personality dysfunction.

Objectives: Reactance refers to an oppositional tendency, and may have the potential to interfere with patients’ engagement in intensive group psychotherapy. Using data from an integrative group treatment program for patients with personality dysfunction, the present study investigated reactance with regard to program attendance and premature termination, and with patients’ perceptions of the group therapy process. Method: Patients with personality dysfunction (N = 138) completed pretreatment assessments of reactance and symptom distress, along with measures of group process during the early phase of treatment. Nonparametric tests were used to examine patients’ attendance and termination status. Mediation analyses were conducted to examine reactance as a potential mechanism in the relationship between personality dysfunction and patients’ perceptions of group climate. Results: Reactance was associated with reduced attendance and both patient-initiated and administratively determined premature termination. Among patients who provided ratings of group process (n = 117), reactance served as a significant mediator of the relationship between personality dysfunction and perceptions of both avoidant and conflictual group climate. Conclusion: Reactance is a potential impediment to treatment completion, and contributes to patients’ negative perceptions of the group therapy process. The findings indicate a need for clinical attention regarding reactance early in the assessment and treatment-preparation process. (PsycINFO Database Record (c) 2018 APA, all rights reserved)