FACTORS MEDIATING THE SUCCESS OF DEFIANCE-BASED AND COMPLIANCE-BASED INTERVENTIONS

Forty-one clients with sleep onset delay problem were randomly assigned to symptom prescription (SP) or stimulus control (SC) treatments and to one of two levels of therapist contact. Levels of reactance were assessed before treatment; sleep onset delay, quality of rest, and total time asleep were monitored during baseline, treatment, and follow-up. No significant differences were associated with levels of therapist contact. The two treatments were equally effective in reducing sleep onset delay and increasing the amount of sleep; however, the SP group rated the quality of rest as more improved. Significant interactions were found involving two of the dependent variables: Although more- and less-reactant individuals benefit similarly from either treatment, more-reactant clients continue to improve beyond active treatment with the paradoxical intervention, whereas less-reactant clients tend to lose some of the initial gains. The opposite interaction pattern was observed with the SC group.