When a patient becomes hostile, loud, intransigent, and/or verbally abusive, it does little good for the therapist to respond in kind (Becket al. 1993).

To deescalate a potentially dangerous situation, the therapist must stay calm, non-defensive, and matter-of-fact. It is important at such times for the therapist to express a genuine concern for the patient's well-being and best interests.

When the therapist and patient are at odds, it is extremely helpful for the therapist to call attention to their areas of agreement and collaboration.

This helps to remind that patient that a single conflict with the therapist does not mean that the entire therapeutic endeavor is adversarial. Although a certain degree of confrontation between the therapist and the drug-abusing patient is almost inevitable during the course of treatment (Frances and Miller 1991), the therapist can minimize damage to the therapeutic relationship by calmly communicating a tone of respect and concern (Newman 1988).