As clinical therapists, we often find ourselves frustrated by our patients’ apparent lack of interest in our carefully planned intervention programs. Patients may report that they had yet to start, or even complete any part of their home program. We as therapists then assume that the patients were uninterested, or didn’t have the necessary motivation; or worst of all, simply did not care. Lack of participation on the patent’s part is frustrating to the therapist, and often devastates our patient’s ultimate recovery.

However, our patients’ behavior might stem from other factors that remain hidden from our personal observation of their communication skills and participation in the intervention program. It is possible that our patients may not comprehend the skills and concepts we teach and are embarrassed by their lack of understanding. As a result, patients may simply pretend to understand the information. They may avoid asking questions because they do not want to “bother us” or “appear ignorant” of their condition.

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