Resistance and its extreme variation, reactance, are uniformly observed across varieties of psychotherapy.Social psychologists note that reactant individuals prove to be less so when offered a receptive and nondirective environment. We provide definitions of reactance, review its frequent measures, and offer a clinical example. A meta-analysis of 13 controlled studies (1,208 patients) examined the degree to which treatment outcomes are enhanced when therapists offer less directive treatments to high-reactance patients. The results revealed a large effect size (d = .79), confirming that highly reactant individuals did better in psychotherapy when the therapist assumed a reflective and nondirective stance than a directive and authoritative one. To a lesser degree, the opposite was also true. Limitations of the research and diversity considerations are noted. Practice recommendations are provided to minimize a patient's reactant behavior. K E Y W O R D S meta-analysis, psychotherapy outcome, reactance, resistance, systematic treatment selection, treatment adaptations 1 | INTRODUCTION Patients who willingly enter psychotherapy typically do so because of a desire to change. At the same time, that desired change can prove a difficult and frightening process and is often met with what clinicians refer to asresistance. The clinician is then confronted with the thorny question, "Why is it that one who wants to change then resists doing so when offered the opportunity?" The role of the clinician is to serve as a facilitator for reconciling these contradictory inclinations of the patient and to produce change and growth in the process. Psychological