Identifying Problems in Treatment. Conceptualizing Patients Who Present Challenges. When a Personality Disorder Challenges Treatment. Developing and Using the Therapeutic Alliance. Therapeutic Relationship Problems: Case Examples. When Therapists Have Dysfunctional Reactions to Patients. Challenges in Setting Goals. Challenges in Structuring the Session. Challenges in Solving Problems and in Homework. Challenges in Identifying Cognitions. Challenges in Modifying Thoughts and Images. Challenges in Modifying Assumptions. Challenges in Modifying Core Beliefs. Appendix A. Resources, Training, and Supervision in Cognitive Therapy. Appendix B. Personality Belief Questionnaire.