The two major areas of intervention involve enabling Passive-Aggressives to be more consistent in their approach to life and to develop insight into the nature of their ambiva- lent style of responding. However, the therapeutic relationship itself is likely to be com- plicated by their ambivalence. Specifically, they desire caring and support by others but perceive the development of such a relationship as a threat to their independence and fear that it will end up with rejection and disappointment. As a result, they may errati- cally criticize their therapist or engage in passive resistance. Dealing with this potential difficulty through early behavioral contracting might be particularly useful in keeping these clients engaged in the therapy process. One concern related to clinical management is that their impulsiveness might involve suicide risk. This is especially problematic if they decompensate into an anxiety or depressive disorder. Family and marital interven- tions are likely to be extremely beneficial because passive-aggressive (negativistic) pat- terns are both initiated by and maintained in these systems. Formal programs of anger management and assertiveness training might also be quite helpful in developing greater control over impulses and learning more effective styles of communication. Their belief in future disappointments, along with their dysfunctional thoughts of having been cheated by life, can be worked on through cognitive interventions that challenge these assumptions. Because they are likely to be resistant, controlling clients, the use of either paradoxical directives or a combination of nondirective and client-directed techniques is likely to optimize outcome.