Although it may seem this way when working with ambivalent clients who have had extreme or repeated experiences of disempowerment (trauma survivors, frequent-flier failures at multiple treatment attempts, to name a couple of profiles), it is simply not true that such individuals are incapable of growing in self-efficacy. It is true that the process may take longer than expected, and require more patience and reinforcement than with other client groups, but it is still possible, and a necessary element for treatment success.