Some people through no fault of your own will just not follow directions. They just will not allow themselves to relax or maintain a sufficient level of mental attention. There are a number of reasons for this, such as negative transference, not wanting to make the change that they came in for, or any fear that you could not educate out of them. In such a case, let them know that this does happen once in a while and the best thing to do is just to go home and practice with a relaxation tape. Then, when they come back they will feel more relaxed, both because they will feel more familiar with you and your office, it will be their second time there with you, and because of the relaxation practice they did with the tape.
Bonus Tip: I have also accomplished the same thing using the EFT (Emotional Freedom Technique) and teaching it to the client to practice at home. There is more information about EFT in the appendix.
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