Andrés Roussos

Introduction to special section on clients' perspective of change in psychotherapy.

The articles included in this special section are based on the works presented in a panel named Clients Talking About Therapy, which took place during the 43rd International Annual Meeting of the Society for Psychotherapy Research in Virginia Beach. One of the main issues at the time of the panel was the difficulty in reaching an agreement about what change represents in psychotherapy research. In this introduction I very briefly present some of the debates that are currently going on about change and the role of qualitative research in that debate. The articles included are qualitative investigations that study the value of clients perspectives from different vantage points. The authors used in-depth interviews, which allow interviewees to communicate whatever they think, enabling the emergence of new perspectives. I look forward to the application of the information obtained among these studies, in the development of applied clinical knowledge.

Psychotherapy Researchers: Reported Misbehaviors and Opinions

The ethical practices of psycho therapy researchers were surveyed online. A total of 257 completed surveys were received from researchers worldwide. Eighty-nine percent of researchers admitted to at least one of the listed behaviors. The most common faults were related to excessive work demands: 44% of the respondents reported “inadequate monitoring of research projects due to work overload” and 37% reported “cutting corners in a hurry to complete a project.” North America was lower in almost all of the reported behaviors. The results about specific behaviors related to psychotherapy research for which rules are still fuzzy reflect the disagreement among researchers. The high prevalence of misbehavior in psychotherapy research is a warning that cannot be ignored.

Psychotherapy and Social Neuroscience: Forging Links Together

Psychotherapy drew on social science to forge the epistemological and methodological approach for its development and validation. Although its emphasis on psychosocial premises isolated it from neurobiological processes, psychotherapy never resigned such concerns. Against this background, here we review studies integrating psychotherapy and neuroscience, focusing on studies that show the path for establishing joint research programs. We describe strategies and instruments that have been used in the literature and identify relevant methodological challenges. In addition, we consider empathy and interpersonal relationships as concepts that can bridge social neuroscience with concepts from psychotherapy, such as therapeutic alliance and emotional regulation. Finally, we discuss the extent to which the integration of these two fields promotes practice-oriented research with valid information to empower practitioners (psychotherapists, psychiatrists, and other mental health professionals) in their work with patients.

For Me It Was a Key Moment of Therapy: Corrective Experience From the Client's Perspective.

Despite recent attempts to develop a consensus definition, questions still remain as to what constitutes corrective experiences (CEs) in psychotherapy and how clients perceive them. This qualitative study assessed clients first person accounts of CEs associated with their own treatment-related changes. Participants were 8 clients in private psychotherapy in Buenos Aires. Treatment, by therapists from diverse theoretical backgrounds, varied from 4 to 24 months. The Patients Perceptions of Corrective Experiences in Individual Therapy interview protocol was used to assess clients perceptions of CEs at posttreatment. All interviews were audiorecorded and transcribed and submitted to a 2-stage thematic analysis to assess CEs and the contextual factors that contributed to them. Of the 8 participants, 5 narrated stories about CEs that changed the way they thought about themselves and their behavior. Additionally, clients highlighted disconfirmation of therapist role expectations and surprise regarding therapists actions and behaviors as mechanisms of these corrective moments.

Ethical behaviors of latin american psychotherapy researchers.

The ethical practices of psychotherapy researchers in Latin America were surveyed online. Of the 114 psychotherapy researchers to whom the survey was sent, 76 responded (67% response rate). Seventy-seven percent of the respondents had not received formal training in research ethics, yet 84% indicated that formal training is useful for the prevention of scientific misbehavior. Researchers admitted to various ethically questionable practices, the most common of which were related to authorship. None reported having fabricated or falsified data. The need for adequate training and evaluation of research projects is addressed.

A time-series analysis of therapeutic alliance, interventions, and client’s clinical status in an evidence-based single-case study: Evidence for establishing change mechanisms in psychotherapy

Abstract Objective: The goal of this study was to analyze the time-series of alliance, interventions, and client’s post-sessions clinical status, to establish if alliance and adherence to cognitive-behavioral interventions preceded improvement in psychotherapy Method: A single-case study of a complete Cognitive-Behavioral treatment of a 27-year-old male diagnosed with Generalized Anxiety Disorder treatment was conducted. Alliance, adherence to cognitive-behavioral interventions, and client’s therapeutic condition were assessed every two sessions during the entire treatment. Results: After controlling for the effect of autocorrelations, the transfer functions showed that alliance predicted client’s clinical condition with a lag of two sessions throughout the entire treatment. However, the inverse relationship was not observed. Conclusions: Results support the hypothesis of a time-lagged association between alliance and subsequent client’s changes in their clinical condition in single case of a cognitive-behavioral treatment.

A therapist version of the Alliance Negotiation Scale

The aim of the current study was to design and evaluate a therapist version of the Alliance Negotiation Scale (ANS). The ANS was created in order to operationalize the construct of dyadic negotiation in psychotherapy and to augment existing conceptualizations of the working alliance. The ANS has existed only as a client self-report form since its inception and has demonstrated promise as a psychotherapy process measure. This research intended to develop a complementary therapist self-report version of the measure. The scale creation process is discussed in detail, and the results of a preliminary psychometric investigation are reported. The ANS-Therapist version (ANS-T) was developed using a sample of therapists (nxa0=xa0114) through a principal components analysis procedure. The ANS-T contains 9 unidimensional items and was moderately correlated with therapist-reported working alliance (rxa0=xa0.468). The results of the study support the composition of the ANS-T and provide initial support for the reliability and validity of the measure.

Client–therapist agreement in the termination process and its association with therapeutic relationship.

There is no consensus among different therapeutic approaches on the process of termination when therapy does not have a prefixed duration. Moreover, both clinicians and researchers are still exploring decision making in the termination of treatment. The present study assessed former client’s perspective of therapy termination in a nonprobabilistic sample from Buenos Aires, Argentina. Seventy-three semistructured interviews, lasting ∼60 min each, were conducted with participants that had finished a therapeutic treatment or dropped out. They were asked about several aspects of therapy, including their experience of termination, specifically who decided to terminate, if there was agreement on termination or not, and their thoughts on the termination process. All interviews were transcribed and analyzed using an adaptation of Consensual Qualitative Research (CQR). Quantitative analyses were also conducted to examine associations between variables. Two main factors emerged from the analysis: client/therapist initiative on termination; and level of agreement between client and therapist regarding termination. Whereas nearly all (95%) of therapist-initiated termination cases agreed on termination, client-initiated termination cases could be sorted in agreed (49%) and disagreed (51%) terminations. Both therapist-initiated terminations and agreed upon terminations presented more categories of positive termination motives, better therapeutic bond, and higher overall satisfaction with treatment. Implications for research and clinical practice are discussed.

Comparative Psychotherapy Process Scale (CPPS): analysis of the validity and reliability of the Spanish adaptation /Escala Comparativa del Proceso Psicoterapéutico (CPPS): análisis de la validez y confiabilidad de su adaptación al castellano

Abstract The study of psychotherapeutic interventions and their link with process and outcome variables has become a popular topic of great interest in psychotherapy research. This paper presents the adaptation into Spanish of the Comparative Psychotherapy Process Scale (CPPS), a 20-item scale that measures the degree to which therapists use Cognitive-Behavioural or Psychoanalytic-Interpersonal interventions. A hundred and one therapists (50 cognitive-behavioural and 51 psychoanalytic) completed the CPPS for the last patient they had treated. In a second sample of 15 patient-therapist dyads, both participants completed the CPPS regarding the same session. The subsequent analyses showed preliminary evidence of reliability (internal consistency and homogeneity) and validity (of construct and criterion) in the adaptation of the CPPS to Spanish. The implications of having a scale of these characteristics in Spanish and future lines of research are discussed.