Charles H. Stinson

Psychotherapy Transcription Standards

Although use of psychotherapy transcripts is becoming increasingly important in psychotherapy research, large-scale collaborative work is hindered by lack of suitable transcription standards. Guidelines are presented for the transcription of discourse, such as psychotherapy sessions, for research and educational purposes. Transcripts generated by following these standards will be readable by human judges; they will also be easily submitted for computer-aided text analysis, such as formal concordance.

Elaboration and Dyselaboration: Measures of Expression and Defense in Discourse

Elaboration and Dyselaboration are new measures for assessing emotional and defensive discourse. The measures can be applied to short segments and so may show the effects of shifts in the subjects state of mind within a session. The measures were reliable when scored on transcripts both from a single case in psychotherapy and from 30 cases in evaluation or therapy dialogues with clinicians. In the single case study these measures were sensitive and able to distinguish different topics of discourse. Results from the group of 30 cases indicated that both measures varied depending on whether the discourse was from therapy, and that some forms of dyselaboration covaried with level of patient distress. Elaboration categories showed convergent and discriminant validity with another relevant measure of therapy process, Depth of Experiencing.

Topics and Signs: Defensive Control of Emotional Expression.

This single-case study examined frank disclosure of important topics in a brief exploratory psychotherapy, including topics closely related to a recent, unintegrated stressor life event. Quantitative measures of emotion and control variables showed heightened levels of both emotionally and defensive control during discourse on the topic of the stressor event. In future studies, such measures of verbal and nonverbal signs of emotional expression and defensive control might be used to identify topics in an unresolved state.

Pathological grief: an intensive case study.

Pathological mourning is such an excessive, blocked, or distorted process that psychiatric signs and symptoms develop. Explanation of how and why these signs and symptoms form could deepen an understanding of both normal and pathological mourning. Because many variables are involved in such explanations, intensive case study is a desirable methodology because it permits a detailed look at how various factors interact (Brewer and Hunter 1989; Luborsky and Mintz 1972; Luborsky and Spence 1971; Nessleroade and Ford 1985). While a patient may complain of symptoms as experiences that endure or occur episodically over days and weeks, a clinician observes psychiatric signs in the here-and-now seconds and minutes of an interview. Relating signs and symptoms to each other and to other variables in order to form a theoretical model of their formation requires exploration of data across long and short time frames. It is important to understand how the here-and-now phenomena combine to form patterns across longer periods of the individuals life. Hence, we developed a combined macro- and microanalytic approach to intensive case studies.

Predictors of complicated grief

Abstract This study examined whether process variables predict an outcome of complicated grief. A turbulent and prolonged grief was predicted to occur after the death of a spouse in subjects who had self-blame, used the deceased for an extension of self, had ambivalence toward the deceased, or overcontrolled emotional responses. Ninety subjects were examined at 6, 14, and 25 months after the loss via a self-report battery of process variables and a structured clinical interview designed to assess symptoms. Subjects with complicated grief were compared with those with normative grief. Predictions were supported only in tertiary data analyses; they were not supported well in the primary and secondary statistical analyses. The authors concluded that either self-reports of process variables are inadequate measures or the theory that led to these measures and predictions is in need of revision.

A Semantic Space Approach to Representations of Self and Other in Pathological Grief: A Case Study

A semantic space model of mental representations of self and other was applied in a case study of pathological grief Traits and characteristics elicited on a questionnaire were used to elicit judgments of similarity of representations of self and important others to one another before therapy began, in the middle of therapy, and at the conclusion of therapy The similarity judgments were analyzed using multidimensional scaling The products of these analyses yielded findings that converged with those derived from coding the therapy transcripts and showed relations between emotions and representations of self

Psyclops: an exploratory graphical system for clinical research and education

We present Psyclops, an interactive computer graphic system designed to help address a growing information dilemma in the examination of individual psychiatric cases. Ever more information is needed to better understand conscious experience, interpersonal behavior, and the formation of psychiatric signs and symptoms, yet the information load already exceeds our usual methods of handling it. Psyclops consists of a suite of software modules, manual sections, and standards that have been developed according to guiding concepts intended to help one collect, organize, access, and explore complex data about a single subject for research, education, and ultimately, clinical care purposes. This document provides background in clinical information science and a description of the system; the reader interested in its application in clinical research theory development is referred to the companion paper in this issue (Horowitz et al., Pathological Grief: An Intensive Case Study).

Distributed expertise: motivation to explore alternative approaches

The authors examine expert system structures and their potential uses in a large psychotherapy research program, which is attempting to examine conscious and unconscious mental processes from a number of perspectives. These include clinical psychodynamics, cognitive science, linguistics, medical anthropology, social psychology, and many others. The program involves multiple experts of different but contiguous or overlapping domains, who perform collaborative coordinated intensive single case studies of psychotherapy sessions. The subjects are individuals who have clearly demonstrable psychopathologies (e.g. pathological grief responses), but who otherwise would be considered high-functioning and normal by most people. The model used in the development of the present system, PSYCLOPS, an interactive high-resolution graphic display system, asserts that in addition to a unique set of measures with knowable reliability and validity, any expert has the capacity to translate technical details into expressions or images meaningful to others with different types or levels of expertise.<<ETX>>