Marilyn Fitzpatrick

The secure-base hypothesis: Global attachment, attachment to counselor, and session exploration in psychotherapy.

This study explored J. Bowlbys (1988) secure-base hypothesis, which predicts that a clients secure attachment to the therapist, as well as the clients and the therapists global attachment security, will facilitate in-session exploration. Volunteer clients (N = 59) and trainee counselors (N = 59) in short-term therapy completed the Experiences in Close Relationship Scale (K. A. Brennan, C. L. Clark, & P. R. Shaver, 1998) as a measure of adult global romantic and peer attachment orientations; the Client Attachment to Therapist Scale (B. Mallinckrodt, D. L. Gantt, & H. M. Coble, 1995) as a measure of attachment to counselor; the Working Alliance Inventory (A. O. Horvath & L. Greenberg, 1989) as a measure of working alliance; and the Session Evaluation Questionnaire-Depth Subscale (W. B. Stiles & J. S. Snow, 1984) as a measure of session depth. In line with Bowlbys hypothesis, the findings suggest that session depth is related to the clients experience of attachment security with the counselor and that counselor global attachment moderates the relationship between client global attachment and session exploration. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Positive Emotions as Generators of Therapeutic Change

The purpose of this article is to highlight commonalities and facilitate links between the domains of psychotherapy and positive psychology. The authors describe the Broaden-and-Build theory and suggest that it has heuristic value for understanding psychotherapeutic processes. The authors propose that broadening represents a common factor in intrapersonal therapy that contributes to many helpful change events across different psychotherapies. The upward spiral in which positive emotions and broadening feed one another enlarges current psychotherapeutic conceptualizations by suggesting that positive emotions are not just indicators but also generators of change. The positive emotionbroadening spiral offers new avenues for research and ways to understand existing research, an alternative avenue to therapeutic change, and a method to tailor therapeutic work to individual clients. It also bridges researcher, clinician, and client points of view about key change events. Links between different viewpoints enhance therapeutic work. Links across lines of theorizing and research foster interdisciplinary ties that fertilize both fields.

Trainees’ experiences of impasses in counselling and the impact of group supervision on their resolution: A pilot study

A qualitative analysis of eight interviews was conducted to answer the following questions: ‘How do trainees experience a clinical impasse?’ and ‘How does the experience of group supervision help or hinder the resolution of these impasses?’ MA students in a counselling psychology program at a Canadian university were interviewed at two points in time: after experiencing a clinical impasse and after receiving group supervision for the impasse. Data were analyzed using consensual qualitative research methodology (CQR; Hill, Thompson & Nutt-Williams, 1997) to identify themes relative to our two questions. Results indicated that when trainees experienced an impasse they reacted with negative emotions because they did not know what to do in session with the client at that point in time, and they experienced the impasse as a failure. Trainees reported seeking supervision to obtain validation/support, and found that supervision provided them with this. As well, a new perspective on the impasse event and increase in self-awareness was reported. An unexpected finding included dissatisfaction with the dynamics of the supervision group. These findings have implications for trainers: for understanding the supervisory needs of trainees, for appreciating the impact of supervision on counsellor development, and for generating alternate practices of supervision.

INTEGRATING WRITING INTO PSYCHOTHERAPY PRACTICE: A MATRIX OF CHANGE PROCESSES AND STRUCTURAL DIMENSIONS

Research on therapeutic writing indicates that it can offer a range of physical and psychological benefits. There is no consensus, however, concerning how writing achieves these benefits. To address this question, the authors propose a matrix framework with emotional-cognitive change processes (what can be activated) along its horizontal dimension and abstract-concrete structure (how the processes are activated) along its vertical dimension. On the horizontal dimension, writing can encourage clients who are distant from their emotional world to approach or to modulate emotional intensity, and to create meaning and coherence. Along the vertical dimension, these processes can be activated through tasks that vary in structure, including programmed writing, diaries, journaling, autobiography, storytelling, and poetry. Finally, the authors consider constraints on writing that apply to particular client groups. The matrix framework is meant to encourage clinicians to use therapeutic writing and to assist researchers in framing questions to advance our knowledge of writing as a therapeutic practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Client relationship incidents in early therapy: doorways to collaborative engagement.

Abstract The purpose of this study was to elaborate how clients understand the development of the alliance and to highlight aspects of the process particular to depressed clients working with experienced therapists. Fifteen participants described critical incidents in early therapy that influenced how they understood their working relationships with therapists. All incidents involved clients appraising what their therapists were doing. Through interviewer probing, participants were able to identify the importance of their own activity (disclosing and working with therapist input) as their collaboration in the incidents. Positive emotional responses were woven through the descriptions of the incidents. The research underscores how client understanding of collaboration might be accessed by researchers or clinicians and the potential importance of the interaction of client active exploration with positive emotions in understanding alliance development.

Cognitive errors, coping patterns, and the therapeutic alliance: A pilot study of in-session process

Aim: This exploratory study examined the association between clients’ assessment of the therapeutic alliance and their cognitive errors (CE) and coping action patterns (CAP). Method: Selected therapy sessions of clients (N = 26) were rated for cognitive errors and coping action patterns using the CERS and CAPRS methods (Drapeau, Perry, & Dunkley, 2008; Perry, Drapeau, & Dunkley, 2005). The therapeutic alliance was assessed using the Working Alliance Inventory (WAI; Horvath & Greenberg, 1989). Results: Following Bonferroni corrections, no significant relationship was found between clients’ CEs and their ratings of the WAI. However, the ‘Negotiation’ CAP was associated with the total alliance score, and with the Task and Goal subscales. Implications: A better understanding of the cognitive processes presented by clients in session can enable clinicians to address these factors early on when the alliance is most critical.

Participant critical events: a method for identifying and isolating significant therapeutic incidents

Abstract The participant critical events (PCE) is an interview and segmentation method to identify and locate critical events nominated by clients or therapists. Twenty-six clients and seven therapists were interviewed and described events located on session tapes. Interrater reliability in identifying the events using a revised protocol and segmentation rules was good (α=.82). Comparison of researcher segmentation of the events to participant segments collected during tape-assisted recall indicated that the method allowed researchers to correctly identify the events. Decision rules for segmenting PCEs are outlined. The potential of the PCE method lies in its capacity to allow researchers to identify critical events for further intensive study and to compare researcher data to participant understandings of the meanings of critical events.

Integrating positive emotions into theory, research, and practice: A new challenge for psychotherapy.

This article elaborates on the themes and directions that emerged from a dialogue on the potential usefulness of positive emotions in psychotherapy. In defining a positive emotion, the authors propose that there are two intersecting axes of interest. The axes are emotional experience—whether something feels good or bad to the client—and therapeutic value—how helpful the emotion is to the therapeutic process. Three of the four quadrants formed by the intersection of these axes potentially contain positive emotions. Special consideration is given to the quadrant of positive experience/ positive value, which has been relatively neglected until now. In this quadrant, positive emotions generate change either in their facilitating role—often in the therapeutic relationship—or as central agents of the change process. The authors conclude by considering how positive and negative emotions interact and call for careful theorizing and research to clearly understand positive emotions in psychotherapy.

The relationship between therapeutic engagement, cognitive errors, and coping action patterns: An exploratory study

Aim: This exploratory study examined the relationship between clients’ involvement in therapy and their cognitive errors (CE) and coping action patterns (CAP). Method: Therapy sessions from N = 26 clients were rated for CE and CP using the CE and CAP methods. Client involvement was measured with the Positive and Negative Affect Schedule, as well as the . Results: The CEs’ ‘magnification of the negative or minimisation of the positive’ and ‘labelling’ were associated with measures of affective therapeutic engagement. The coping styles ‘negotiation’, ‘opposition’, ‘submission’, ‘isolation’, ‘support seeking’, ‘information seeking’, ‘delegation’, and ‘escape’ were found to be associated with affective and behavioural dimensions of therapeutic involvement. Conclusions: These findings provide preliminary supporting evidence that CE and CP are related to the extent to which clients engage in the work of therapy. Implications for researchers and therapists are discussed.

The manifestation of transference during early psychotherapy sessions

Despite the clinical use of therapeutic transference across various schools of psychotherapy, there have been relatively few empirical studies of this phenomenon, none of which has examined transference with a non-pathological population. In this study, the core conflictual relationship theme (CCRT) method was used to examine the manifestation of therapeutic transference in the first three sessions of 22 counselling contracts with high-functioning individuals. Factor analyses of the wish (W) and response of other (RO) components of the CCRT indicate a complementary pattern of relating in which the therapist is idealised and others are devalued. Within the response of self (RS) component, clients exhibited a concordant relational transfer whereby they had a negative response to both the therapist and others. Additionally, control issues emerged in the W component for significant others and in the RS component for the therapist.