Michael J. Patton

The Missouri Psychoanalytic Counseling Research Project: Relation of Changes in Counseling Process to Client Outcomes

A short-term psychoanalytic counseling model was used to identify process dimensions and client outcomes. Six counselors saw 16 clients over the course of 2 semesters. Clients responded to measures at pre- and posttest and after each session, and counselors filled out measures following each session. Sessions were audio- and videotaped and viewed by trained raters. P-technique factor analysis identified 4 dimensions: Psychoanalytic Technique, Working Alliance, Client Resistance, and Client Transference. Results of hierarchical linear modeling indicated that counselor use of psychoanalytic technique and the working alliance increased steadily across the sessions, whereas client resistance steadily decreased. The alliance dimension also changed in a quadratic fashion. The process dimensions also influenced each other and were related to better client outcomes. Implications are discussed and suggestions for future research are provided. The research reported here is about the process and outcomes of time-limited psychoanalytic counseling and is based on a program of theory-driven inquiry derived from the work of Patton and Meara (1992). The need for the study arises from the absence of systematic empirical knowledge about the key elements of the psychoanalytic counseling process, particularly as those are continuously measured over the course of counseling. Given our own understanding of psychoanalyti c counseling as both researchers and practitioners, we were interested in answering the following questions: (a) What are the important dimensions of the psychoanalytic counseling process? (b) What is the nature of changes in these dimensions over time? (c) What are the ways in which these dimensions are related to each other over time? (d) How are changes in these dimensions related to client outcomes? To help us examine these questions we formulated a model to guide our inquiry.

Research in Counseling Psychology: Prospects and Recommendations

This report presents a summary of the conclusions and recommendations of the Research Group at the Third National Conference for Counseling Psychology. The report is organized into five topics, as were discussed during the conference. These topics are (a) definition and image, (b) methodological diversity in counseling research, (c) multi- and cross-cultural issues, (d) the connection of research to practice, and (e) research training. Fifteen general recommendations are offered to the specialty regarding research in counseling psychology.

Insight and Symptom Reduction in Time-Limited Psychoanalytic Counseling.

The contention that client insight causes symptom reduction was examined for 12 clients who completed 20 sessions of psychotherapy. Clients rated target complaints before each counseling session and completed the Important Events Questionnaire (IEQ; A. L. Cummings, J. Martin, E. T. Hallberg, & A. G. Slemon, 1992) after each counseling session. Counselors rated target complaints for their clients after each session. Three judges rated the IEQs using the Insight Rating Scale (IRS; R. W. Morgan, L. Luborsky, P. Crits-Christoph, H. Curtis, & J. Solomon, 1982). Validity of the IRS was established by examining the relationship between IRS ratings, counselor-judged insight, and counts of client insight statements. Regression analyses showed that clients had significant linear increases in insight and significant linear decreases in target complaint distress across the 20 counseling sessions. Time-series analyses showed that increases in insight led reductions in target complaints. These results support the importance of insight for symptom reduction.

Counseling Psychology Training A Matter of Good Teaching

The six articles on training in counseling psychology in this issue of The Counseling Psychologist provide the reader with some valuable information about important challenges facing those who would educate and train graduate students in our specialty. One strength of this series of articles is that the topics were determined by a survey of Council of Counseling Psychology Training Programs (CCPTP) members who were asked to identify issues they thought would most likely affect training into the near future. Although I would have wished the authors had provided more specific suggestions about how their many recommended changes in the training curriculum should be implemented, these articles nonetheless do us a good turn by focusing our attention on graduate training in our specialty. The topic of training is more important to counseling psychology now than it has ever been. It is important because of increased sociopolitical pressures that are reshaping the professions in North America (McGuire, 1993), including our own.

Theory and Meaning in Counseling Research: Comment on Strong (1991)

Although distinctions between theory-driven and naive empirical approaches to research are recognized as valuable, the distinction Strong (1991) makes between them is questionable. An argument is made that the more relevant debate is between qualitative and quantitative approaches to counseling research. Some of the differences between the two approaches, as they relate to Strongs ideas, are presented. A proposal is set forth stating that until a more accurate account of events in counseling is achieved, research that is driven by formal theory is of no greater scientific value than less theoretical approaches. Strong (1991) has constructed an interesting argument in favor of theory-driven research in counseling. At the same time, he has contrasted theory-driven research with what he refers to as naive empiricism. The latter is equated, in Strongs view, with alternative (Hoshmand, 1989) or qualitative approaches to research. Although we agree with much of what Strong has to say, we believe that the parallel he draws between naive empiricism and alternative methods is misleading. Theory-driven methods are not exclusively quantitative, nor are empirical methods exclusively qualitative. We believe that progress in advancing scientific knowledge of counseling, however that is achieved, will occur more rapidly when counseling psychologists obtain a correct understanding of the basic facts of counseling. Therefore, the critical problem facing counseling researchers is finding scientific paradigms that are suitable for studying counseling phenomena. Questions about

Non-Metric Multidimensional Scaling Profile Analysis of Non-Growth Change in Groups A Demonstration

Whether groups develop in stages, cycles, or combinations of cycles within stages, processes guiding group development rarely follow monotonic growth patterns (e.g., linear). Standard statistical methods cannot be used to model non-growth processes because they assume that all group members manifest the same growth pattern. We demonstrate how non-metric multidimensional scaling (MDS) profile analysis detects population-level latent normative profiles of non-growth change for repeatedly measured group processes (therapeutic factors) and estimates their association with an external outcome measure (interpersonal problems). Thirty-three individuals participating in counselor training groups reported critical incidents for each of 22 consecutive sessions. Independent judges coded critical incidents using a therapeutic factors rating scheme. Three normative therapeutic factor non-growth profiles were retained, one of which (cycles of interpersonal exploring followed by retreating to safety) predicted decreases in interpersonal problems between pre-test and post-test. Identifying normative- and member-specific change patterns may aid practitioners in matching therapeutic strategies with therapeutic needs.

Kohut and counselling Applications of self psychology

Abstract We summarize Kohuts (1971) bi-polar self which enables counsellors to understand and treat narcissistic behaviours and narcissistic personality disorders in a psychoanalytic framework. After Patton and Meara (1992), we describe Kohuts formulations regarding self-development and disorders of self and how such formulations inform critical components of psychoanalytic counselling with particular emphasis on the explicit and implicit strategies and characteristics the counsellor brings to the process. Finally, we suggest that a promising arena for future theorizing and applications of Kohuts ideas is consultation with parents, teachers and other community leaders to help prevent or remedy psychological self-injuries with systemic interventions outside short-term counselling or long-term therapy. We have suggested that Kohuts self psychology is a good vehicle for understanding what brings a client to counselling: namely, disorders of the self or self-injury. We review strategies and ‘ways of being...