Myrna L. Friedlander

Primary therapist response modes: Comparison of six rating systems.

Six therapist response-mode rating systems were compared in order to delineate a set of primary modes that would best summarize the domain of therapist actions. Ratings of seven diverse therapy sessions showed that, in spite of differences in measurement assumptions and rater characteristics, interrater reliabilities generally were similar. When categories in different rating systems were collapsed to the same level of specificity, moderate to strong convergence was found for the six modes rated in all systems: question, information, advisement, reflection, interpretation, and self-disclosure. These modes discriminated among the seven contrasting therapeutic approaches. Each therapist was characterized by a unique pattern of response modes that differed significantly from the others. Researchers interested in assessing therapist in-session behaviors should consider incorporating measures that include these six modes.

Anchoring and Publicity Effects in Clinical Judgment.

Extrapolation from the literature of social-cognitive bias suggested testing anchoring and publicity effects in clinicians (N = 46) successive judgments of detailed interview notes, five per case. If anchoring occurs, Ss estimates of a clients pathology and prognosis at the final judgment point would be related differentially to the time (early/late) that they had received salient, pathognomonic case material. The publicity effect would be a tendency toward more conservative estimates on the part of Ss who are asked to justify their ratings in writing. Results among an experienced sample of clinicians indicated significant anchoring in one case but not the other, which suggests a clinical bias to disregard pathognomonic data about a client who is seen initially as less disturbed. Public justification was related neither to Ss ratings, to reported confidence in their ratings, nor differentially by case. Implications and limitations are suggested.

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.

Sustaining Engagement: A Change Event in Family Therapy.

It comes as no surprise to experienced family therapists when family members, feeling desperate about their situation, are nevertheless reluctant to work through their interpersonal difficulties with each other. In the session, family members may resist engaging with one another when they do not recognize the potential benefits of doing so or the potential costs of not doing so. Even when the therapeutic alliance is strong, not all family members may be ready or willing to take the risks necessary for change. Indeed, for many reasons, resistance to the therapeutic process is likely to be more problematic in conjoint family therapy than it is in individual treatment. Despite an abundant literature on reducing clients resistance and enhancing their active involvement in individual psychotherapy, surprisingly little has been written about engagement in family therapy. In the clinical literature, we found that only structural theorists have provided extended discussions on the topic (e.g., Aponte & VanDusen, 1981; Colapinto, 1991; Minuchin & Fishman, 1981; Szapocznik & Kurtines, 1989). In these discussions, however, engagement tended to be defined either as entering treatment or complying with the therapist, rather than as a productive collaboration between and among family members in the session. Szapocznik and Kurtines (1989), for example, detailed strategies (e.g., phone calls, home visits, or homework

How do therapists enhance family alliances? Sequential analyses of therapist-client behavior in two contrasting cases.

To identify alliance-related behavior patterns in more and less successful family therapy, the authors intensively analyzed two cases with highly discrepant outcomes. Both families were seen by the same experienced clinician. Results showed that participants perceptions of the alliance, session impact, and improvement at three points in time were congruent with the families differential outcomes and with observer-related alliance behavior using the System for Observing Family Therapy Alliances. In this measure, therapist behaviors contribute to the alliance and client behaviors reveal the strength of the alliance on four dimensions: Engagement in the Therapeutic Process, Emotional Connection with the Therapist, Safety within the Therapeutic System, and Shared Sense of Purpose within the Family. In the poor outcome case, observer ratings and self-reported alliance scores revealed a persistently split alliance between family members; this family dropped out midtreatment. Only in the good outcome case did the clients follow the therapists alliance-building interventions with positive alliance behaviors; sequential analyses showed that therapist contributions to Engagement significantly activated client Engagement behavior, and therapist Emotional Connection interventions significantly activated client Emotional Connection. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Children's depressive symptoms, negative self-statements, and causal attributions for success and failure

On the basis of the reformulated model of learned helplessness, we tested relationships among level of depression, negative self-statements, causal attributions for success and failure, and mood states among schoolchildren. The experimental manipulation of success and failure on an anagram task was an extension of previous work with depressed and nondepressed college students. Results showed, first, that depressive symptoms were related to impaired performance. Second, there were no significantly different responses to success and failure by children with depressive symptoms versus those without such symptoms. Neither causal attributions, self-statements, nor postanagram mood was affected by the presence of depressive symptoms, regardless of whether the child succeeded or failed. On the other hand, across conditions, subjects responded differentially to success and failure. Those in the success condition attributed their performance more to ability and luck and less to task difficulty than did those in the failure condition. Additionally, successful subjects reported a more elevated mood than did unsuccessful subjects. Future research is suggested, based on these results and the different patterns of correlations that emerged among negative self-statements, causal attributions, and mood for successful and unsuccessful subjects.

Demographic, cognitive and experiential predictors of presurgical anxiety

A heterogeneous sample completed a demographic survey, a measure of internal-external locus of control (I-E), the Hospital Stress Rating Scale (HSRS), and a state anxiety measure on the eve of major surgery. Three sets of variables (demographic, cognitive, and experiential) together significantly accounted for one-quarter of the variance in state anxiety. However, only the cognitive set (I-E and the HSRS) was uniquely significant, supporting the view of presurgical anxiety as a patients response to interpretation of a life-threatening event. Higher levels of anxiety were associated with more anticipated stressful experiences, stronger beliefs that powerful others and chance influence events, and weaker beliefs that events are caused by ones own efforts. Implications are presented for identifying patients at risk for presurgical anxiety and for designing interventions to enhance the patients sense of control.

25 Years of systemic therapies research: Progress and promise

Abstract Objective: In this article we describe and assess the state of the science on systemic psychotherapies. In the quarter century since the first issue of Psychotherapy Research was published, considerable progress has been made. There is an increasingly solid evidence base for systemic treatments, which includes a wide range of approaches to working conjointly with couples and families. Moreover, there are exciting new developments that hold promise for explicating the dynamic processes of therapeutic change in couple and family systems. Method: We begin by explaining how we view “systemic therapies” as different from individual approaches and then summarize what we have learned in the past 25 years about this set of treatments, how we have learned it, and what we have yet to learn. Results and Conclusions: We consider current trends in research on outcomes and change process mechanisms, and end with speculations about what lies ahead in the interrelated domains of systemic research and practice.

Exploring corrective experiences in a successful case of short-term dynamic psychotherapy.

The concept of corrective emotional experience, originally formulated by psychoanalysts Alexander and French (1946), has been redefined by contemporary researchers to be theoretically nonspecific, that is, as coming to understand or experience an event or relationship in a different or unexpected way (Castonguay & Hill, 2011). Using postsession questionnaires, videotapes, and posttermination interviews, we explored whether (and how) a corrective experience occurred in a successful case of short-term dynamic psychotherapy (STDP; Davanloo, 1980). A 35-year-old woman suffering severe panic attacks was seen for 31 sessions by an experienced STDP therapist. The questionnaires and interviews focused on (a) perceived intrapsychic and interpersonal changes, and (b) how these changes came about. At termination, the client reported complete symptom relief, greater self-acceptance, improved relationships, and more emotional flexibility. Her corrective experience was evident in the qualitative themes, which showed that she came to understand and affectively experience her relationships with both parents differently. Moreover, the themes reflected both STDP-specific (e.g., confrontation of defenses) and nonspecific (e.g., rapport, acceptance) mechanisms of change. Conversation analysis (Sacks, 1995) of what the client described as the gentle shove of questions that make me see what I have been trying to ignore since childhood showed, on a microlinguistic level, how she overcame resistance to strong emotional experience and expression.

Introducing Semantic Cohesion Analysis: A Study of Group Talk.

This article introduces semantic cohesion-a nonreactive, atheoretical indicator of conversational involvement-to the study of group process. Conversational involvement is assumed to be necessary and common to all types of groups, but groups achieving more cohesive involvement are expected to be relatively more effective. Cohesive talk was observed over time and across four psychotherapy groups led by self-disclosing or nondisclosing therapists; clientsperceptions of the process and outcome were assessed on multiple indicators. Despite individual therapist differences, the nondisclosing groups showed significantly more cohesive interactions throughout (and especially in the early phase) therapy. No differences were observed in clientsperceptions of therapists or their attraction to the group. On all indicators clients showed appreciable gains, but the nondisclosinggroups were relatively more successful. Differences in how self-disclosing and nondisclosing leaders elicit group involvement are discussed and the utility of semantic cohesion analysis in future work on group process is considered.