The specific aim is to use a case study design to examine the impact of therapist techniques on client outcome in individual insight-oriented psychotherapy. An electic process model will be used to conceptualize how techniques operate in psychotherapy. In the beginning of treatment, the therapist's intent is to use empathic responding and expertise to build the relationship. In middle stages, the therapist's hypotheses about client dynamics enable him/her to formulate intents to change client behaviors, affects, and cognitions through the implementation of specific techniques. The final stage consists of the therapist's intents to help the client generalize changes to situations outside therapy. Thus, it is hypothesized that therapists will use different response modes, intentions, and reported techniques for progressive stages of therapy. Further, different therapists techniques will lead to different immmediate client responses, ratings of sessions, reports of impacts, and outcomes of treatment. Two male and two female experienced therapists will do two cases of 12-20 sessions of individual psychotherapy with young motivated adults of the same gender. Following each session, clients and therapists will report about techniques and rate sessions. Transcripts of each session will be judged for therapist intentions and client and therapist resoponse modes. Outcome of treatment will be determined by changes after treatment and at a 6-month follow-up on the MMP1, HSCL, TSCS, Target Complaints, and ratings. The influence of therapist techniques on client outcome will be determined by analyses of variance of thirds of sessions and thirds of treatment, sequential analyses of immediate effects, comparison of techniques used in best vs. worst sessions of each case and of cases with most vs. least overall change, evaluations by peer reviewers, and qualitative analyses of the research team. The results will indicate specific response modes, intentions, and reported techniques which are appropriate for specific situations in treatment. The findings will have implications for the improvement of psychotherapy practice, training, and credentialling, particularly in providing a model for evaluating competence of psychotherapists.
| Hill, C E; O'Grady, K E; Elkin, I (1992) Applying the Collaborative Study Psychotherapy Rating Scale to rate therapist adherence in cognitive-behavior therapy, interpersonal therapy, and clinical management. J Consult Clin Psychol 60:73-9 |
| Hill, C E (1990) Exploratory in-session process research in individual psychotherapy: a review. J Consult Clin Psychol 58:288-94 |
