The aim of this renewal proposal is to do further analyses of nine cases of brief psychotherapy with experienced therapists and anxious depressed female clients. Four studies are proposed to explore clinically relevant variables which have received minimal empirical attention. Study 1 will focus on the working alliance between the therapist and client. Observer measures of working alliance be compared to select the best measure. Also, a new measure will be developed to investigate the ebb and flow of working alliance within sessions. Then, comparisons will be made bewteen therapist, client, and observer meaures of working alliance in relation to therapy process and outcome. Further, how working alliance is related to subsequent interventions as well as how specific interventions affect working alliance will be examined. Study 2 will focus on the effects on gender to determine whether female clients have different experiences with male and female therapists; and if so, what accounts for these differences. Three models of gender effects (gender per se, sex role characteristics, and the dyadic composition of sex role characteristics) will be related to therapy process and outcome. Study 3 will investigate therapist interpretations, often described as the """"""""pure gold"""""""" or sine qua non of therapy. Evidence is needed about when to use interpretations, what type will be most effective, and how to judge quality, timing, and impact. Different types of interpretations will be studied under different contextual conditions and related to subsequent client response as well delayed impact. Study 4 will explore client transference and therapist countertransference, both of which have been postulated to have a powerful influence on therapy. Most of the literature on these variables is from the psychoanalytic perspective and consists of clinical speculation rather than rigorous empirical examination with clear operational definitions. These variables will be examined both as they occur through behaviors within sessions and through therapist, client, and researcher reports of their occurrence.
| 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 |
