Follow you or follow me? Examining therapist responsiveness to client and responsiveness to self, using differential equations model and multilevel data disaggregation from an interpersonal theory framework.

Abstract

This study examined the effects of therapist interpersonal responsiveness on client-rated working alliance in their first psychotherapy session using the ordinary differential equations (ODE) model and multilevel data disaggregation. Responsiveness was operationally defined in this study as therapists adjusting their subsequent level of control/affiliation based on their clients' and their own current level of control/affiliation. Every 2-min segment of 111 first psychotherapy sessions for 111 clients nested within 38 therapists was rated by 11 trained raters on therapist and client levels of control and affiliation. An ODE model produced dynamic coefficients capturing therapists' responsiveness to clients and to themselves in that session, which were then disaggregated into between-therapist and within-therapist components. Hierarchical linear modeling revealed that for the control dimension, at the between-therapist level, therapist responsiveness to the client significantly predicted client-rated working alliance: Client-rated working alliance was (a) highest for therapists who generally increased their level of dominance/submission when their client was more dominant/submissive in the previous turn, and (b) lowest for therapists who generally increased their level of dominance/submission when their client was more submissive/dominant in the previous turn. None of the other associations were significant. Theoretical, methodological, and practical implications are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).