Therapist Response Research Articles

Coding the Therapeutic Process: Emblems of Encounter. A Manual for Counsellors and Therapists; Structuring the Therapeutic Process: Compromise with Chaos—the Therapist's Response to the Individual and the Group

Back to table of contents Previous article Next article ArticleNo AccessCoding the Therapeutic Process: Emblems of Encounter. A Manual for Counsellors and Therapists; Structuring the Therapeutic Process: Compromise with Chaos—the Therapist's Response to the Individual and the GroupTHEODORE NADELSONTHEODORE NADELSONSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.136.2.264-aAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail "Coding the Therapeutic Process: Emblems of Encounter. A Manual for Counsellors and Therapists; Structuring the Therapeutic Process: Compromise with Chaos—the Therapist's Response to the Individual and the Group." American Journal of Psychiatry, 136(2), pp. 264-a–265 Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited ByNone Volume 136Issue 2 February 1979Pages 264-a-265 Metrics PDF download History Published online 1 April 2006 Published in print 1 February 1979

Contingent and non-contingent therapist response.

Contingent and non-contingent therapist response.

Covert outpatient drug abuse. Incidence and therapist recognition.

One hundred ninety-five consecutive psychiatric outpatients were surveyed for covert drug abuse by a standardized technique for determining opiates, cocaine, barbiturates, and amphetamines in urine samples. On the basis of demographic variables, diagnostic information, and treatment course, patterns of abuse were defined for the 13.3 per cent with positive test results. Covert abusers demonstrated a higher incidence of adverse drug reactions and a less favorable therapy course than controls. Covert abuse was meaningfuly related to misdiagnosis, management problems, and therapist's response. Demographic variables and patient reports of previous abuse were not found to be reliable predicators of covert drug abuse. Urine screening for drug use is recommended as an aid to proper diagnosis of psychiatric outpatients that present diagnostic questions.

“I'm dead.”: A linguistic analysis of paradoxical techniques in psychotherapy

This paper deals with paradoxical responses given by psychotherapists to certain utterances of patients in which they exhibit their symptoms. These interventions are paradoxical because they accept, join or reflect the symptom and thus contradict certain expectations that we have for normal reactions in a psychotherapeutic conversation or for conversation in general. f The interest of these paradoxical techniques for linguistics lies in the fact that their analysis allows us to deduce norms and principles holding in the psychotherapeutic situation and in psychotherapeutic discourse. If we can explain why the therapist responses are odd, irregular and paradoxical, we learn about the normality of psychotherapeutic discourse, its regularities and rules. Since the psychotherapeutic conversation is an example of human dialogue in general (and an important part of it), its analysis throws light on even more general principles underlying all conversation. Our paper develops a number of assumptions, and consequences of these assumptions, which must hold for the psychotherapeutic conversation situation. We then show in the analysis of six dialogue sequences how these assumptions together with more general conversational assumptions and social norms are violated by the therapist responses producing the paradoxical effect. However, these violations turn out to be superficial only, limited to the direct, literal semantic level of the utterance. Via the device of violating obvious assumptions on one level the patient is led to infer indirect meanings on a deeper semantic level, the impact of which accounts for the therapeutic effect of the paradoxes. On the indirect meaning level, which is where the relevant communication between patient and therapist takes place, the therapists do not flaunt the basic deep assumptions about psychotherapy or human interaction in general. This has to be the case, for otherwise therapy could not work. In fact the paradoxical techniques are said to be very effective, although it must be conceded that they are not free of manipulation because the maneuvers and tricks to which their effect is due are not usually transparent to the patients.

The Therapist's Response to The Family's Aggression*

Within our own bodies our cells are constantly in a process of repair and disassemblage. It is this process of disassemblage which is the physical analog of psychological destructive ness. In some families, the primary interchanges are not aimed at encouraging constructive ness, and if the family is uncomfortable with this state of affairs they may seek professional help. If the counselor does nothing to relieve the anxiety engendered by their hostile interchanges, the family may view him as just one more discordant element in their unhappy system and leave him very quickly. They may take up the gauntlet with another counselor or they may go on to continue to engage in the process of feeding their energy into the perpetuation of a system which takes up so much of the family's energy that it permits the family to accomplish little else besides maintaining the status quo.

The Initial Psychotherapy Interview: A Content Analysis of the Verbal Responses of Novice and Experienced Therapists

This study tested and confirmed the clinical impressions that (a) the novice psychotherapist may focus so much upon the exact words and nonverbal behavior patterns of his client (the process of making "concrete" statements) that he may lose sight of the larger picture that his client may be revealing at any given moment during the interview; (b) the experienced psychotherapist, on the other hand, seems to be responding to the words of the patient at a level of abstraction that attempts to integrate and understand the messages that the patient is trying to convey about himself; and (c) this latter process is reflected in the making of relatively more "abstract" comments than is true of the novice. Ss were 24 first-year psychiatric residents and 19 staff psychologists and psychiatrists at a veterans hospital and a medical school. The learning theory implications of these findings is discussed.

Assessing intertrainer effects on the Empathic Understanding Scale: training the trainer.

The purpose of this study was to develop a procedure that would provide a preliminary assessment of the level of intertrainer agreement on the Empathic Understanding scale. To illustrate the proposed procedure, a pilot study was undertaken in which 30 excerpts of helping interactions that included the client's statement, therapist response, and client's subsequent response were rated by experienced raters trained by a Carkhuff trainer and a non-Carkhuff trainer. Results indicated that raters trained by different trainers make significantly different judgments about the level of therapist empathy at high levels of empathy. Results of this study were discussed in light of possible scale reliability and construct validity problems. A detailed description and rationale of the proposed procedure was outlined.

An Empirical Investigation of the Construct Validity of Empathic Understanding Ratings

This study examined the effect of different amounts of client‐therapist interaction data on empathy ratings. Audiotaped therapist‐client interactions including client statement, therapist response, and subsequent client response were rated for therapist empathy by high‐functioning, experienced raters. Raters made significantly different judgments about levels of therapist empathy depending on the amount of therapist‐client interaction data available. The raters tended to give therapist responses higher empathy ratings when they did not hear the client's preceding statement.

A modest proposal: A family therapist's response to pathogenic relatedness in mental health agencies or what to do about “the santa claus factor”

A modest proposal: A family therapist's response to pathogenic relatedness in mental health agencies or what to do about “the santa claus factor”

Empathic: An Unappreciated Way of Being

It is my thesis in this paper that we should re-examine and re-evaluate that very special way of being with another person which has been called empathic. I believe we tend to give too little consideration to an element which is extremely important both for the understanding of personality dynamics and for effecting changes in personality and behavior. It is one of the most delicate and powerful ways we have of using ourselves. In spite of all that has been said and written on this topic, it is a way of being which is rarely seen in full bloom in a relationship. I will start with my own somewhat faltering history in relation to this topic. Personal Vacillations Very early in my work as a therapist I discovered that simply listening to my client, very attentively, was an important way of being helpful. So when I was in doubt as to what I should do, in some active way, I listened. It seemed surprising to me that such a passive kind of interaction could be so useful. A little later a social worker, who had a background of Rankian training, helped me to learn that the most effective approach was to listen for the feelings, the emotions whose patterns could be discerned through the client's words. I believe she was the one who suggested that the best response was to reflect these feelings back to the client-- reflect becoming in time a word which made me cringe. But at that time it improved my work as therapist, and I was grateful. Then came my transition to a full-time university position where, with the help of students, I was at last able to scrounge equipment for recording our interviews. I cannot exaggerate the excitement of our learnings as we clustered about the machine which enabled us to listen to ourselves, playing over and over some puzzling point at which the interview clearly went wrong, or those moments in which the client moved significantly forward. (I still regard this as the one best way of learning to improve oneself as a therapist.) Among many lessons from these recordings, we came to realize that listening to feelings and reflecting them was a vastly complex process. We discovered that we could pinpoint the therapist response which caused a fruitful flow of significant expression to become superficial and unprofitable. Likewise we were able to spot the remark which turned a client's dull and desultory talk into a focused selfexploration. In such a context of learning it became quite natural to lay more stress upon the content of the therapist response than upon the empathic quality of the listening. To this extent we became heavily conscious of the techniques which the counselor or therapist was using. We became expert in analyzing, in very minute detail, the ebb and flow of the process in each interview, and

Predictions of outcome in psychoanalysis and analytic psychotherapy.

The written records of 1,348 patients treated at Columbia University's Psychoanalytic Clinic and the responses of therapists to a follow-up questionnaire were studied to relate clinical change and predictions of outcome made at the time of admission. Predictions were associated with the type of treatment offered, with the function of the observer, and the completion of long-term analysis.

Verbal interaction analysis of empathic and nonempathic responses of therapists.

Verbal interaction analysis of empathic and nonempathic responses of therapists.

Reliability among physical therapists in diagnosis and treatment of gait deviations in hemiplegics.

A questionnaire study and an observational study were conducted to investigate reliability among physical therapists in diagnosing and treating gait deviations in hemiplegics. In Study 1, groups of 3 therapists independently filled out questionnaires on each of 10 patients to determine the extent to which therapists agree on deviations to be treated and on treatment approach. In Study 2, raters observed gait training classes and independently scored the frequency of a variety of ongoing therapist responses and the frequency of specified gait deviations being treated in the patients. The aims of this study were to determine whether observers agreed on frequencies of therapist and patient responses, to assess quantitatively whether different therapists differ in their treatment approaches, and to determine whether some of the observed therapists produce greater changes in frequency of gait deviations than others. The results of Study 1 suggested rather poor agreement among therapists as to the major gait deviations to be treated and the preferred approaches to treatment of the individuals observed. Study 2 indicated high agreement among raters scoring both therapist and patient responses and suggested differences in observed treatment approaches and differences in degree of change produced by different therapists. Results, observations, and the need for further research were discussed.

Cross-validation of some personality correlates of the A-B therapist scale among male alcoholics.

The A-B therapist distinction, determined by a therapist's responses to a scale composed of Strong Vocational Interest Blank items, seems a promising variable for predicting therapist-patient compatibility. One assumption of A-B laboratory analogue studies, needed to justify the use of non-therapists, is that scores on the A-B scale have some basic personological invariance across populations. Recently, the explicability of the scores in terms of scales and factors of Jackson's Personality Research Form has been demonstrated (1). Also, five core correlates of A-B scores in Jackson's Harmavoidance, Dominance, Change, Sentience, and Succorance scales for male professionals, male students, male patients, and female smdents have been shown (2). The present aim was to examine the invariance of the A-B scale within a radically different population, 129 chronic alcoholic male veterans, whose mean age was 42 yr., and mean education 11 yr. The A-B scale was included in the admissions battery of this hospital's Alcoholic Treatment Program of which Form AA of Jackson's inventory was already a part. Of Jackson's 20 content scales, 8 were significantly (p < .05) but very modestly correlated with A-B total scores-Harmavoidance ( - .25 ) , Sentience (.23), Change (.23 ) , Play (.21) , Affiliation (.21), Nurmrance (.21), Dominance (.19), and Understanding (1) Among these 8 scales are 4 of the 5 core correlates, 3 of which, here, rank as the best 3 correlates of A-B scores for male alcoholics. Ss were then assigned an A-B status on the basis of total score cut-offs for male professionals and male students (1). Univariate F ratios, berween the 16 As and 52 Bs thus obtained, for each of Jackson's scales, yielded significant Fs (p < .05, df = 1/66) for 7 scales (only Play did not differentiate groups). The same 4 core scales emerged among the first 5 largest F ratios across the A vs B groups. Thus, even for chronic alcoholic males these core scales were related to both the distribution of A-B total scores and, more importantly, to the A and B prototypes (based on total score cut-offs) as used in analogue studies. Thus, like the A-type professional therapists, collegiate Ss, and outpatients studied in prior research, the A-rype male alcoholics emerge as cautious, uninclined to seek sensory thrills, change-avoidant, and submissive; the B-types, in contrast, may be depicted as more adventurous, as seekers of sensation and change, and as more dominant. The convergence of these data with those of prior studies (1, 2) leads to the conclusion that the A-B scale's personological invariance is not only replicable, but quite robust.

Experimental psychotherapy: effectiveness of therapist response under two conditions of threat.

Journal of Clinical PsychologyVolume 29, Issue 1 p. 100-103 Psychotherapeutic Processes Experimental psychotherapy: Effectiveness of therapist response under two conditions of threat Henry J. Paar, Henry J. Paar Springfield CollegeSearch for more papers by this authorJulius Seeman, Julius Seeman George Peabody CollegeSearch for more papers by this author Henry J. Paar, Henry J. Paar Springfield CollegeSearch for more papers by this authorJulius Seeman, Julius Seeman George Peabody CollegeSearch for more papers by this author First published: January 1973 https://doi.org/10.1002/1097-4679(197301)29:1<100::AID-JCLP2270290136>3.0.CO;2-BCitations: 2AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Citing Literature Volume29, Issue1January 1973Pages 100-103 RelatedInformation

Length of therapist response, accurate empathy and patient improvement.

Length of therapist response, accurate empathy and patient improvement.

When Hetty meets Betty who does Hetty meet?

I am a narrative psychotherapist. When I work with a client I attempt to use the language of the client to describe what is going on for the client. Narrative therapy considers not only the individual within the family context but considers wider influences by deconstruction of the understandings and stories about the self that come from society on a more global level. This process externalises problems and opens space for reauthoring lives. Countertransference is a psychodynamic term used in a fairly universal way by therapists of many different theoretical backgrounds. Rather than taking a blameful position (e.g. that the individual has the problem) the presentation takes a questioning position about the influence of the predominant heterosexual culture on the individual therapist's response (the countertransference).

The response to psychotherapy in chronic ulcerative colitis. II. Factors arising from the therapeutic situation.

The outcome of psychotherapy in 30 patients with chronic ulcerative colitis was correlated with factors arising from the psychotherapeutic situation. Factors introduced by the therapist included his technical interventions, his personality, his attitudes toward the patient, his competence, and his grasp of the patient's psychodynamics. Patient factors included the latter's attitudes toward his illness and toward psychotherapy, his ability to change unfavorable life situations, the quality of his object relationships, his reactions to object loss, and his capacity for ego strengthening. Other factors were the frequency of sessions and the duration of psychotherapy. Interpretation, support, emotional abreaction, and direct suggestion were variably effective with different types of patients. Individuated patients did well with interpretation and abreaction. Symbiotic patients did better with support, suggestion, and graded abreaction. The fit between the patient's dependency needs and style of expressing them and the therapist's responsiveness to them was particularly important to the outcome. Therapist's interest, empathy, and optimism when combined with his patient's hopefulness produced the highest improvement rate. The patient's ability to change unfavorable life situations helped to maintain improvement. Psychoanalysis was indicated in selected patients. Less intensive psychotherapy helped the majority. Longer therapies generally gave more lasting results.

Responses of non-professional therapists to chronic schizophrenics.

Responses of non-professional therapists to chronic schizophrenics.

相談過程における関係認知と治療的変化

This study is an attempt to test and examine hypothesis 1 (a),(b) and 3 in the experimental hypotheses by G. T. Barrett-Lennard.By their hypothesis 1 (a), the relationship variables as measured after interviews at initiation of therapy, were assumed to be positively correlated with the therapeutic change during the period of therapy. Moreover, these associations were predicted to be stronger when the relationship qualities were measured from client perceptions than when they were measured from therapist perceptions. However converse results have come out in this research.The hypothesis 1 (b) predicted that the relationship as measured from client or therapist perceptions at termination of therapy would also be positively associated with change. For this hypothesis this researcher has found that correlation at termination of therapy was stronger in the case of therapist perceptions than in client perceptions.So far as their hypothesis 3 is concerned, the same outcome has been produced: that is, combined relationship perception total scores of the two participants (clients and therapists) were more associated with therapeutic change than scores of either one of them (the clients or therapists).The fact that could be stated in common after examinations of these three hypotheses in this correlation between the variable of empathic understanding and the therapeutic improvement were greatest. From these investigations, the next questions will be presented: 1) The generalization of client perceptions 2) The limitation of perceived relationship inventory(1) In the procedure of the generalization of client perceptions by Barrett-Lennard, the response of the differential therapists related to the identical clients would be responsible for the different perceptions of the clients and, hence, for differences in therapy outcome. In this paper, for identical therapist attitude related to different clients, they express different responses. This difference would come out as the variable of empathic understanding in therapist perceptions.(2) Variables of “self-congruence” and “unconditionality of regard” in therapist perceptions secure the stability of attitude necessary for therapists in spite of therapeutic change. On the other hand, client perceptions are not responses for the three variables (congruence, empathy, and unconditionality) but these are understandable as reflection upon the inner state with dependency, hostility, disturbancy.