The need for systematic research of patient selection variables and group composition dimensions that are related to favorable group therapy process and outcome has been emphasized repeatedly by clinicians and researchers alike. The present study attempted to address this issue by investigating the efficacy of pretraining work behavior as a selection and a composition variable in group psychotherapy. / The work behavior of 66 outpatients in nine cognitive-experiential pretraining groups was measured. Six of the pretraining groups were recomposed into either high or low work therapy groups on the basis of the pretraining scores. The other three groups entered therapy intact. The therapy groups met once weekly for 90-minute sessions and were time-limited for an expected duration of two years. The orientation was psychodynamic. Audiotapes of group sessions from the first five months of therapy were process-analyzed by means of the Therapeutic Work Rating System to assess levels of work in therapy. A comprehensive battery of outcome measures was administered before therapy and six months after therapy began. Hypotheses were formulated concerning: (1) the effects of composition on process and outcome; (2) the relationship of work behavior to outcome; and (3) the rates of premature termination. / The results indicated that pretraining work behavior had merit as a composition variable and showed promise as a selection variable. Group composition was shown to have a strong effect on therapy process, but less effect on outcome. Patients in the high work therapy groups produced significantly more work and worked at significantly higher levels than patients in either the low work or intact therapy groups. In terms of outcome, few significant group condition differences were found. When group conditions were collapsed, a general trend of improvement was found for 10 out of 12 outcome variables. Pretraining work scores correlated modestly with improvement on four outcome variables. Dropout rates were higher than predicted and appeared to be affected by recomposition. The methodological limitations and the clinical implications of the study were discussed in detail. Suggestions for future research were provided.

This study explored the relationship between psychotherapists' personality and choice of theoretical orientation. A total of 493 participants (274 practitioners and 219 students) completed a web-based survey. Personality was assessed using the HEXACO Personality Inventory (HEXACO-PI; Lee & Ashton, 2004) while theoretical orientation preference was assessed using a modified version of the Theoretical Orientation Profile Scale-Revised (TOPS-R; Worthington & Dillon, 2003). In the practitioner sample, the Humanistic/Existential scale was found to be significantly correlated with the Openness Unconventionality scale (r = .34). Results further revealed that practitioners' theoretical orientation preference differed based on the Conscientiousness and Openness personality dimensions. In the student sample, the cognitive-behavioural orientation was significantly correlated with Conscientiousness ( r = .37) and the Conscientiousness Prudence facet scale (r =.36). The humanistic/existential scale was significantly related to Openness ( r = .34) and the Openness Creativity subscale (r = .35). Results further indicated that students' theoretical orientation preferences were different based on the Agreeableness, Conscientiousness, and Openness personality dimensions. Lastly, results showed that students' theoretical orientation preferences were significantly related to their supervisors'. Implications for future research, training, and practice are discussed.

The importance of emotionality during the psychotherapeutic hour has been extensively documented in the psychotherapy theory and research literature. Prominent theorists and researchers have advocated that the degree of client's emotionality is an important therapeutic variable that facilitates therapeutic and personality change. The purpose of this study was to (a) examine the relationship between client level and type of emotionality as measured by the Experiencing, Strength of Feeling-Revised, and Vocal Quality Scales and the occurrence of in-session therapeutic phenomena as measured by the Category System of Client Good Moments scale, and (b) what levels and types of emotionality occur with specific categories of in-session therapeutic phenomena. Trained judges from Master's and Ph.D level in counselling psychology assessed the occurrence of in-session therapeutic phenomena and levels and types of emotionality in 19 psychotherapy sessions from 8 different therapeutic approaches. The findings indicated that: (a) as the level of experiencing and strength of feeling increased, so did the occurrence of in-session therapeutic phenomena; (b) when the client's vocal quality was Focused or Emotional, the occurrence of in-session therapeutic phenomena significantly increased; and (c) there are optimal levels and types of emotionality associated with particular categories of in-session therapeutic phenomena. These findings have implications for refining and extending counselling theory, for process research, and for clinical practice and training. Future directions are also outlined.

This research examined the relationship between client emotional expression and the level of working alliance between therapist and client. The data were collected from 24 psychotherapy sessions conducted by exemplary psychotherapists of different theoretical orientations. The results of the quantitative analysis indicated that there was no significant linear relationship between the level of intensity of client emotional expression and the level of working alliance. Client emotional expression occurred independently of the level of the working alliance. Using a qualitative method, the study restricted its sample to 5 episodes each from the high and low working alliance sessions in order to examine therapeutic processes surrounding client emotional expression more closely. It was found that the nature of emotional expression and the interaction between therapist and client were quite different in episodes taken from the high and the low alliance sessions. In the high alliance sessions, clients expressed their troubling feelings as they examined their problems. Client emotional expressions were signs of productive therapeutic process. On the other hand, in the low alliance sessions, clients expressed anger and frustration toward their therapists for certain breaches of their relationship. Independently of the differing theoretical orientations, the therapeutic process appeared to converge particularly in the low alliance sessions, showing a similar pattern of therapist and client transactions. In addition to the findings, the study proposed a qualitative method suited for examining a wide variety of questions arising from clinical practice.

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The major purpose of this study was to investigate the satisfaction clients obtain from counseling. Satisfaction was determined by means of the degree of fulfillment of expectancy utilizing the Inventory of Fulfillment of Client Expectancy (IFCE). The fulfillment of expectancy was compared between three groups of counselors with different degrees of professional preparations in two domains--cognitive and affective. The total fulfillment of the two domains were also compared among the three groups. Other purposes of the research were to identify the expectancies clients have when they enter counseling, and to determine if a difference exists as to the expectancies of clients within the three counselor groups in regards to the cognitive domain, the affective domain, and the total of the two domains.

This research explores the potentialities of psychotherapy for the management of chronic pain. The model used is brief therapy of systemic orientation and the chronic pain managed is primary headaches (namely, migraines and tension-type headaches). In order to produce clinically relevant material, this research is carried out within an alternative research paradigm. The raw data are the audio-recordings of two cases: one with a man suffering from migraines; the other with a woman suffering from chronic tension-type headaches (aggravated by migraine episodes). These were selected from a pool of cases because they illustrate the phenomena under study and both completed a follow-up which confirmed an acceptable headache management outcome. The recordings were transcribed in order to be studied using discourse analysis of social constructionist orientation (DA hereafter). The research questions explored are: How were the headache problems, the therapeutic aims and the resources for managing them constructed during therapy? What did the participants do with these constructions? How was this particular type of talk interaction helpful in changing the way these two people managed their primary headaches? DA reveals that: (1) the headache problems are entangled in many vicious cycles, Catch-22 situations and even double-binds, and that these patterns have the tendency to perpetuate the problems; (2) the meaning of the headaches vary from one patient to the other, being greatly influenced by their personal experiences, family histories and interaction with health professionals; (3) these meanings influence the co-construction of the therapeutic aims, with management (rather than a cure) emerging as a more achievable goal, with additional auxiliary aims also becoming very important; (4) specific interventions for managing the headaches and for achieving the auxiliary aims lead to concrete changes; (5) these changes are sometimes generalized for other situations, and therapy is seen as a useful resource. Thus, this study shows some of the potentialities of brief therapy of systemic orientation to manage primary headaches, producing concrete suggestions that can be applied in clinical work.

This thesis employs detailed naturalistic observations to study infants from birth to two years. The intensive observational method was originally a training method used in the education of psychotherapists, and it is here adapted for the purposes of research, providing the means whereby the adaptation of the infants within the context of their families could be studied in considerable detail. In particular, the qualities of development that were associated with'risk' (and its corollary, resilience) were capable of detailed observation using this method The naturalistic observational method and the interest in developing relationships and relatedness of the infants and their parents required consideration of a theoretical approach in which the data from the observations could be thought about in terms of emotionality. These theoretical considerations are located in the literature of the two paradigms of child developmental research and psychoanalysis, and leads to an operationalisation of key psychoanalytical concepts, especially Bion's container-contained. In conjunction with the data from the observations, a model is developed which forms a conceptual framework for the purposes of structuring the writing of a descriptive case study for each infant. Further, the categories of the 'model' are used to form an assessment grid, which provides comparisons over time and between the infants in the study. The grid is used both qualitatively and quantitatively. The thesis is therefore innovative and exploratory It contributes to the field through developing new theoretical and methodological approaches. The operationalisation of psychoanalytical concepts adds to the understanding of infancy through empirical study.. The thesis also contributes to and extends psychoanalytical theory with regard to infant development. Thirdly, the study makes a contribution to the understanding of the dynamics of risk in infancy, which is of practical use to professionals in the field. Methodologically, the thesis provides evidence for the efficacy of the wider application of this method of studying infancy, which leads to suggestions for future research through the validation of the concepts and categories developed here.

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No description available.