Couple therapy has been proven to be successful in treating marital distress and mental health problems; however, not everyone benefits from couple therapy. Although research suggests that some couple therapists are more effective than others, little research has explored the in-session behaviors of effective couple therapists. The purpose of this study was to code the therapist behaviors of therapist warmth, empathy, validation, presence, collaboration, systemically-based techniques, and session structure in the first session of 17 Emotionally Focused Therapy cases of couple therapy to examine their ability to predict pre-therapy to post-therapy change in male and female marital satisfaction. The seven hypotheses were tested utilizing Bayesian structure equation modeling (BSEM). Results indicate that 13 of the 14 hypothesized relationships between therapist behaviors and change in marital satisfaction were not significant. Only therapist empathy was a significant predictor, but it unexpectedly predicted a decrease in female marital satisfaction over the course of therapy. Possible explanations for the findings and clinical implications were discussed.

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While the Common Factors (CFs) model is becoming more popular it has been criticized for the lack of empirical evidence compared to empirically supported treatments and the lack of capacity to guide clinicians on what to do and when to do it in the course of therapy. This parallel mixed methods study addressed both of these critiques. In phase one, a Common Factors Questionnaire (Karimi-CFQ) was developed to collect empirical data of CFs. In phase two, the Karimi-CFQ was administered to 391 clinicians in the United States to survey the therapists' perspective regarding the contribution of common factors to therapy outcomes. In this phase data was also collected to assess the relationship between clinicians' demographic characteristics and their perceived contribution of common factors to therapeutic change. The CFQ Cronbach's Alpha and Split-half reliability were .84 and .87, respectively. Content Validity Index by expert panel, concurrent validity, and construct validity including Exploratory Factors Analysis (EFA) and Confirmatory Factor Analysis (CFA, χ²=797.96, df=326; RMSEA=.06; CFI=.83) evaluated the validity of the scale. Clinicians across five clinical orientations (Integrative, Cognitive Behavior Therapy, Humanistic, Psychodynamic, Postmodern) and three mental health disciplines (marriage and family therapy, psychology, counseling) attributed 69% of therapeutic change to common factors versus 31% to model-specific factors. Clinicians attributed different contributions to specific components of the CFs model: client (25%), therapist (20%), relationship (23%), hope (12%), non-theory specific (11%), and systemic (9%). Particular clinicians' characteristics (e.g., gender, year of experience) were found to be associated with contributions of specific components of CFs. In phase three, six CF experts were invited to respond to open-ended questions via Wiki that explored how and when experienced therapists use specific common factors in the course of therapy to reach to their therapy goals. Thematic Analysis (TA) generated a chronological map with specific themes that can guide clinicians on how and when specific CFs can be used in each of the three stages of therapy (i.e. Initial, Intermediate, Termination). Findings further indicated that CFs and model-specific factors can be operationally defined and empirically studied within the same evidence-based practice framework. Clinical and research implications of the results are also discussed. / Ph. D.

O objetivo desta tese consiste na elaboração de dois estudos empíricos. No primeiro, estuda-se as propriedades da estrutura a termo das taxas de juros e em particular testa-se a validade da hipótese de expectativas a dados brasileiros e americanos. Os melhores resultados foram obtidos para os dados americanos. No segundo estudo pesquisa-se os determinantes da volatilidade dos títulos de dívida soberana de quatro países – Brasil, Argentina, Rússia e México. Os modelos utilizados são multivariados da família GARCH. Avalia-se em que medida as crises financeiras pelas quais passaram os países citados implicaram em algum tipo de contágio aos demais. Há evidência favorável à hipótese de contágio de muitos dos eventos estudados. / The thesis is composed by two empirical studies. In the first it’s analyzed the proprieties of the interest rate term structure and, in particular, it’s investigated whether or not the expectation hypothesis is a good description of Brazilian and American data. The results are better for American data. In the second study it’s investigated the sovereign debt bonds volatility of four countries – Brazil, Mexico, Russia and Argentine. The volatility was analyzed by the estimation of multivariate GARCH models. The existence of financial crises contagion was investigated and tested. There is some evidence in favor of the contagion hypothesis.

Våld i hemmet är ett växande samhälls- och folkhälsoproblem. En stor utsatt grupp inom våldsutsatta kvinnor är mammorna. Flera studier tyder på att många av kvinnorna och mammorna är nöjda med deras erhållna stödinsatser, trots detta framkommer det att våldet inte alltid upphört efter erhållen insats och att flertalet kvinnor fortfarande i stor utsträckning mår psykiskt dåligt. Syftet med studien är att analysera de grunder våldsutsatta mammor uppger för att de är nöjda eller mindre nöjda med de stödinsatser de erhållit för att få stöd för sig själva och sina barn. Vidare syftar studien till att få en förståelse om vilka förändringsfaktorer som påverkar mammornas upplevelser av stödinsatserna. Studien har en kvalitativ ansats, där vi valt att utifrån teoretiskt förankrade tematiseringar analysera resultatet. I resultatet fann vi fem huvudteman: betydelsen av behandlaren; relationen, alliansen och kommunikationen; klienten; modeller och tekniker; samt tillgängligheten. Resultatet visade att dessa faktorer (temana) spelar en viktig roll i hur mammorna upplever insatserna. Deras inställning och motivation till insatsen samt behandlarens personlighet och kompetens är i själva verket avgörande för hur insatsen uppfattas och påverkar dess resultat. / Domestic violence is a growing community and public health problem. A large and vulnerable group among women exposed to domestic violence are the mothers. Despite the fact that several studies indicate that many of the women and mothers are satisfied with the support received, it appears that the violence has not always ceased at the conclusion of this effort and that a majority of the women are still to a great extent feeling psychologically unwell. The purpose of this study is to analyse on what grounds mothers exposed to domestic violence declare themselves to be satisfied or less satisfied with the support received by themselves and their children. Furthermore, this study purposes to discern which factors of change influence how the mothers perceive the support received. The study utilises a qualitative approach, where we have chosen to analyse the results according to theoretically based thematisations. We have discerned five main themes from our results: The importance of the caseworker, the relationship, the alliance, the communication, the client, models and techniques plus the availability. The results showed these factors (the themes) to play an important role in the way support was perceived by the mothers. In fact, their attitude towards and motivation regarding the support, as well as the personality and competence of the caseworker, determine how the support is perceived, and influence the outcome of the effort.

O objetivo desta tese consiste na elaboração de dois estudos empíricos. No primeiro, estuda-se as propriedades da estrutura a termo das taxas de juros e em particular testa-se a validade da hipótese de expectativas a dados brasileiros e americanos. Os melhores resultados foram obtidos para os dados americanos. No segundo estudo pesquisa-se os determinantes da volatilidade dos títulos de dívida soberana de quatro países – Brasil, Argentina, Rússia e México. Os modelos utilizados são multivariados da família GARCH. Avalia-se em que medida as crises financeiras pelas quais passaram os países citados implicaram em algum tipo de contágio aos demais. Há evidência favorável à hipótese de contágio de muitos dos eventos estudados. / The thesis is composed by two empirical studies. In the first it’s analyzed the proprieties of the interest rate term structure and, in particular, it’s investigated whether or not the expectation hypothesis is a good description of Brazilian and American data. The results are better for American data. In the second study it’s investigated the sovereign debt bonds volatility of four countries – Brazil, Mexico, Russia and Argentine. The volatility was analyzed by the estimation of multivariate GARCH models. The existence of financial crises contagion was investigated and tested. There is some evidence in favor of the contagion hypothesis.

Despite evidence supporting a robust relation between common factors- aspects of the therapeutic setting that are common across all types of treatment- and treatment response, little is known about the mechanisms by which these common factors effect change. Two of the most well-researched common factors include the client’s expectations about the effectiveness of treatment (termed outcome expectancy), and the quality of the therapeutic relationship (termed working alliance). Using archival data, the present study tests the hypothesis that the relation between outcome expectancy and symptom reduction is mediated by the alliance following treatment for social anxiety disorder. Data were collected in a sample of 65 individuals who received cognitive behavioral therapy for social phobia with public speaking fears. Mediation analyses were conducted using Andrew Hayes’ Process Macro (Hayes, 2013). None of the mediation analyses were significant. These findings suggest that the mechanisms of common factor variables may vary by disorder.

This study investigated the experiences of clients who completed a brief heart rate variability biofeedback protocol. The purposes of this study were to (1) learn about client experiences of biofeedback because almost no previous research has done so and (2) explore the potential role of common factors in biofeedback. Fifteen clients were interviewed and their data analyzed according to the methods of Consensual Qualitative Research (CQR; Hill, 2012). CQR relies on the use of group consensus to construct representations of participant experiences and categorize themes within the data. The results of the study showed that participants generally experienced the HRVB+ protocol as helpful. They typically expressed that the intervention helped them with their anxiety or stress and that it increased their self-efficacy concerning their ability to manage anxiety or stress. Several domains emerged that captured data about the biofeedback therapist. Though more research is undoubtedly needed, the findings of this study provide some preliminary support for the idea that common factors could play a role in biofeedback interventions.

The possibility for a positive treatment result increases when clients decide to stay in their treatment programs. For this to happen the client needs to feel respected and treated with dignity. When the therapist and client are able to build a constructive relationship, a therapeutic alliance will almost certainly follow. This takes work. The purpose of this study was to, thorough the eyes of four therapists, examine to what extent the chosen therapeutic method and/or the personality traits of the therapist creates prerequisites for therapeutic success. Are there shared similarities between different methods of therapy, so called ”Common Factors”, that distinguish themselves as central for creating change?Through qualitative interviews with the therapists working with CBT or Solutionwork and Family systems therapy I found many similarities and some differences. By studying modern research on “Common Factors” and comparing it to the interviews I’ve found several interesting results. Traits like empathy and sensitivity are cornerstones in building the coveted alliance. Change is reached through curiosity, exceptions in behavior and thought but maybe most of all compliments and confirmation. Although it is difficult to define which common factors are of greatest importance this study gives some insight to how therapists with different backgrounds, experience and schooling think about their work and what similarities and differences can be identified in their stories.

Research has indicated that there are certain ingredients that make therapy successful. One of these ingredients may be the actual therapist providing the therapy. The concept of a person’s way of being appears in some literature, but the concept of therapist way of being has not been well developed and explored. The purpose of this study was to form a definition of therapist way of being, to gain an understanding of how way of being influences a client’s change in therapy, and to describe and ways of being that are beneficial and detrimental to a client’s journey of change. Data were collected from panelists, who were all licensed clinicians and all reported being at least somewhat familiar with the concept of way of being. The results of the study include a proposed definition of way of being, descriptions of ways of being that promote and deter client change, questions that might be asked of a therapist to better understand his or her way of being, potential responses to these questions that might indicate a change-promoting or change-deterring way of being, and lastly, suggestions for future research on therapist way of being.