Individuals who report better relationships with their mental health providers have better treatment outcomes. One element of the relationship is therapist empathy, or the therapist's ability to see the world from the client's point-of-view. Researchers have struggled to define, measure, and teach empathy. The purpose of this study was to investigate whether instruction in character analysis techniques, such as those used by actors, had an effect on cognitive empathy. A convenience sample of 20 adults enrolled in undergraduate or graduate-level coursework was recruited for participation in this study. Each individual provided demographic information and completed the Interpersonal Reactivity Index (IRI) and the Literature Empathy Test (LET). The intervention group (n = 10) participated in a 45-minute character analysis training prior to completing the LET. The control group (n = 10) completed both assessments in a separate meeting with no intervention. A univariate analysis of covariance was used to discover the effect of character analysis training on LET scores in light of IRI scores. The data analysis revealed no significant relationship between the intervention and LET scores, but the findings provided several insights. Future research would benefit from modifications to the LET, inclusion of an additional empathy measure, and revisions to the sample size and inclusion criteria. Although the results of the present study were not significant, this area of research remains a promising means by which to promote social change by informing the pursuit of positive interpersonal relationships and prosocial behaviors

Many clients drop out of therapy before reaching their goals, (Bohart & Wade, 2013) though research shows that being in therapy is more effective in producing change than not being in therapy, (Lambert, 1992). Little is known about what makes therapy effective (Davis & Piercy, 2007a, b; Pinsof & Wynne, 2000). The purpose of the present study was to understand what clients believe is productive about therapy, and how clients’ assessment of therapy productiveness impacts their decision to remain in therapy or to drop out of therapy. For the qualitative strand of this simultaneous convergent mixed methods study, grounded theory was used to inductively develop a common-factors informed model describing how productive change processes influence intended retention. The convenience sample consisted of 19 current clients in therapy with a marriage and family therapist. For the quantitative strand, participation involved completing a semi-structured interview and quantitative survey. Direct, binary logistic regression analyses were conducted to determine whether perceived productiveness, goal attainment and therapeutic alliance, predicted intended treatment retention or intended dropout. The convenience sample for quantitative analysis included the 19 qualitative participants, and continued sampling until adequate statistical power was reached with 72 participants. Mixed analysis strategy was data comparison for the purpose of triangulation. Qualitative results span three categories emerged from qualitative: client factors, therapy process factors and evaluation of progress. Client factors, including presenting problem factors, expectations and motivation were considered when participants made decisions about staying in therapy or dropping out of iii therapy. Therapy process factors, including therapists’ understanding of the presenting problem, therapeutic alliance, therapists interventions and the pacing and timing of those interventions were also considered when participants made decisions about staying in therapy or dropping out of therapy. When participants evaluated the progress made because of therapy, they evaluated changes in the presenting problem, symptom reduction, and noticed this progress took place outside of therapy. Quantitative results showed that goal attainment, therapeutic alliance and productiveness significantly predicted intended retention when each was tested as an individual predictor. When tested in a full model, containing goal attainment, therapeutic alliance and productiveness; only the task domain of therapeutic alliance emerged as significant. Results confirm the importance of therapeutic tasks to clients’ decision to stay in therapy or to drop out of therapy. Results contribute to the importance of common factors in keeping clients in therapy until they reach their goals. Further, results inform research, clinical practice and training in the MFT field. / Ph. D.

Studien syftade till att belysa hur ungdomar med missbruksproblem i efterhand värderar en behandlingsinsats samt vilka betydelsefulla förändringar som de uppfattar har skett. Studien har utgått från ungdomarnas egna utsagor med hjälp av UngDOK och dess uppföljningsformulär. Studien har sin grund i mixed methods, vilket innebär inslag av både kvalitativ och kvantitativ forskningsansats. Den teori som användes för att analysera resultatet var The Common Factors Theory. Resultatet visade att gemensamma faktorer såsom den terapeutiska alliansen mellan behandlare och ungdom samt den professionellas acceptans och empati var viktiga aspekter för ungdomarna under behandlingskontakten. När det gäller betydelsefulla förändringar var faktorer utanför behandling mest betydelsefullt för tillfrågade ungdomar. Dessa förändringar handlade om att ungdomarna har lyckats med att återuppbygga relationer till sin familj och vänner samt att de har träffat en ny partner eller att de har lyckats fullfölja sina studier och skaffat en meningsfull sysselsättning.

The Common Factors Model was introduced in 1992 by Michael Lambert suggesting that four factors that exist in all forms of psychotherapy are what account for positive therapeutic outcomes. The four common factors posited by Lambert include: Extratherapeutic Factors, The Therapeutic Relationship, Hope and Expectancy and Specific Factors. Marriage and family therapy is one form of psychotherapy that has taken an interest in The Common Factors Model and dedicated various amounts of research to understand connections between the two philosophies. Despite the efforts to understand common factors that exist in marriage and family therapy, very little research has been done studying the relationship between the common factor Hope and Expectancy, and marriage and family therapy. The current study aimed to fill that gap, by exploring the relationship between marriage and family therapy, and the common factor hope and expectancy through the lens of Snyder’s Hope Theory. In this study, a mixed methods sequential embedded designed was implemented to examine the relationship that exists between marriage and family therapy and the common factor Hope and Expectancy. The results indicated that levels of hope and expectancy were high in parents/guardians who were going to start participating family therapy with their child. The high levels of hope and expectancy were likely due to the activation of an interaction between extratherapeutic factors and hope and expectancy. Some of the extratherapeutic factors involved in the interaction were specific to marriage and family therapy, while others can be found in all forms of psychotherapy.

This study compares the counselor credibility of therapists who use problem-focused with those who use solution-focused language. Participants from two undergraduate classes at a southeastern state university were assigned to one of two eight-minute videotapes of a role-played family therapy session: problem-focused or solution-focused. This study is a posttest only quasi-experimental design. One group (N=35) viewed a videotape of a session that used solution-focused language. Another group (N=38) viewed a videotape of a session that used problem-focused language. The same therapist conducted both sessions and the same actors were used as the client couple. After viewing the videotape, participants rated the therapist's credibility (as measured by the Counselor Rating Form - Short Version), completed a Demographic Questionnaire and answered three open-ended questions. Two research questions were examined in this study: (1) Do potential clients perceive a therapist using solution-focused language as more attractive, experienced, trustworthy, and more credible than the same therapist using problem-focused language? (2) What other variables affect potential clients' view of the therapist? No significant differences in counselor credibility were found between the two groups. Three categories were discovered in the analysis of the open-ended questions: therapist characteristics, actions/skills of therapist, and other. When asked what they liked the most about the therapist, the majority of the participants' (86 percent) responses fell into the category of actions and skills of the therapist. When asked what they liked the least about the therapist, the majority of the participants' (64 percent) responses fell into the category of therapist characteristics. / Master of Science

Researchers and clinicians report that they think the client is the most influential component in determining the outcome of therapy. Although a variety of studies have examined the impact of various client factors on the outcome of couple therapy, this research is not cohesive and produces inconsistent results. The purpose of this multi-method study is to present a sense of the range and depth of client factors that influence the outcome of couple therapy. The use of qualitative and quantitative methods allowed the data to build on existing research while expanding the range of client factors considered. Data were gathered using a dynamic, web-based survey which assigned participants to discuss a case of successful or unsuccessful couple therapy. Participants provided their own descriptions of influential client characteristics. Participants also rated how important they thought several literature-based client factors were. Quantitative data analysis utilized descriptive statistics, principal components analysis, and logistic regression. Qualitative data were analyzed in two stages, using content analysis. Results indicated that couples can be conceptualized by five arenas of couple focus; these arenas accurately predicted whether participants were discussing a successful or unsuccessful case of couple therapy 85.9% of the time. Regarding individual client characteristics, in general, clients whose couple therapy was successful tended to be open to each other and committed to the relationship and to therapy. Unsuccessful couple therapy tended to focus on a greater number of individual issues. Couple dynamics characteristics differed according to outcome groups; participants described four types of couple dynamics that influenced couple therapy to be unsuccessful. Data showed that many client factors influenced the outcome of couple therapy, and that uncommon client characteristics could be vital to the outcome of some cases. Participants described a client's life events as impacting the outcome of couple therapy by increasing one person's vulnerability to his or her partner. If the partner acted in a way that created a sense of connection or support, this contributed to successful couple therapy. The results are presented in connection to previous research, when possible. Finally, implications for theory, research, and clinical work with couples are discussed. / Ph. D.

The purpose of this study was to explore the aspects of therapy as proposed by "common factors" literature (e.g., extratherapeutic change, hope and expectancy, therapy technique, and therapeutic relationship) by surveying the clients of a university based family therapy clinic. Data were used to provide information about what factors are therapeutically helpful according to the client's perspective. Surveys provided a quantitative and qualitative description of the client's therapeutic experience and were compared with those aspects of therapy found in the research. Quantitative results indicate that therapeutic relationship, client motivation, factors outside of therapy, and hope and expectancy accounted for around 49% of the variance of clients' perception of change and about 73% of the variance of clients' perceptions of therapy helpfulness. Findings further suggest that the clients' level of hopefulness and expectancy for positive change is the most significant predictor for both client change and therapy helpfulness. Qualitative results indicate that the therapeutic relationship is considered by clients to be the most helpful aspect of their therapeutic experience. / Master of Science

In both individual and relational psychotherapy contexts, it has been argued that the effectiveness of psychotherapy practice is associated with common factors cutting across the models including client factors, therapist factors, hope/expectancy of the clients, allegiance of the therapists, the quality of therapeutic relationship, and the basic counseling skills rather than model specific factors (Davis and Piercy, 2007a, 2007b; Lambert, 1992; Hubble, Duncan, and Miller, 1999; Sprenkle, Davis, and LeBow, 2009; Sprenkle, Davis, and LeBow, 2009; Wampold, 2001, 2008, 2015). However, the common factors perspective has been criticized for not having a theoretical framework, operationalization of its elements, and research support (Sexton, Ridley, and Kleiner, 2004). Despite gradually increasing interest in the literature, the research exploring the common factors of effective psychotherapy practice is still in its baby steps in the context of relational psychotherapy. In this study, motivational interviewing (MI) is presented as a theoretical framework and a practical research tool for exploring common factors in the context of relational psychotherapy. The research questions of to what extent motivational interviewing elements are implemented in the context of relational psychotherapy and to what extent therapist behaviors are associated with client change behaviors were explored by using task analysis and sequential analysis methodologies. Using the AAMFT Masters Series Tapes of MFT Model developers, including Boszmormenyi-Nagy, Minuchin, Satir, Whitaker, and White, the exemplary demonstrations of relational psychotherapy were rated on the Motivational Interviewing Treatment Integrity Scale (MITI 4.2.1., Moyers et al., 2014) for therapist behaviors and on the Motivational Interviewing Skills Code-Client Behaviors Scale (MISC; Miller, Moyers, Ernst, and Amrhein, 2003) and the Experiencing Scale (EX; Klein, Mathieu, Kiesler, and Gendlin, 1969) for the client change behaviors. The results are discussed in terms of a common factors perspective. / Ph. D. / Since the beginning of psychotherapy as a method of treatment, the answers to the age-old question of how psychotherapy helps people to change has become more sophisticated, elaborated, and diversified. Recent literature focusing on individual psychotherapy processes shows that it might be the common factors cutting across the models including the quality of therapeutic relationship, and the basic counseling skills rather than model specific factors are responsible for change in psychotherapy process. However, there are few studies exploring these factors in the context of relational psychotherapy. By means of in depth analyses of the relational psychotherapy training videos, this study contributes to the understanding of common factors of effective practice in relational psychotherapy. Thanks to this study, the clinicians and researchers can have a better understanding of the effective relational psychotherapy practice. This understanding will allow the clinicians, researchers, and health care providers and educators to provide better clinical service and develop more effective psychotherapy practices.

Inledning: Syftet med den här uppsatsen att undersöka hur fem psykodynamiskt inriktade privatpraktiserande psykoterapeuter definierar begreppet det psykoterapeutiska kontraktet, hur de arbetar med det psykoterapeutiska kontraktet och vilka effekter de anser att detta arbete ger. Frågeställningar: Hur definierar du begreppet psykoterapeutiskt kontrakt? Hur arbetar du praktiskt med det psykoterapeutiska kontraktet? Vilka effekter ser du av ditt arbete med det psykoterapeutiska kontraktet? Metod: En kvalitativ induktiv analys har använts. Fem psykodynamiskt inriktade psykoterapeuter har intervjuats med semistrukturerade frågor. Därefter har materialet kodats, tematiserats, analyserats och sammanställts. Resultat: Det psykoterapeutiska kontraktet som begrepp har inte upplevts som vedertaget av de intervjuade. Samtliga använder sig dock av ett psykoterapeutiskt kontrakt på olika sätt. Samtliga intervjuade upplever fördelar av att arbeta med det psykoterapeutiska kontraktet under förutsättning att det används på rätt sätt. Diskussion: Det psykoterapeutiska kontraktet tolkas och tillämpas på varierande sätt beroende på teoretisk inriktning. Utifrån uppsatsens ramar kan slutas att psykodynamisk psykoterapi tolkas och utövas på olika sätt beroende på hur psykoterapeuten förhåller sig till det psykoterapeutiska kontraktet. / Introduction: The purpose of this paper to examine how five psychodynamic oriented private practice psychotherapists define the concept of the psychotherapeutic contract, how they work with the psychotherapeutic contract and what effects they think this work provides. Issues: How do you define the concept of psychotherapeutic contract? How do you work practically with the psychotherapeutic contract? What impact do you see your work with the psychotherapeutic contract? Method: A qualitative inductive analysis has been used. Five psychodynamic oriented psychotherapists were interviewed with semi-structured questions. The material has thereafter been encoded, thematized, analyzed and compiled. Results: The psychotherapeutic contract terms have not been perceived as acknowledged by those interviewed. All uses, however, a psychotherapeutic contract in different ways. All interviewees are experiencing the benefits of working with the psychotherapeutic contract provided it is used correctly. Discussion: The psychotherapeutic contract is interpreted and applied in various ways depending on the theoretical orientation. Based on the frames of the essay it can be concluded that psychodynamic psychotherapy is interpreted and practiced in different ways depending on how the psychotherapist relate to the psychotherapeutic contract.

Existerande skolstrider, överlappande skolteorier samt vetskapen att erfarna psykologer arbetade integrativt var anledningarna till att Örebro Universitet, 2002, startade ett Psykologprogram med integrativ psykoterapiinriktning. Den grupp som examinerats från programmet har ännu inte studerats utifrån hur de beskriver sitt arbetssätt, deras föreställningar om psykoterapiintegration och hindrande faktorer för integration av terapiskolor samt hur de tolkar evidensbegreppet. Studien är en tvärsnitts enkätstudie med kvantitativa och kvalitativa frågor som syftar till att besvara dessa frågeställningar. Ett tillgänglighetsurval resulterade i 70 stycken deltagare. Deltagarna anger sitt arbetsätt som i huvudsak integrativt. En förvirring kring hur och när integration ska ske samt en snäv tolkning av hur evidensbegreppet definieras finns i gruppen. Vi föreslår att framtida integration bör guidas av evidensbaserad praktik. / Existing school conflicts, overlapping schooltheories and knowledge that experienced psychologists were working integrative were reasons why Örebro University, in 2002 started a Psychologist Program with an integrative psychotherapy approach. The graduated from this program have not yet been studied based on how they describe their practices, their beliefs about psychotherapy integration and impeding factors for the integration of therapy schools and how they interpret the concept of evidence. The study is a cross-sectional questionnaire study with quantitative and qualitative questions designed to answer these questions. An availability sample resulted in 70 participants. Participants indicates their practices as substantially integrative. A confusion about how and when the integration will take place, and a narrow interpretation of how evidence is defined is present in the group. We suggests that future integration should be guided by evidencebased practice.