The principal purposes of this study were to investigate the persistence of therapeutic change during the posttherapy period and the client variables associated with the persistence of therapeutic change. Secondary attention was given to the analysis of change and associated variables during the actual treatment period. Thirty outpatient, psychotherapy clients were studied and their relative change of status at termination and six-month follow-up was assessed through percent gain and residual change score analysis. Emphasizing the probability of change, the vast majority of clients (97%), using the percent gain analysis, and a substantial minority (30%), using residual change analysis, gained significantly during the treatment period. These differing results were attributed to the "outlier" effect, in which 17% of the clients did not evidence regression toward the mean, and thus made residual change an overly conservative estimate of improvement. Additionally, the low correlation between the residual change scores and the Follow-Up Rating supported this position. A majority (73%) maintained or continued to gain during the posttherapy period, using the residual gain analysis, while a majority (77%) maintained or continued to gain during the posttherapy period, using the percent gain analysis. Socioeconomic status, age, total psychotherapy sessions, initial neuroticism, and initial extroversion were identified as predictors of positive change in status at termination and follow-up. Socioeconomic status, negative life events, marital change, total psychotherapy sessions, initial neuroticism, and age were identified as variables discriminating between positive change and negative change in status groups. A number of limitations for this study were incorporated in implications for future research. These suggestions were designed to assist future researchers and therapists in understanding the persistence of change following psychotherapy.

The central aim of this study was to contribute to the understanding of the process of interpretation as it occurs in the context of a dialogue in insight-oriented psychotherapy. The literature review consisted of two parts. Firstly, the philosophical literature on the theory of interpretation was reviewed. A set of central philosophical issues was identified, which pertain to the psychotherapeutic project of interpreting the meaning of a person's experience in the context of a dialogue with that person. Secondly, the psychotherapeutic literature was reviewed. Previous attempts to conceptualise and prescribe processes of interpretation were described. The issues which appeared to be in need of further clarification were identified. A clinical study was conducted to further explore the questions raised in the literature reviews. A methodology was developed which gave access to the direct experience of both clients and therapists during the events of psychotherapeutic interpretation. The methodology yielded a description of the interpretative structure of the psychotherapeutic dialogue for each therapist-client pair. These were then consolidated into a description of general structural features of the psychotherapeutic dialogue. The results consisted of a description of processes and structural features which are intrinsic to the psychotherapeutic interpretation of the meaning of a person's experience in the context of a dialogue. The results were elaborated in an extensive discussion from which the following findings emerged: (l)It is important to distinguish between communicative and interpretative forms of dialogue. (2)Thematisation activity is mediated by a number of dialectically related operations which are intrinsic to the interpretative project of psychotherapy. (3)Insight-oriented psychotherapy relies on the presence of the therapist as a dialogical partner and the therapist is not merely a facilitator of introspection on the part of the client. (4)The character of interpretation in psychotherapy may be understood in certain respects to be an elaboration of functions of the imagination. (5)The process of interpretation can be understood in relational terms and the variations of interpretative experience may be understood as variations of 'an inter-subjective interpretative ideal. (6)Understanding of certain forms of psychopathology is deepened when they are considered as variations of an ideal capacity to engage in interpretative dialogue. (7)It is possible to describe certain ideal conditions which are facilitative of interpretative dialogue and hence of the psychotherapeutic development of self-insight. In conclusion suggestions for further research were made. It was suggested that the perspective of hermeneutic phenomenology provides an appropriate philosophical and methodological foundation for understanding the unique dialogical interpretative situation which is psychotherapy. The study emphasized, both in its content and in the manner of its execution, the need for interpretative efforts to be accompanied by methodological reflection and especially an awareness of how interpretative strategies partially constitute the realities they set out to describe.

Psychotherapy research indicates that metaphors are often used to express a client's meaningful experience. This study measured the impact of client-generated metaphors on in-session experiencing. The research question explored whether client-generated metaphor use would be associated with greater in-session experiencing as rated by the Experiencing Scale (EXP; Klein, Mathieu-Coughlan, & Kiesler, 1986). It was also asked whether metaphor use would increase the subsequent experiencing of a client. Forty-seven client-generated metaphor events were randomly selected from 47 psychotherapy transcripts of clients in therapy with counsellors-in-training. For each metaphor event, a pre-metaphor and post-metaphor client utterance was selected. A total of 140 utterances were compared using a repeated-measure analysis of variance. Results indicate that client-generated metaphors are not significantly different from pre-metaphor or post-metaphor client utterances. The role of language and the clinical importance of metaphor use in psychotherapy were discussed.

No description available.

This investigation sought to discover, identify and describe in-session change episodes in marital Experiential Systemic Therapy (Friesen et al., 1989) through a naturalistic discovery-oriented methodology. This study responds to calls made regarding the need to study complex and intricate processes, such as psychotherapy (Greenberg, 1986), via discovery-oriented methods (Mahrer, 1988). The observational analysis of 40 videotaped-sessions, of three couples, revealed the presence of ten episodes of change. The actions and interactions of the members of the therapeutic system in these episodes were analyzed via the grounded theory method of analysis. This analysis generated a conceptual framework describing the internal structure of change. The resulting conceptual framework consisted of a core category named synergetic shifting. This category refers to an interactional process in which the partners with the assistance of the therapist moved away from rigid, distancing and alienating interactional patterns toward interpersonal flexibility, compassion and affiliation by working through blocks hindering the couples' engagement and intimate connection. Synergetic shifting consists of four client and three therapist categories. Within the progressive nature of synergetic shifting, the client categories were: (1) owning one's part in the relational conflict; (2) couple contacting: restricted and limited; (3) couple working through blocks to intimacy; and (4) couple engaging compassionately. The therapist's actions and interactions were categorized under supporting, transitional and shifting operations.

This investigation sought to discover, identify and describe in-session change episodes in marital Experiential Systemic Therapy (Friesen et al., 1989) through a naturalistic discovery-oriented methodology. This study responds to calls made regarding the need to study complex and intricate processes, such as psychotherapy (Greenberg, 1986), via discovery-oriented methods (Mahrer, 1988). The observational analysis of 40 videotaped-sessions, of three couples, revealed the presence of ten episodes of change. The actions and interactions of the members of the therapeutic system in these episodes were analyzed via the grounded theory method of analysis. This analysis generated a conceptual framework describing the internal structure of change. The resulting conceptual framework consisted of a core category named synergetic shifting. This category refers to an interactional process in which the partners with the assistance of the therapist moved away from rigid, distancing and alienating interactional patterns toward interpersonal flexibility, compassion and affiliation by working through blocks hindering the couples' engagement and intimate connection. Synergetic shifting consists of four client and three therapist categories. Within the progressive nature of synergetic shifting, the client categories were: (1) owning one's part in the relational conflict; (2) couple contacting: restricted and limited; (3) couple working through blocks to intimacy; and (4) couple engaging compassionately. The therapist's actions and interactions were categorized under supporting, transitional and shifting operations. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

The aim of this study is to develop a methodology, through phenomenology, for exploring the unknown in the acquisition of therapeutic knowledge. An exploration is made of the way various writers attempt to explain the unknown, raising a problematic about how the unknown can become defined as if known, whereas others attempt to hold open the question of the unknown of the unknown. It is argued that learning places emphasis on knowing whereas in psychotherapy, there is increasing interest in learning to tolerate doubt and uncertainty. Ten participants were interviewed in terms of the question ‘how do psychotherapists learn about the unknown?’ An empirical phenomenological method was utilised to translate a general descriptive structure of the phenomenon. Findings suggest learning about the unknown as acquired during a process of lifelong enquiry through interrelated experiences, including: the known, training, therapy and supervision, practice and just living. Furthermore, immersion in experiences and relationships highlighted recognition of the spiritual or mystical, opening up hope in the face of fear of death and repeated disillusionment, with realisation that no single theory explains everything. In de-translating findings, examples of a second analysis suggested that reverie seemed more helpful in researcher and participants was disrupted, compared to empirical psychological phenomenology which separates phenomenology from philosophy. Reverie was explored as an approach, which can attend more to aspects where something other than dialectic of birth and death has possibility, and the unknown emerges when one disrupts the intentional position of the other.

Honest communication between therapists and their clients is an essential part of good psychotherapy. Previous research has examined the impact of dishonesty on the part of the client; however, the topic of therapist dishonesty has remained virtually unexplored. This study examined the prevalence, motivations, and perceived consequences of therapist dishonesty as part of the psychotherapy process. Specifically, the present study asked therapists to report the topics about which they are more and less likely to be less than completely honest with their clients in session and looked for common characteristics among therapists who reported being more frequently dishonest with their clients. Therapists’ reported motivations for and perceived consequences of dishonesty with their clients was also examined. Findings revealed that the vast majority of therapists report having been dishonest with their clients at least once and that therapists are significantly more likely to engage in covert dishonesty than overt dishonesty. Most therapists described using dishonesty in service of their clients’ therapy or wellbeing and with no perceived negative consequences. Novice therapists reported using dishonesty with their clients more frequently than therapists with more years of experience. The use of dishonesty and its relationship to therapist disclosure, clinical tact, and the role of hope in psychotherapy is discussed. Directions for future research, as well as implications for training programs and ethical guidelines put forth by the American Psychological Association, are discussed.

This qualitative study aimed to investigate psychotherapists’ experience of dishonesty in the therapy setting. Therapist dishonesty is broadly defined as “behaviors or words, spoken or withheld, that are meant to deceive or mislead” (Jackson & Farber, 2021, p. 1). Though it is anecdotally acknowledged in the clinical literature, the phenomenon of therapist dishonesty has been empirically under-researched and unexplored, in favor of topics such as client dishonesty and client and therapist self-disclosure. Designed as a follow-up to a quantitative study of 401 participants (Jackson & Farber, 2021), the present study aimed to capture a comprehensive phenomenological understanding of the circumstances, motives, feelings, perceived consequences, guidelines, and attitudes therapists carry about dishonesty in therapy. Further, this study aims to understand the extent to which therapists, in practice, are dishonest, and whether this occurrence is consistent with professional ethics and guidelines regarding dishonesty. Additionally, this study intends to review and synthesize the advice practicing therapists would provide to beginning therapists on handling situations in which they are tempted to refrain from telling the entire truth to patients. Following the methodology of Consensual Qualitative Research (CQR), 20 psychotherapists participated in semi-structured interviews prompting the factors that contribute to honesty and dishonesty in psychotherapy and its perceived impacts and clinical implications. Nine domains and various salient findings emerged from the analysis. Findings revealed that most commonly, dishonesty occurs around personal disclosures to patients, reasons for dishonesty are typically associated with boundary setting to protect therapists’ needs or patients’ feelings, while nearly all therapists would not have handled their dishonest moment differently, many regret this moment, and typically, therapists contend that their honest disclosure have increased, rather than decreased, over the course of their careers. Therapist dishonesty and its association with clinical tact, therapist disclosure, and therapist matching are discussed. Limitations, clinical implications for novice therapists, and future directions are noted. Keywords: Therapist dishonesty, therapist honesty, therapist disclosure, clinical tact, therapist effects

In order to prepare counselor-trainees to practice competently and maximize client outcomes, counselor-trainees must develop a broader understanding and explanation, called a case conceptualization, of their clients presenting problems, personality, and systemic dynamics. There is a limited body of research that examines the effects of training on the ability for counselors to develop an effective case conceptualization. This is the first study to train counselors to develop competence in formulating an integrative case conceptualization. This quasi-experimental study aimed to determine whether an intervention had an effect on the 85 counselors in training that participated in a 2-hour training. Data was analyzed using paired sample t-tests, an independent t-test and correlation methods. Participants’ CCEF scores significantly improved from the training (t = -25.970, df = 84, ES = 3.67, p < 0.001). Participants’ CFCCM scores significantly improved as well (t = -21.693, df = 84, ES = 2.78, p < 0.001). Participants’ scores also significantly improved with their perceptions about case conceptualization (t = -30.828, df =84, ES = 5.47 p < 0.001), for items 1-5. Item 6 resulted in values of (t = -13.295, df = 84, ES = 2.14, p < 0.001). The level of cognitive complexity as measured by the CCQ did not have a significant effect on the quality of the counselors in training case conceptualizations. Compared to the CFCCM, the CCEF is a much shorter and easier instrument for evaluating a case conceptualization. Overall, results of this study provide support that counselors in training can improve their quality of case conceptualization skills in as little as 2 hours. This can aid in understanding and explaining their client’s situation better, which may significantly improve the treatment process and client. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2014. / FAU Electronic Theses and Dissertations Collection