The present research explores a promising therapy – Supportive Expressive Therapy (SET; Luborsky, 1984) – for adolescents with mood and/or anxiety disorders. It has been proposed that therapist expressive techniques (e.g., challenges and interpretations) and client interpersonal mastery (i.e., self-understanding and self-control in relationships) are two elements central to the success of SET (Luborsky, 1984; Grenyer & Luborsky, 1996). The current thesis employs a microprocess approach to examine expressive techniques and interpersonal mastery as potential mechanisms of change in SET.
The study first provides preliminary evidence that SET is effective in helping adolescents suffering from internalizing disorders. Clients (N = 10) reported significantly fewer symptoms of depression and anxiety post-therapy. The body of the study then focuses on two research questions pertaining to the microprocesses occurring during SET. First, employing graphical and statistical analyses, the study investigates the notion that SET helps clients develop greater interpersonal mastery. Ten clients’ levels of interpersonal mastery were assessed at four points throughout therapy to determine whether clients demonstrated higher levels of interpersonal mastery over time. Secondly, this dissertation explores the impact of therapist expressive statements on clients' narratives, using a lag sequential analysis. Clients' statements were examined to determine whether higher levels of interpersonal mastery were exhibited following higher-level expressive techniques versus other therapist statements (i.e., supportive statements).
Statistical analyses pertaining to the first research question did not reveal significant changes in interpersonal mastery over the course of therapy. However, graphical analyses suggested specific patterns of gains in interpersonal mastery during SET.
With respect to the second research question, results demonstrated therapists employed significantly more higher-level expressive techniques in the later stages of SET, in accordance with the guidelines provided in SET manuals. Lag sequential analyses did not, however, provide substantial evidence of gains in interpersonal mastery following higher-level therapist techniques. Despite a lack of evidence supporting a general link between higher-level techniques and increased client mastery, exploratory analyses suggested change-focused expressive statements were linked to fewer client statements reflecting low interpersonal mastery. Future research should examine (1) change-focused statements as potentially important variables fostering improvement, and (2) moderators of client responses to higher-level techniques.
| Identifer | oai:union.ndltd.org:TORONTO/oai:tspace.library.utoronto.ca:1807/32300 |
| Date | 26 March 2012 |
| Creators | Ceurstemont, Kim |
| Contributors | Manassis, Katharina |
| Source Sets | University of Toronto |
| Language | en_ca |
| Detected Language | English |
| Type | Thesis |
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