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Research on therapist variables in relation to process and outcome
... Finally, we questioned whether therapy effects differ with level of therapist training. The evidence thus far is mixed but is often discouraging for trained therapists in general (see Auerbach & Johnson, 1977;Parloff, Waskow, & Wolfe, 1978). However, there is little summary evidence on therapists who work with young clients in particular, which is an unfortunate gap given the substantial time and resources invested in the professional training of child clinicians. ...
... Our failure to find an overall difference in effectiveness between professionals, graduate students, and paraprofessionals might be disquieting to those involved in clinical training programs (see also Auerbach & Johnson, 1977;Parloff, Waskow, & Wolfe, 1978). A simplistic interpretation might suggest that training does not enhance therapeutic effectiveness. ...
How effective is psychotherapy with children and adolescents? The question was addressed by meta-analysis of 108 well-designed outcome studies with 4–18-year-old participants. Across various outcome measures, the average treated youngster was better adjusted after treatment than 79% of those not treated. Therapy proved more effective for children than for adolescents, particularly when the therapists were paraprofessionals (e.g., parents, teachers) or graduate students. Professionals (with doctor’s or master’s degrees) were especially effective in treating overcontrolled problems (e.g., phobias, shyness) but were not more effective than other therapists in treating undercontrolled problems (e.g., aggression, impulsivity). Behavioral treatments proved more effective than nonbehavioral treatments regardless of client age, therapist experience, or treated problem. Overall, the findings revealed significant, durable effects of treatment that differed somewhat with client age and treatment method but were reliably greater than zero for most groups, most problems, and most methods.
... Over time, more criticisms of non-directivity (e.g. Parloff et al., 1978) have emerged, and further, Tudor and Worrall (2006) have emphasised the need for therapist freedom from the dogma of the approach. A common argument is that some clients need more than empathic reflection (Lazarus, 1969) and for Patterson (1980), some clients may need new skills or knowledge, for which even teaching may be necessary. ...
... Further, it was interesting to note that the participants began to question whether it is possible to engage in therapeutic dialogue without questions and these views on the inevitability or necessity of directivity in PCT are also supported in the literature, (e.g. Parloff et al., 1978;Patterson, 1980;Sachse, 2004). In fact a study of Rogers' responses in his own demonstrations of PCT reveal; an extensive use of questions about factual or situational matters; diagnostic questions about feelings; questions intended to check the client's experiencing; and open exploratory questions (Lietaer & Gundrum, 2018). ...
This study collated person-centred therapists’ views on their use of questions in person-centred counselling. It asked whether the therapists considered that questions are useful and how they seek to implement them. Six experienced person-centred therapists were interviewed and their comments analysed using Thematic Analysis. Therapy transcripts by Rogers and Mearns were also analysed to obtain examples of their questioning techniques. Results suggested that these person-centred therapists ask questions regularly for many reasons including; to check their understanding or to clarify an issue for the client; to challenge the client; to enable the client’s processing; and sometimes just out of curiosity. However generally, questions were used to represent the counsellor’s way of being and subtly facilitate progress in the counselling relationship.
... Nevertheless, it is important to reiterate what others (Mitchell, Bozarth, Truax, & Krauft, 1973;Parloff, Waskow, & Wolfe, 1978) have pointed out-that there are multiple ways of understanding these findings. For example, of 108 correlations between warmth/positive regard and specific outcomes noted in this report, only 34 were reported as significantly positive. ...
This article reviews the research on the association between therapists' provision of positive regard and therapeutic outcome. Issues of definition (e.g., the extent to which positive regard is confounded with other therapist characteristics, including empathy) are considered, and a case example is offered. Prior reviews of the research are summarized, and 16 new articles published since 1990 are evaluated. Positive regard is most often significantly associated with therapeutic success when patients' perspectives on outcome are considered. Virtually all significant findings bear relatively modest effect sizes. The effectiveness of positive regard may lie especially in its ability to facilitate a long-term working relationship.
... Research to date has emphasized antecedent patient and relationship variables, although generally failing to demonstrate unique effects of therapist technique, leading to unsettling speculations that perhaps therapist techniques are unimportant (e.g. ^ Parloff, Waskow, & Wolfe, 1978). ...
Research strategies employing Structural Analysis of Social Behavior (SASB) were demonstrated in a study comparing 4 therapists, each of whom saw a good and a poor outcome case (N = 8), on interpersonal process variables in the third session. SASB represents complex interactive processes in a manner that is both theoretically cogent and empirically sound. Good versus poor therapeutic outcome was differentiated on the basis of the following interpersonal process variables: greater levels of “helping and protecting” and “affirming and understanding” and significantly lower levels of “blaming and belittling” were associated with high-change cases. Patient behaviors of “disclosing and expressing” were significantly more frequent in high-change cases, whereas “walling off and avoiding” and “trusting and relying” were significantly more frequent in low-change cases. Additionally, negative complementarity was greater in poor outcome cases. Implications for research methodology and interpersonal theory are discussed.
... What is needed, then, is a procedure for evaluating the accuracy or suitability of therapist behaviors to the particular problems and needs of the patient (cf. Elliott, 1983;Fiske, 1977;Parloff, Waskow, & Wolfe, 1978;Schaffer, 1982)-a procedure that can determine when a patient will be helped or hindered by a particular interpretation. ...
Due to imprecise methods of evaluating therapist behaviors, little progress has been made in demonstrating how the therapist contributes to the success of psychotherapy. More important, the suitability of the therapist’s behavior to the particular needs of a given patient has not been adequately assessed. In this article, we describe a new approach for assessing the suitability of therapist interventions. We hypothesized that the suitability of interpretations would be more predictive of patient progress than the category of interpretation: transference versus nontransference. The transcripts of three brief psychodynamic psychotherapies were studied. Interpretations in the three therapies were identified and categorized as transference or nontransference and were then rated for suitability. Patient productivity was rated using the Experiencing Scale. As predicted, in each case suitability of interpretations correlated significantly and positively with patient productivity, whereas type of interpretation did not correlate with patient progress.
... There is a strong conviction among mental health professionals that the characteristics and behaviors of a psychotherapist are associated with treatment outcome. Unfortunately, research efforts in this area have met with little success (Parloff, Waskow, & Wolfe, 1978). Contributing to the lack of substantive findings is the fact that targeted therapist variables have often been confounded with other uncontrolled therapist characteristics, with unspecified client characteristics and with the therapist's idiosyncratic adaptation of the treatment techniques. ...
Examined therapist variables presumed to be related to outcome in a structured, cognitive-behavioral group treatment for depression. Each of 8 leaders conducted 2 consecutive psychoeducational treatment groups consisting of 5–8 Ss. Of the 106 Ss (aged 17–67 yrs) who participated in the study, 79 were clinically depressed; measures of depression included the Beck Depression Inventory, Hamilton Rating Scale for Depression, and a measure of social adjustment. A broad multivariate assessment was conducted of pretreatment leader characteristics, leader behavior and style during treatment, group behavior and process, and depression outcome. Results indicate that leaders differed significantly on behavioral and group-process measures, but differences in depression outcome between leaders did not attain statistical significance. (5 ref)
... Similarly, research on therapist variables and their relationship to psychotherapy outcome fails to support Frank's conclusion that therapist characteristics are important determinants of therapy outcome. After reviewing the literature on therapist variables, Parloff, Waskow, and Wolfe (1978) concluded that the vagueness of the variables studied (i.e., level of experience, sex, race, social class, mental health, and personality) and their inevitable confounding with other variables have precluded meaningful conclusions regarding the relationship between therapist qualities and outcome. ...
J. D. Frank argued that therapy outcome depends more on client and therapist characteristics than on therapeutic methods. Based on this assertion, Frank suggested that researchers should direct their attention to the identification of relevant client and therapist characteristics. The aim of the present author is to challenge Frank's argument and to offer an alternative direction for clinical researchers that emphasizes the development of more potent psychological procedures. (30 ref)
... For this reason, different findings might reault. Research has further indicated that the attitudes and biases of clinicians severely limit their ability to effectively treat minority clients (Parloff, Waskow and Wolfe, 1978). Consequently, any training that can assist mental health service providers in general, and social workers in particular, to become more knowledgeable and sensitive to the concerns and lifestyles of minority clients will help facilitate the treatment process. ...
... Others took a more moderate position. Parloff, Waskow, and Wolfe (1978) felt that the paucity of treatment outcome studies on African Americans did not permit conclusions to be drawn, a point supported in the reviews by Abramowitz and Murray (1983) and Sue, Zane, and Young (1994). Because reviews of the literature are available, I shall only mention some of the research in passing. ...
In this book a group of experts in the field explored how evidence based treatment guidelines might be developed and deployed to increase the impact of science on psychological practice.
... Until recently, however, the accumulated wisdom of experienced clinicians frequently was ignored or lost in global outcome studies designed to test the effectiveness of psychotherapy. Traditional outcome studies have demonstrated that both therapist and patient variables impact the effectiveness of psychotherapy, while treatment interventions from a variety of orientations have been shown to produce behavioral change (Kiesler, 1966;Luborsky et al., 1975;Orlinsky & Howard, 1978;Parloff et al., 1978;Smith & Glass, 1977;Smith et al., 1980). As the controversy over which system of psychotherapy is most effective melts to the quiet conclusion that all systems seem equally effective, the research Reprints may be ordered from M. Katherine Hudgins, 1537 Americana Drive, Richmond, VA 23228. ...
16 White female undergraduates were randomly assigned to a doubling intervention (DI) or control group. The DI module focused on the resolution of interpersonal situations, with the interviewer "doubling" the S's nonverbal behavior and making statements for the S. Analyses of responses to interview questions across 5 stages of the treatment session and of postsession ratings supported the predicted superiority of the DI in promoting revealingness. The constructs of experiencing and empathic understanding are considered essential mechanisms of proximal therapeutic change. (APA PsycInfo Database Record (c) 2016 APA, all rights reserved)
... The first major review of the association between therapist facilitative conditions (including empathy) and outcome (Truax & Mitchell, 1971) was later strongly criticized (Lambert et al.,1978) for selective citations of results and numerous methodological failings. Two reviews in the 1970s (Gurman,1977;Parloff, Waskow & Wolfe, 1978) focused on client perceptions of facilitative conditions and were fairly positive, but expressed concern about possible confounds among client-perceived empathy, other facilitative conditions, and client-rated outcome. These focused more broadly on facilitative conditions without attempting to separate out therapist empathy, and were either narrative reviews or used box scores to summarize results. ...
Empathy refers to understanding what another person is experiencing or trying to express. The chapter begins by discussing definitional issues and presenting an integrative definition. It then reviews measures of therapist empathy, including the conceptual problem of separating empathy from other relationship variables. Clinical examples illustrating different forms of therapist empathy and empathic response modes are then presented. The core of the review is a meta-analysis of research on the relation between therapist empathy and client outcome. Results indicated that empathy is a moderately strong predictor of therapy outcome: mean weighted r = .28 (equivalent of d = .58) for 82 independent samples and 6,138 clients. In general, the empathy–outcome relation held for different theoretical orientations and client presenting problems. The chapter considers the limitations of the current data and concludes with diversity considerations and practice recommendations, including endorsing the different forms that empathy may take in therapy.
... Major reviews of the empathy literature have occurred since the 1970s (Gurman, 1977;Lambert et al., 1978;Parloff, Waskow, & Wolfe, 1978;Truax & Mitchell, 1971). More recently, Orlinsky, Grawe, and Parks (1994;Orlinsky et al., 2003) separated out therapist-client mutual empathic resonance and reported strong results using a box score method. ...
Put simply, empathy refers to understanding what another person is experiencing or trying to express. Therapist empathy has a long history as a hypothesized key change process in psychotherapy. We begin by discussing definitional issues and presenting an integrative definition. We then review measures of therapist empathy, including the conceptual problem of separating empathy from other relationship variables. We follow this with clinical examples illustrating different forms of therapist empathy and empathic response modes. The core of our review is a meta-analysis of research on the relation between therapist empathy and client outcome. Results indicated that empathy is a moderately strong predictor of therapy outcome: mean weighted r-.28 (p .001; 95% confidence interval [.23, .33]; equivalent of d-.58) for 82 independent samples and 6,138 clients. In general, the empathy-outcome relation held for different theoretical orientations and client presenting problems; however, there was considerable heterogeneity in the effects. Client, observer, and therapist perception measures predicted client outcome better than empathic accuracy measures. We then consider the limitations of the current data. We conclude with diversity considerations and practice recommendations, including endorsing the different forms that empathy may take in therapy.
... The first major review of the association between therapist facilitative conditions (including empathy) and outcome (Truax & Mitchell, 1971) was later strongly criticized (Lambert et al.,1978) for selective citations of results and numerous methodological failings. Two reviews in the 1970s (Gurman,1977;Parloff, Waskow & Wolfe, 1978) focused on client perceptions of facilitative conditions and were fairly positive, but expressed concern about possible confounds among client-perceived empathy, other facilitative conditions, and client-rated outcome. These focused more broadly on facilitative conditions without attempting to separate out therapist empathy, and were either narrative reviews or used box scores to summarize results. ...
Put simply, empathy refers to understanding what another person is experiencing or trying to express. Therapist empathy has a long history as a hypothesized key change process in psychotherapy. We begin by discussing definitional issues and presenting an integrative definition. We then review measures of therapist empathy, including the conceptual problem of separating empathy from other relationship variables. We follow this with clinical examples illustrating different forms of therapist empathy and empathic response modes. The core of our review is a meta-analysis of research on the relation between therapist empathy and client outcome. Results indicated that empathy is a moderately strong predictor of therapy outcome: mean weighted r= .28 (p< .001; 95% confidence interval: .23 –.33; equivalent of d= .58) for 82 independent samples and 6,138 clients. In general, the empathy-outcome relation held for different theoretical orientations and client presenting problems; however, there was considerable heterogeneity in the effects. Client, observer, and therapist perception measures predicted client outcome better than empathic accuracy measures. We then consider the limitations of the current data. We conclude with diversity considerations and practice recommendations, including endorsing the different forms that empathy may take in therapy.
... Major reviews of the empathy literature have occurred since the 1970s (Gurman, 1977;Lambert et al., 1978;Parloff, Waskow, & Wolfe, 1978;Truax & Mitchell, 1971). More recently, Orlinsky, Grawe, and Parks (1994;Orlinsky et al., 2003) separated out therapist-client mutual empathic resonance and reported strong results using a box score method. ...
After defining empathy, discussing its measurement, and offering an example of empathy in practice, we present the results of an updated meta-analysis of the relation between empathy and psychotherapy outcome. Results indicated that empathy is a moderately strong predictor of therapy outcome: mean weighted r = .31 ( p < .001; 95% confidence interval: .28–.34), for 59 independent samples and 3599 clients. Although the empathy-outcome relation held equally for different theoretical orientations, there was considerable nonrandom variability. Client and observer perceptions of therapist empathy predicted outcomes better than therapist perceptions of empathic accuracy measures, and the relation was strongest for less experienced therapists. We conclude with practice recommendations, including endorsing the different forms that empathy may take in therapy.
Although the thrust of the nation’s cancer objectives for the year 2000 is prevention and screening, each year approximately 1 million Americans are diagnosed and must cope with the disease and treatments. They do so with the aid of family, friends, and the health care system, but accumulating data suggest that psychological interventions may be important for reducing emotional distress, enhancing coping, and improving “adjustment.” Experimental and quasi-experimental studies of psychological interventions are reviewed, and discussion of treatment components and mechanism is offered. A final section discusses future research directions and challenges to scientific advance.
Complex issues are inherent in psychology training. This bibliography addresses diverse aspects of supervision in psychotherapy and more generally in professional psychology, especially during internship. English-language articles, books, and chapters are listed in eight categories: books; administrative, ethical, and legal issues; evaluation; internship; professional standards and training; supervisee development, perspectives, and issues; supervisor issues and the supervisory relationship; and supervision approaches, issues, research, techniques, and theories. Citations from the counselor education, marital/family therapy, psychiatry, psychoanalysis, school psychology, and social work literatures are also included. Most references are from the 1970s and 1980s; older citations are included to provide historical perspectives on supervision.
Reviews studies on training, experience, and clinical judgment. The results on the validity of judgments generally fail to support the value of on-the-job experience in mental health fields. The validity results do provide limited support for the value of training. Other results suggest that experienced clinicians are better than less experienced judges at knowing which of their judgments are likely to be correct and which are likely to be wrong. Reasons why clinicians have trouble learning from experience are given. Recommendations are made for improving training and clinical practice.
It is useful to reconceptualize social support as coping assistance. If the same coping strategies used by individuals in response to stress are those that are applied to distressed persons as assistance, models of coping and support can be integrated. To illustrate the utility of such an integration, coping strategies and support strategies are derived from a more general theory of stress-buffering processes in this article. A variety of supportive strategies not previously identified by researchers are derived. Further, predictions regarding efficacious and nonefficacious types of support are made, and empathic understanding (based on sociocultural and situational similarities between a distressed person and a helper) is identified as a crucial condition for coping assistance to be sought, accepted, and found effective.
Vocational choice can be defined as the process by which an individual comes to follow a certain occupation, to enter a specific field of work. The theme of vocational choice has largely been explored by occupational psychologists and career guidance officers. Various theories have been developed, regarding how the actual choice is made, what process(es) one goes through, and what factors act on the process and influence the final decisions.
Although theories about vocational choice have been put forward from various disciplines, the ones that will be presented here come primarily from the psychology field. These theories deal primarily with aspects within the individual which play a role as motivating forces and/or as part of the process, and include psychodynamic theories and need theories, self theory of occupational choice, and the developmental and the differentialist theories.
Traditional counselling theories have frequently been criticised for their lack of multicultural relevance, yet even today many UK counsellors assume a prevailing white (and middle class) culture. This summary of research findings in multicultural counselling has had to rely entirely on evidence from the USA, since to my knowledge very little comparable work has been done in this country.
This section gives a brief overview of the current research, emphasizing its lack of agreed findings and the limitations in methodology. It then focuses on three major questions, asking whether counsellor race/ ethnicity, explicit multicultural counsellor education and current research affect the counselling process and outcome.
The present literature review aims to offer an in-depth examination and critical evaluation of the concept of the therapeutic alliance, as it has been historically unfolded in psychotherapy theory, research and practice. The construct of the alliance holds particular theoretical and practical significance for counselling psychologists, who are expected to demonstrate an understanding of the therapeutic relationship and alliance as conceptualised in different models (HCPC, 2015), as well as the ability to engage in relational practice (BPS, 2015). The critical literature review therefore opens with an examination of the concept of the therapeutic alliance as defined and conceptualised in the major schools of psychotherapy. Core alliance measures are also presented and critically evaluated in relation to their methodological rigour and usefulness in alliance research and practice. The relationship between the therapeutic alliance and outcome is critically reflected upon, whilst giving thorough consideration to therapist, client and interactive factors impacting the development and maintenance of the therapeutic alliance, thus possibly mediating and/ or moderating the relationship between alliance and treatment outcome. Contemporary re-conceptualisations and critiques of alliance theory and research are in turn thoroughly examined and critically discussed. Taking into account the primacy of the therapeutic relationship in Counselling Psychology (BPS, 2005), the literature review concludes with a presentation of the therapeutic implications of alliance theory and research for practitioner psychologists in general and counselling psychologists in particular, irrespective of their therapeutic orientation, in order to enhance their therapeutic skills and efficacy.
This article meta-analytically reviews the research on the association between therapist positive regard (PR) and treatment outcome. The history of the construct of unconditional PR in client-centered theory and the efforts to clearly operationalize and measure this construct are reviewed. Several clinical examples are presented. The updated meta-analysis, which features expanded inclusion criteria and a larger number of studies (k-64) than previous analyses, yielded a small positive association between PR and treatment outcome, g-.28. To control for the repeated use of data sets and study samples within the database, a multilevel meta-analysis was adopted that indicated a stronger relation between PR and clinical outcome (g-0.36). These analyses support PR's standing as a significant component of the therapy relationship that leads to improved clinical outcomes. The article concludes with limitations of the research, patient contributions, diversity considerations, and recommendations for using PR in practice.
How should counselors be trained? This issue has concerned professionals for many years but interest in counselor education has increased with the proliferation of training models, the appearance of new training programs, and the increased public acceptance of counseling. This article reviews several present approaches to counselor training, summarizes some current trends in counselor education, and proposes a people helper training model. This model begins with the Bible, is strongly based in psychological knowledge and techniques, and emphasizes professional, pastoral, peer, psychological-apologetic, public, and preventive aspects of people helping.
Humanistic-experiential approaches are extremely popular in the training and practice of pastoral counseling. Training programs employing a humanistic-experiential model for training and practice view training as a period for the personal growth of trainees. Students are taught that the need for pastoral counseling reflects a need for personal growth. Critics of humanistic-experiential methods cite the lack of academic rigor and the proliferation of “half-truths” as evidence that a goal of personal growth is neither an effective training model nor an effective pastoral initiative toward people in need of specific help. It is suggested that training centers may best serve by challenging trainees academically and by teaching specific cognitive-behavioral counseling skills rather than focusing upon trainees' personal growth.
There is nothing new about the activity of psychotherapy. Attempts to solve personal problems through conversation can be traced back to biblical times, and in many tribal societies the shaman or medicine man has the role of helping to resolve psychological disorder (Frank, 1973). However, the way that psychotherapy is currently practised, organized, researched and theorized about make it a peculiarly twentieth-century phenomenon.
The relation between graduate training and counselor trainees' self-efficacy in using basic counseling skills was examined. Subjects included 78 first- through 4th-year graduate counseling students. They were presented a videotape of a client and were instructed to make categorized verbal responses to each client statement. Efficacy expectations and outcome expectations, the components of self-efficacy, were measured separately for each counselor response. Counselor experience was covaried. The results revealed a significant relation between level of graduate training and efficacy expectations and between level of graduate training and outcome expectations. Students were also found to have significantly higher efficacy expectations than outcome expectations regardless of training level. Because significant relations were found between verbal response type and both efficacy expectations and outcome expectations, the hierarchical rankings of verbal response difficulties by Hill, Charles, and Reed (1981) were supported.
A survey was conducted to explore the degree to which practicing psychologists are involved in exercise programs, the patterns of exercise favored, and the degree of effect attributed to exercise on various dimensions of psychotherapy practice. Survey instruments were mailed to 262 psychologists listed in the National Register of Health Service Providers; 196 (74.81%) responded. Most of the respondents (71.43%) reported engaging in regular exercise. Chi-square analyses revealed that patterns of exercise were related to demographic factors. Dimensions of psychotherapy perceived as most positively affected by exercise were the physical stamina, mood, and mental stamina of the therapist. Analyses of variance revealed that demographic and exercise pattern variables were related to perceptions of exercise effect on some of the dimensions of psychotherapy. Most respondents reported that they would recommend regular exercise both to other therapists and to patients.
Although interpretation is a theoretically important and frequently used technique in brief and time-limited individual therapy, the contribution of the research has been limited because of several methodological problems in the areas of (a) definitions, (b) designs, (c) the search for a single underlying mechanism, (d) individual differences between clients, (e) measurement of the impact, (f) type, (g) the role of the therapeutic relationship, and (h) timing. We offer recommendations that can help make research on interpretation more methodologically rigorous and clinically relevant. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Psychotherapy studies published in the Journal of Counseling Psychology ( JCP ) and the Journal of Consulting and Clinical Psychology ( JCCP ) between 1978 and 1992 were examined. Differences were found between the 2 journals. JCP published mostly process, outcome, and analog research, whereas JCCP published mostly outcome research. Most process and process-outcome studies across journals were of individual, brief therapy. Across the years, more diversity was evident in samples used in process research in terms of student status, gender, and race of clients and therapists. Three content areas were prominent in the process measures and classic studies: therapist techniques, therapist influence, and facilitative conditions. Lists are provided of the frequently used measures, most productive authors, and classic studies in process research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
A teaching model for personality theories based on and resulting from an evaluation and theoretical position of the field is described. After a review of the problems and diversity of the field and their limiting implications, especially for the professional psychologist teaching the graduate clinical student, some of the possible reasons behind the difficulties are explained. These include diminishing emphasis on theory exploration and construction, dismissing classical questions about human nature, cutting bonds to related theoretical disciplines, disregarding questions that cannot be dealt with experimentally, and narrowing the definition of clinical psychology. These problems are addressed in order to derive a rationale for interdisciplinary and basic categories and dimensions serving as guidelines to comprehension, examination, and teaching of personality theories. The teaching method integrates intellectual and experimental involvement. A sample implementation of the teaching program is proposed.
In the prevalent clinical training model, experienced clinicians provide direct supervision for apprentice trainee/interns. The literature provides some indications of what and how evaluations of training could be conducted. This literature is reviewed, and guidelines are offered for developing an evaluation package to provide ongoing (a) performance evaluation of internship training and (b) data collection to support psychotherapy research within the training program.
From a situation in the mid-1960s when ‘counselling’ was seen by many in education as a transatlantic transplant which hopefully would never ‘take’, we have today reached the position of being on board a band-wagon; ‘counsellors’ are everywhere: beauty counsellors, tax counsellors, investment counsellors, even carpet counsellors. There are ‘counsellors’ in schools, industry, hospitals, the social services. There is marriage counselling, divorce counselling, parent counselling, bereavement counselling, abortion counselling, retirement counselling, redundancy counselling, career counselling, psychosexual counselling, pastoral counselling, student counselling and even disciplinary counselling! Whatever the original purpose for coining the word ‘counselling’, the coinage has by now certainly been debased. One of the unfortunate consequences of the debasing has been that the word has become mysterious; we cannot always be sure just what ‘counselling’ involves. One of the results of the mystification of language is that we rely on others to tell us what it is: that is, we assume that we, the uninitiated, cannot know and understand what it is really about. That can be a first step to denying ourselves skills and knowledge we already possess or that we may have the potential to acquire.
In order to study the course and outcome of neurosis, the principles of epidemiology as they apply to psychiatry become relevant. These have been described and helpful applications demonstrated by Hare and Wing (1970), and by Cooper and Morgan (1973). The essential elements of choosing an appropriate population sample and carrying out a meaningful survey have been discussed by Moser and Kalton (1971). Epidemiological work with the neuroses is extremely difficult; it is rather like sculpting in butter — a very slight change in the climate and one is presented with a totally meaningless mess.
From a situation in the mid-1960s when ‘counselling’ was seen by many in education as a transatlantic transplant which hopefully would never ‘take’, we have today reached the position of being on board a band-wagon; ‘counsellors’ are everywhere: beauty counsellors, tax counsellors, investment counsellors, even carpet counsellors. There are ‘counsellors’ in schools, industry, hospitals, the social services. There is marriage counselling, divorce counselling, parent counselling, bereavement counselling, abortion counselling, retirement counselling, redundancy counselling, career counselling, psychosexual counselling, pastoral counselling, student counselling and even disciplinary counselling! Whatever the original purpose for coining the word ‘counselling’, the coinage has by now certainly been debased. One of the unfortunate consequences of the debasing has been that the word has become mysterious; we cannot always be sure just what ‘counselling’ involves. One of the results of the mystification of language is that we rely on others to tell us what it is: that is, we assume that we, the uninitiated, cannot know and understand what it is really about.
An important variable relating to both the course and outcome of psychotherapy involves the patient and the characteristics he or she brings into the therapeutic situation. Past research in this area has attempted to relate patient variables such as motivation, expectancies, demographic characteristics, diagnosis, severity of maladjustment, and personality traits to continuation in therapy, therapy outcome, and in-therapy patient behavior.
In this chapter we consider therapist variables in psychotherapy and psychotherapy research. Our endeavor is not at all a new one, since the topic has been of interest from the very beginning of systematic thought about the complex, dynamic set of processes that define psychotherapy. It is a difficult endeavor, however, because of the massive literature, including expert opinion and systematic research, that has addressed the topic. Fortunately, in the last decade or so two major critical surveys (Meltzhoff & Kornreich, 1970; Parloff, Waskow, & Wolfe, 1978) as well as numerous specialized reviews (e.g., Dent, 1978; Kilman, Scovern, & Moreault, 1979) have systematized the literature either generally, to a specified point in time, or with regard to a particular issue or perspective. Our strategy will be to summarize briefly the conclusions that previous reviewers reached and then, in the process of updating the literature, to comment on selected issues that we view as enduring or promising. One departure from the approach that other reviewers have taken will be our use of the term psychotherapist to include persons, regardless of professional discipline, who synthesize pharmacological and psychological treatment of emotional or behavioral disorders. Also, we will use the terms psychotherapy and psychotherapist in a generic sense to include a wide range of intervention techniques or strategies and persons who practice them. Parloff et al. (1978) critically surveyed the literature on therapist variables through about 1977 and systematically considered most of what had been covered in the earlier major review by Meltzhoff and Kornreich (1970). We consider both of these reviews required reading for the serious researcher, therapist, or planner, since they often critique studies from somewhat different methodological or philosophical perspectives. However, here we will draw mainly on Parloff et al. (1978), since it is the most recent and, in our opinion, more readily accessible survey.
Within the broad area of marketing of nonprofit service organizations, the matching of volunteers to clients within social service agencies has received no attention in the marketing literature. Three theories were successfully applied to matching in a direct-service setting.The theory of referent power, based on an analogy with the buyer-seller dyad, was used to predict success in a volunteer-client dyad.Additional theories were Schutz’ theory of compatibility and Bierman’s model of interpersonal facilitation.
From a situation in the mid-1960s when ‘counselling’ was seen by many in education as a transatlantic transplant which hopefully would never ‘take’, we have today reached the position of being on board a band-wagon; ‘counsellors’ are everywhere: beauty counsellors, tax counsellors, investment counsellors, even carpet counsellors. There are ‘counsellors’ in schools, industry, hospitals, the social services. There is marriage counselling, divorce counselling, parent counselling, bereavement counselling, abortion counselling, retirement counselling, redundancy counselling, career counselling, psychosexual counselling, pastoral counselling, student counselling and even disciplinary counselling! Whatever the original purpose for coining the word ‘counselling’, the coinage has by now certainly been debased. One of the unfortunate consequences of the debasing has been that the word has become mysterious; we cannot always be sure just what ‘counselling’ involves. One of the results of the mystification of language is that we rely on others to tell us what it is: that is, we assume that we, the uninitiated, cannot know and understand what it is really about.
The objective of this introductory chapter is to provide a historical overview of the major theoretical, conceptual, and methodological issues and trends in psychotherapy research. The chapter is intended to illustrate the issues rather than detailing them exhaustively. However, the reader should find in-depth reviews of the substantive issues in the remaining chapters of the text. For purposes of this review, historical trends will be divided into three decades: 1950s, 1960s, and 1970s. Although these demarcations are admittedly artificial, they do provide boundaries that facilitate description and understanding of the issues in psychotherapy research over the past 30 years.
Congruence or genuineness is a relational quality receiving renewed interest in recent years. This article offers a description of the conceptual nature of this construct as well as a selective review of the empirical literature documenting its relationship to outcome and other therapy change processes. Of the 77 results reviewed, 34% showed a positive relation to outcome; none were negative. The majority of the positive results came from research within client-centered settings. Associations with the experiential quality of the therapy relationship suggest that there is both empirical and theoretical justification for congruence as a central component of a complex conception of the therapy process. Therapeutic practices that might promote congruence are discussed.
No presente artigo procede-se a uma breve resenha histórica da psicoterapia e do papel atribuído ao psicoterapeuta em diferentes modelos. Com base nesta análise, o autor tenta contribuir para a compreensão de resultados actuais da investigação que apontam para o facto de as variáveis do psicoterapeuta explicarem cerca de oito vezes mais da variância dos resultados terapêuticos do que a respectiva orientação teórica e/ou técnica que utiliza.
Zur Frage steht: Was läßt sich aus der Psychotherapie in die ärztliche Praxis wie überführen?
From a situation in the mid-1960s when ‘counselling’ was seen by many in education as a transatlantic transplant which hopefully would never ‘take’, we have today reached the position of being on board a band-wagon; ‘counsellors’ are everywhere: beauty counsellors, tax counsellors, investment counsellors, even carpet counsellors. There are ‘counsellors’ in schools, industry, hospitals, the social services. There is marriage counselling, divorce counselling, parent counselling, bereavement counselling, abortion counselling, retirement counselling, redundancy counselling, career counselling, psychosexual counselling, pastoral counselling, student counselling and even disciplinary counselling! Whatever the original purpose for coining the word ‘counselling’, the coinage has by now certainly been debased. One of the unfortunate consequences of the debasing has been that the word has become mysterious; we cannot always be sure just what ‘counselling’ involves. One of the results of the mystification of language is that we rely on others to tell us what it is: that is, we assume that we, the uninitiated, cannot know and understand what it is really about.
From a situation in the mid-1960s when ‘counselling’ was seen by many in education as a transatlantic transplant which hopefully would never ‘take’, we have today reached the position of being on board a band-wagon; ‘counsellors’ are everywhere: beauty counsellors, tax counsellors, investment counsellors, even carpet counsellors. There are ‘counsellors’ in schools, industry, hospitals, the social services. There is marriage counselling, divorce counselling, parent counselling, bereavement counselling, abortion counselling, retirement counselling, redundancy counselling, career counselling, psychosexual counselling, pastoral counselling, student counselling and even disciplinary counselling! Whatever the original purpose for coining the word ‘counselling’, the coinage has by now certainly been debased. One of the unfortunate consequences of the debasing has been that the word has become mysterious; we cannot always be sure just what ‘counselling’ involves. One of the results of the mystification of language is that we rely on others to tell us what it is: that is, we assume that we, the uninitiated, cannot know and understand what it is really about. That can be a first step to denying ourselves skills and knowledge we already possess or that we may have the potential to acquire.
From a situation in the mid-1960s when ‘counselling’ was seen by many in education as a transatlantic transplant which hopefully would never ‘take’, we have today reached the position of being on board a band-wagon; ‘counsellors’ are everywhere: beauty counsellors, tax counsellors, investment counsellors, even carpet counsellors. There are ‘counsellors’ in schools, industry, hospitals, the social services. There is marriage counselling, divorce counselling, parent counselling, bereavement counselling, abortion counselling, retirement counselling, redundancy counselling, career counselling, psychosexual counselling, pastoral counselling, student counselling and even disciplinary counselling! Whatever the original purpose for coining the word ‘counselling’, the coinage has by now certainly been debased. One of the unfortunate consequences of the debasing has been that the word has become mysterious; we cannot always be sure just what ‘counselling’ involves. One of the results of the mystification of language is that we rely on others to tell us what it is: that is, we assume that we, the uninitiated, cannot know and understand what it is really about. That can be a first step to denying ourselves skills and knowledge we already possess or that we may have the potential to acquire.
Counselling, as Barrie Hopson reminds us, has become an important part of the repertoire of the helping professions in the UK over the last 15 years or so. It follows that medical practitioners, many of whom will have the overall responsibility for clients’ welfare within the Health Services, should have some understanding of the aims, nature and effectiveness of these psychological techniques. The following review provides the basis of such an understanding and attempts to provide answers to questions which should interest both the trainee and the more experienced clinician. For example, what is distinctive about counselling techniques? How does counselling differ from the everyday processes of help and support which untrained individuals provide for others? What are the characteristics of the effective counsellor? What are the goals of counselling? What are the most significant features of the process of counselling?
This chapter attempts to provide a fresh look at the psychotherapy process from a contextual-epistemic perspective. Two areas will be carefully examined: symptom formation and symptom resolution. Fundamental questions will be raised, such as “What is a symptom?” “Who is the client?” and “Does a therapist ever cause change?” The ideas to follow, while perhaps unfamiliar at first, should become acceptable to readers if they temporarily relax some assumptions about the known world and our relationship to it. The metatheory of contextualism, as explicated by Pepper (1942) and advanced in psychology by Rosnow and Georgoudi (1986a), provides the basis for current theorizing.
This chapter concerns the clinical application of the author’s model. The chapter will begin with a conceptional overview concerning the psychotherapy of marital discord. This section will be followed by brief discussions of technical considerations, the goal and length of marital therapy, and the indications for marital therapy. Then the typical stages of marital therapy will be discussed. The chapter will end with a brief discussion of the differing needs of practicing clinicians and clinical researchers.
By viewing counseling and therapy in their intercultural context, several points will become apparent: (1) That these functions have spread rapidly to a complex social industry on a world-wide basis; (2) That counseling and therapy as we know them are labels for one of the many alternatives for intervention to influence a person’s mental health; (3) That counseling and therapy as the preferred alternatives are based on assumptions generic to a very small portion of the world’s people; (4) That an interculturally appropriate application in counseling and therapy is necessarily responsive to the social context.
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