Influence of Therapist Behaviors on Therapeutic Alliance

A number of recent studies have investigated the relationship between therapist and client gender and conversation in marriage and family therapy. There has also been recent empirical investigation of therapeutic alliance and its influence on therapy outcome in marriage and family therapy. However, there has been limited investigation of the influence of interactional patterns on therapeutic alliance. It seems probable that therapy conversation (which seems to be influenced by gender) will influence therapeutic alliance and subsequent outcome.     

Revisiting Bordin's Theory on the Therapeutic Alliance: Implications for Family Therapy

Because of the belief that relationships are a major contributor to problems as well as the avenue for bringing about change, the alliance between therapists and clients is important in family therapy. Writings and ideas on the therapeutic alliance from psychoanalytic theory were used by Edward Bordin to develop a working theory in 1979, and later adapted to the field of family therapy. However, the adaptation did not account for many variables unique and important to family therapy. This article describes the therapeutic alliance and the necessity of creating a theory of therapeutic alliance that accounts for family therapy concepts. Future ideas for scholarship are presented.     

Influence of Therapist and Client Behaviors on Therapy Alliance

This study considers the combined effect of therapist behaviors and couples interaction dynamics on therapeutic alliance because it seems to be a significant predictor of successful therapy outcomes. We measured therapeutic alliance using the Working Alliance Inventory, Observer Version (WAI-O), which includes three subscales: goals, tasks, and bond. We investigated the combined effect of therapist behaviors and couples interactions on therapeutic alliance. There were three significant findings: (1) the models better predicted therapeutic alliance for men clients than women clients; (2) combined consideration of partner behaviors and therapist behaviors provided the stronger prediction of therapeutic alliance; and (3) different variables predicted alliance for women clients versus men clients.     

当事人眼里的工作同盟：质的分析

为了解中国当事人如何看待咨询中的工作同盟, 对工作同盟做初步的本土概念化, 采用协商一致的质的研究方法对来自1所大学心理咨询中心的20名当事人的访谈结果进行了分析。结果发现, 与工作同盟相关的域有6个, 分别是情感联结、任务、投入、合作模式、发展变化、影响因素。前三个域可以看作是工作同盟的构成要素, 而后三个域则是对其外部特征的描述。对每个域的含义及其与现有理论和研究的关系进行了讨论。     

A Career Developmental Perspective on the Therapeutic Alliance: Implications for Counseling

This review explores the role played by childhood emotional maltreatment (CEM) in selecting a career in the field of mental health and the potential positive and deleterious effects of these career‐choice motives on the therapeutic alliance. The reviewed findings support the assumption that CEM may serve as a precursor for career choice of professions in the mental health field. Implications are suggested for the counselor/therapist–client relationship, also known as the therapeutic alliance, as well as for career counseling.     

Examining Spirituality Over Time: Latent Growth Curve and Individual Growth Curve Analyses

SUMMARY

Research on spirituality and religiousness has gained growing attention in recent years; however, most studies have used cross-sectional designs. As research on this topic evolves, there has been increasing recognition of the need to examine these constructs and their effects through the use of longitudinal designs. Beyond repeated-measures ANOVA and OLS regression models, what tools are available to examine these constructs over time? The purpose of this paper is to provide an overview of two cutting-edge statistical techniques that will facilitate longitudinal investigations of spirituality and religiousness: latent growth curve analysis using structural equation modeling (SEM) and individual growth curve models. The SEM growth curve approach examines change at the group level, with change over time expressed as a single latent growth factor. In contrast, individual growth curve models consider longitudinal change at the level of the person. While similar results may be obtained using either method, researchers may opt for one over the other due to the strengths and weaknesses associated with these methods. Examples of applications of both approaches to longitudinal studies of spirituality and religiousness are presented and discussed, along with design and data considerations when employing these modeling techniques.     

Narrative Process Coding System in Marital and Family Therapy: An Intensive Case Analysis of the Formation of a Therapeutic System

The aim of this study is to investigate whether the method (Narrative Processes Coding System) for studying the narrative sequences of individual psychotherapy developed by Angus and Hardtke (1994) can be applied in a family therapeutic process. According to the results narrative process coding system adds new dimensions and gives new depth in the narrative understanding of family therapeutic process. In micro-analytic interactional level it shows the complicated interactions between narration, plot, and narrative process type.     

Therapeutic Alliance,Interpersonal Relations,and Trauma Symptoms: Examining a Mediation Model of Women With Childhood Abuse Histories

The current study explored the dimensions of the early therapeutic alliance (tasks, goals, bonds, and other-therapist [people important to clients who support their involvement in therapy]) as mediators between clients’ interpersonal relations problems and outcome measures of trauma symptoms (dissociation and total trauma symptoms). Seventy-six female participants who were receiving treatment for posttraumatic stress due to child abuse (CA), were recruited from a university training clinic. The bond and other subscales mediated the association between interpersonal relations problems and dissociation. The element of client trust associated with the alliance bond, as well as clients’ sense that people who are important to them support their involvement in therapy, should be focal in treating CA survivors. Clinical implications revolve around developing, maintaining, and repairing the therapeutic relationship, especially the bond, within the context of dissociation, as well as exploring clients’ views of important others and its impact on their therapy.     

Don't Let the Doorknob Hit You: A Relational-Intersubjective Exploration of Leaving and Remaining within the Therapeutic Frame

“Doorknob comments” is a concept that is not well represented in the professional literature. Through three case examples the author develops the theory that doorknob comments can fall within the internal structure of the session or outside of such a structure. In the former case, giving the internal element precedence by extending the session length to address the comments may be warranted. In the latter case, helping a client by scaffolding their ability to structure experience may require that the comment be processed at a later session. In either case, the ability to structure experience, which is the process of elaborating meaning, is an important aspect of treatment.     

Relationship Between the Supervisory Working Alliance and Outcomes: A Meta‐Analysis

This study investigated the relationships between the supervisory working alliance and supervision outcome variables using meta‐analysis. The authors reviewed 27 articles, dissertations, and theses published between 1990 and 2018. The authors used the MIX program to calculate the meta‐analyses. The results indicate that the supervisory working alliance is positively related to supervision outcome variables. Supervisees’ perceived relationship with the supervisor was positively related to the relationship with the client. This shows that the phenomenon of isomorphism is a repeated pattern in the relationships in supervision and counseling. The authors discuss the limitations and implications.     

童年中晚期孤独感的发展轨迹：一项潜变量增长模型分析

使用问卷法和同伴提名法对884名小学二年级学生进行历时三年的四次追踪测试, 采用潜变量增长模型建模, 检验小学2~5年级学生孤独感的变化趋势, 并考察不同性别儿童孤独感变化的差异性以及同伴接纳对孤独感变化的影响。结果发现：(1) 2~5年级小学生孤独感呈曲线递减趋势, 递减速度逐渐减缓, 起始水平及发展速度均存在显著的个体差异; (2)女孩起始的孤独感水平显著低于男孩, 而发展速度、加速度则不存在显著的性别差异; (3)较高的同伴接纳对当时儿童孤独感的降低具有显著的促进作用。研究采用孤独感发展的情境观, 并结合儿童认知、自我发展的特点对结果进行了分析。     

Therapeutic processes in group therapy: Intersections between general change mechanisms and motivational stages of change from patient perspective

Intersections between Grawe’s General Psychotherapy and Prochaska’s Transtheoretical Model were investigated in group therapy in a longitudinal design. It was assumed that general change mechanisms have an impact on patients’ stages of change. Specifically, the main hypotheses were that experiential change mechanisms (ECM; clarification of meaning, problem actuation, emotional bond and group cohesion) should be especially relevant for early stages of change (precontemplation and contemplation), whereas behavioral change mechanisms (BCM; resource activation, mastery/coping and task and goals) should be especially relevant for late stages of change (action and maintenance). Therefore, 140 outpatients attending different types of group therapy, with a typical duration of 8 sessions, were investigated. Patients completed the Form for the Evaluation of Therapeutic Processes in Group Therapy (FEPiG), the University of Rhode Island Change Assessment, short version (URICA-S) and several symptomatology measures (BDI-II, BSCL and IIP-32) at two measuring times. Intersections were analysed through correlational analyses, cross-lagged panels and a path-analytic model, supporting the hypotheses. Specifically, results suggested that experiencing ECM at t1 predicted higher levels of reported contemplation at t2. Patients experiencing higher levels of BCM at t1 reported higher levels of action at t2. Clinical implications of the results are discussed.     

Therapeutic activities and the assimilation model: A preliminary exploratory study on the Insight stage

The assimilation model describes the process of change assuming that the self is enriched when there is a dialogue between nondominant voices or problematic experiences and the dominant voices. This dialogue is best seen in the Insight stage. The aim of this paper is to study the Insight stage during the assimilation process in relation to the main therapeutic activities performed by the therapist. All the Insights from the assimilation process of a patient, María, were analysed. In assimilation terms, María could be described through the nondominant voices of “dizziness,” “tiredness,” and “inability to cope with daily demands,” and through the dominant voices of “control,” “overcome and solve,” and “why something is happening.” María showed a successful assimilation of her problematic experiences. The therapeutic context was the Linguistic Therapy of Evaluation (LTE), a kind of cognitive therapy based on the theory of General Semantics. María was considered a good outcome case in the LTE sample. Results showed that there were some general therapeutic activities related to these Insights. A high percentage of activities pointed to one of the main issues of LTE: the development of an extensional orientation. At the same time, some of these activities were related to María’s voices. Results are discussed in relation to the relevance of the development of an extensional orientation for the assimilation process; how voices are recognized or challenged in therapy, and to the importance of considering relationship issues during the assimilation process.     

Computerised Cognitive Behavioural Therapy in an Adult Mental Health Service: A Pilot Study of Outcomes and Alliance

This pilot study aimed to explore the clinical outcomes and therapeutic relationship for clients of an adult mental health service using Beating the Blues, a computerised cognitive behaviour therapy (CCBT) package. Sixteen participants completed the programme and reported a significant reduction in Beck Depression Inventory scores posttreatment. Participants' mean item ratings on the relationship measure were above the neutral midpoint, but no association was found between the therapeutic relationship and outcome. The results are discussed in terms of the utility of CCBT as part of a stepped-care model and how further research might usefully explore the nature of the relationship formed between clients and CCBT programmes.     

Family-of-Origin,Sexual Attitudes,and Perceptions of Infidelity: A Mediation Analysis

Abstract

The purpose of this study was to examine the influence family of origin and sexual attitudes have on perceptions of infidelity through a mediation analysis to test whether sexual attitudes mediates the relationship between family of origin attitudes and perceptions of infidelity. Results indicated that family of origin attitudes were linked with higher permissive sexual attitudes and lower perceptions of infidelity. Additionally, results indicated an indirect link between family of origin attitudes and perceptions of infidelity through sexual attitudes. These findings align with previous research examining how family of origin influences the occurrence of infidelity and provides insight to helping professionals as they address infidelity in romantic relationships.     

A Cross-Domain Growth Analysis: Externalizing and Internalizing Behaviors During 8 Years of Childhood

In a sample of 405 children assessed in kindergarten through the seventh grade, we determined the basic developmental trajectories of mother-reported and teacher-reported externalizing and internalizing behaviors using cross-domain latent growth modeling techniques. We also investigated the effects of race, socioeconomic level, gender, and sociometric peer-rejection status in kindergarten on these trajectories. The results indicated that, on average, the development of these behaviors was different depending upon the source of the data. We found evidence of the codevelopment of externalizing and internalizing behaviors within and across reporters. In addition, we found that African-American children had lower levels of externalizing behavior in kindergarten as reported by mothers than did European-American children but they had greater increases in these behaviors when reported by teachers. Children from homes with lower SES levels had higher initial levels of externalizing behaviors and teacher-reported internalizing behaviors. Males showed greater increases in teacher-reported externalizing behavior over time than did the females. Rejected children had trajectories of mother-reported externalizing and internalizing behavior that began at higher levels and either remained stable or increased more rapidly than did the trajectories for non-rejected children which decreased over time.     

The Interactive Effects of Impulsivity and Negative Emotions on Adolescent Nonsuicidal Self‐injury: A Latent Growth Curve Analysis

This study employed latent growth curve analysis to evaluate the interactive effects of two specific facets of impulsivity (i.e., negative urgency [NU] and premeditation [PRE]) and negative emotions (NE) on the developmental trajectory of nonsuicidal self‐injury (NSSI) among 3,453 (57% females) Chinese community adolescents. Participants completed questionnaires assessing NSSI, NU, PRE, and NE (i.e., depression, anxiety, and stress) at three waves of time. The initial levels of NE and NU significantly predicted the initial level of NSSI. Changes in NE and NU significantly predicted change in NSSI. Moreover, the initial levels of NU and PRE significantly moderated the relationship between the initial levels of NE and NSSI, such that among individuals with higher NU or less PRE, the three NE were associated with a higher level of NSSI. Additionally, among individuals with a faster increase in NU, depression and anxiety were associated with a faster increase in NSSI. These findings suggest that adolescents with trait impulsivity, especially in the form of NU, are more vulnerable to the engagement in NSSI.     

Effects of physical and verbal aggression,depression, and anxiety on drinking behavior of married partners: a prospective and retrospective longitudinal examination

In an ethnically diverse sample of 195 married couples, we conducted a latent factor growth analysis to investigate the longitudinal link (4 time points over 4½ years) between marital aggression (physical and verbal aggression self‐ and partner‐reports) and individual internalizing symptoms (depression and anxiety) as they relate to trajectories of alcohol use among husbands and wives. Alcohol use was operationalized as a latent factor with self‐ and partner reports of problem drinking as measured by the Michigan Alcoholism Screening Test and the Alcohol Dependence Scale. Verbal aggression by husbands or wives, by itself, has no effect on their alcohol use over time. In conjunction with depression, however, verbally aggressive husbands do have elevated drinking levels. The effects of husbands' and wives' physical aggression on their own and their partners' drinking behavior were also significant. This study is one of the first to examine the change over time in alcohol use for marital partners as related to marital aggression and internalizing symptoms. Our results shed light on areas of marital functioning (aggression, internalizing, alcohol use) that have not been investigated in conjunction with each other in a longitudinal design. Aggr. Behav. 35:296–312, 2009. © 2009 Wiley‐Liss, Inc.