Psychotherapy Process in the Exploration Stage

The purpose of this study was to examine the counseling process within the exploration stage of Hill and O'Brien's (1999) 3-stage helping skills model. Cochran-Mantel-Haenszel chi-square analyses revealed that: (1) therapists did not use significantly different response modes in response to client narrative process modes; (2) when therapists asked an open question about feelings or reflect feelings, clients were more likely to respond with the internal narrative processing code; and (3) there were no significant associations between therapist response mode and client shift or maintenance of narrative process modes. In addition the hypotheses that (1) client helpfulness ratings can be predicted by client narrative response mode in the previous turn and therapist predominant verbal response mode in that turn, and (2) that client helpfulness ratings can be predicted by client narrative response mode in the previous turn and therapist predominant verbal response mode in that turn were not supported

Client Preferences for Insight-Oriented and Action-Oriented Psychotherapy

Client preferences for psychotherapy style have been understudied, despite their value in adding to our understanding of psychotherapy process and outcome. Furthermore, current research trends point towards investigating the match between client and therapist in determining outcome (ATI research). One match that has not been studied as much is the match between client preference for type of therapy and therapist therapy style. Two styles that seem particularly important are insight- and action-oriented therapy, which are often distinct therapy approaches. Clients often come to counseling anticipating either receiving insight or making a plan for action. This research has implications for enhancing client outcome due to its promise to determine better client-therapist matches. The present study employed an experimental laboratory method with two independent variables. The independent variables were client preferences for insight oriented therapy versus action oriented therapy, and counseling style provided (insight oriented therapy vs. action oriented therapy). Dependent variables were changes in target problem, relationship strength (RS), session depth, session evaluation (SES), therapist credibility, and change in preference for insight versus action. Control participants watched a videotape of Carl Rogers performing psychotherapy. Hypothesis 1 was that clients who receive their preferred therapy style will have a more positive outcome than clients who do not receive their preferred therapy style. Result indicated that hypothesis 1 was not supported. Hypothesis 2 was that credibility will be associated with better outcome. Results indicated that hypothesis 2 was partially supported. Hypothesis three was that match between client preferences and treatment received will be a greater predictor of outcome than credibility. Hypothesis 3 was not supported. Hypothesis 4 was that clients who perceive their therapists as credible will shift more towards the style received than clients who do not perceive their therapists as credible. Hypothesis 4 was not supported. Limitations and suggestions for future research are discussed

The Attainment of Insight in the Hill Dream Model: A Case Study

Using a variety of different measurement methods, it has been shown that clients valued insight in dream sessions and that they gained insight into their dreams as a result of sessions. However, very little is known about the mechanisms through which insight is attained in dream sessions, other than the fact that client involvement and therapist adherence and competence are related to insight gains and that therapist interpretation may not be necessary for insight gains. Knowledge about how client insight develops in dream sessions might provide clues about how insight develops in therapy more generally, a useful pursuit given that insight is a major goal of many therapies. The purpose of the present study, then, was to investigate the development of insight within a single case of dream work. Because we currently know little about how insight develops in dream sessions and because insight might develop differently across clients, we studied one case of a client who developed insight during a dream session. We used a combination of quantitative and qualitative methods to maximize our ability to highlight the development of insight in this case. In this chapter we first describe the process and outcomes of the session, documenting that insight did occur. We then explore factors suggested from psychotherapy process research; dream work research; and our clinical experiences that may have facilitated or inhibited insight gains. (PsycINFO Database Record (c) 2010 APA, all rights reserved