Pre-therapy process and outcome: A review of research instruments and findings

Pre-Therapy aims at stimulating psychological contact in persons suffering psychosis. We offer a review of Pre-Therapy research instruments and findings. The Pre-Therapy Rating Scale (PTRS, Prouty, 1994) and the Evaluation Criterion for the Pre-Therapy Interview (ECPI, Dinacci, 1997) have been the two most frequently used instruments for the assessment of psychological contact. PTRS scores seem more reliable than ECPI scores, but all manuals need revision. Particular attention is needed for the rating of nonverbal behavior. A preliminary evaluation of the structure of the PTRS indicates that it is two-dimensional rather than three-dimensional. The PTRS and the ECPI can be regarded as measures of communicative contact but also as measures of the meaningfulness of communication. Preliminary outcome studies suggest that pre-post and comparative effect sizes of Pre-Therapy are large for communicative contact, but the number of participants in these studies is generally low, as is the number of systematic case studies

Body-oriented intervention in psychotherapy

In the Person-Centered/Experiential tradition, moment-by-moment empathy is every therapist’s baseline activity for the session. Thus, the general theoretical question of my research program is: What is the relation between empathy and the bodily interaction of client and therapist in Person- Centered/Experiential Psychotherapies? Starting from the classic Person-Centered model of the Empathic Cycle (EC), I discriminate three basic assumptions with respect to participants’ bodily interaction. The first is a relational account of individual experience by acknowledging the mutual, immediate effect that both the client and the therapist have on one another. Second, the EC concept installs a focus on agency, stressing that client and therapist share a common goal, and that they both engage in an active effort to attain it. Third, the EC acknowledges the immediacy of empathy, or the possibility of an immediate access to the other’s emotions and intentions. A short elaboration of these assumptions, shared by some theorists in general psychology, shows the way to an Experiential, Body-Oriented version of the EC model. This model is abstract in the sense that it is applicable to clients with very different problems and disorders. In the light of this revised model, I propose my general research question: How do Body-Oriented interventions influence (enhance or disturb) empathic interaction in Person-Centered/Experiential Psychotherapy? Based on the above model, I offer a perspective from which to understand the relevance of interventions typical of Body-Psychotherapy. I discriminate between them as to their role in the EC. Two empirical studies will help me to test and refine the revised EC model and the functional discrimination of Body-Oriented responses. Study 1 is the development of a scale for Body- Oriented Verbal Responses for use in therapy observation. It entails iterative development of a coding manual, repeated reliability tests, and an assessment of the scale’s validity. The coded material is a collection of videotaped therapy segments from three therapeutic schools: Focusing Oriented Therapy, Body-Processing and Pre-Therapy. Study 2 is a clinical study of Contact Work, an approach derived from Pre-Therapy. The formulation of hypotheses in this study requires a translation of the abstract, revised EC model to the context of therapy with psychotic patients. The empirical part of the study entails task analysis of significant events in sessions, within a multiple case baseline design for three patients. Finally, I argue that my project has relevance for the integration of therapy approaches, that it is an important methodological exercise, and that it has clinical implications for both training and practice.status: Unpublishe

Empathy in psychotherapy: dialogue and embodied understanding

In this chapter, we present an account of empathy in psychotherapy that is based on a more general, multidisciplinary understanding of everyday empathic interaction. We want to argue that, for two reasons, this approach can contribute to a better understanding of processes of empathy in the therapeutic context. Neurological studies and social psychology research have demonstrated the power and complexity of interpersonal influence on a physical, nonverbal level, a complexity that is sometimes ignored by therapists (Shaw, 2004). Second, understanding problems in client-therapist interaction requires us to examine how clients both understand and misunderstand their therapists, including their therapists' intentions, emotions, and other internal states (e.g., Rhodes et al., 1994). These problems are grasped with more coherence when they are described using parallel concepts for the client and the therapist. For example, it is easier to understand and tackle severe communication problems in psychosis treatment when both the client's and the therapist's 'sides' of the communication are considered

Studying body-oriented responses: From the therapist to the client and back again

Aims and Methods: It is a truism that therapist's interventions mediate the work done by clients in psychotherapy. There is an implicit difference in how the therapist's and client's work are generally viewed, however. The therapist's work tends to be framed in terms of performances, while the client's work is construed in terms of emotional-cognitive processes as well. Although the therapist's consideration of his or her counter-transference is an exception, this consideration represents just one aspect of a much broader phenomenon. This phenomenon is the therapist's use of embodied emotions and feelings experienced from moment to moment when responding to the client. Results and Conclusions: The paper highlights the role of the therapist's attention to and use of embodied experience in illuminating in a more complete way the complexity of what goes on in therapeutic engagement. Illustrations are drawn from clinical practice in support of the argument.12status: publishe

Empathy in psychotherapy: Dialogue and embodied understanding

In this chapter, we present an account of empathy in psychotherapy that is based on a more general, multidisciplinary understanding of everyday empathic interaction. We want to argue that, for two reasons, this approach can contribute to a better understanding of processes of empathy in the therapeutic context. Neurological studies and social psychology research have demonstrated the power and complexity of interpersonal influence on a physical, nonverbal level, a complexity that is sometimes ignored by therapists (Shaw, 2004). Examples of such influences are emotional contagion (e.g., Preston & de Waal, 2002) and automatic vigilance (Wentura, Rothermund, & Bak, 2000). Second, understanding problems in client-therapist interaction requires us to examine how clients both understand and misunderstand their therapists, including their therapists’ intentions, emotions, and other internal states (e.g., Rhodes et al., 1994). These problems are grasped with more coherence when they are described using parallel concepts for the client and the therapist. For example, it is easier to understand and tackle severe communication problems in psychosis treatment when both the client’s and the therapist’s “sides” of the communication are considered (Peters, 2005).status: publishe

Pre-therapy process and outcome: A review of research instruments and findings

Pre-Therapy aims at stimulating psychological contact in persons suffering psychosis. We offer a review of Pre-Therapy research instruments and findings. The Pre-Therapy Rating Scale (PTRS, Prouty, 1994) and the Evaluation Criterion for the Pre-Therapy Interview (ECPI, Dinacci, 1997) have been the two most frequently used instruments for the assessment of psychological contact. PTRS scores seem more reliable than ECPI scores, but all manuals need revision. Particular attention is needed for the rating of nonverbal behavior. A preliminary evaluation of the structure of the PTRS indicates that it is two-dimensional rather than three-dimensional. The PTRS and the ECPI can be regarded as measures of communicative contact but also as measures of the meaningfulness of communication. Preliminary outcome studies suggest that pre-post and comparative effect sizes of Pre-Therapy are large for communicative contact, but the number of participants in these studies is generally low, as is the number of systematic case studies.status: publishe

Communicatief Contact Schaal

18status: publishe

Evaluating patients' cognitive performance with the Attention Diagnostic Method

The Attention Diagnostic Method (ADM), J. Rutten's adaptation of the Grünbaum test, is a valuable test for research in mild cognitive impairment. It offers the opportunity of evaluating attention,sequencing, mental flexibility, and visual search, independent of the patient's motor coordination capacities. The ADM is administered in two parts. First the patient is shown a screen with an array of 50 two-digit numbers with different colors for each number. The patient is requested to look up the numbers in their numerical order and to name both the number and its color. Secondly, when another screen is shown, the patient is requested to look up numbers in numerical order, to name the color of each number, and to name another number printed smaller below it. We compared test behavior of 81 young schizophrenic patients with the performance of 81 healthy controls matched for gender, age, and education. Patients took longer to complete both parts of the ADM and made more errors. Changes in attention over time appeared to be similar for both groups. The ADM is a valuable test for evaluating impairments of attention and working memory in schizophrenia.status: publishe

Kentucky Inventory of Mindfulness Skills: Dutch form

18status: publishe