Client concealment and self-presentation in therapy: Comment on Kelly (2000).

The authors disagree with A. E. Kelly's (see record 2000-08364-001) conclusions that clients conceal things from therapists primarily for self-presentational reasons and that client concealment is positively related to positive therapy process and outcome. They also disagree with A. E. Kelly regarding the implications of self-presentation theory for therapy. Their review of the research suggests that clients do not conceal much from therapists, that what they do conceal involves many different kinds of information hidden for many different reasons, that therapists have wide variability in being able to detect hidden client material, and that the relationship of client concealment and therapist awareness of client concealment with therapy process and outcome is not clear. Finally, the authors discuss their views about implications of client concealment and self-presentation for therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The necessary and sufficient conditions of therapeutic personality change.

This reprinted article originally appeared in Journal of Consulting Psychology, 1957(Apr), Vol 21(2), 95-103. (The following abstract of the original article appeared in record 1959-00842-001.) "For constructive personality change to occur, it is necessary that these conditions exist and continue over a period of time: (1) Two persons are in psychological contact. (2) The first, whom we shall term the client, is in a state of incongruence, being vulnerable or anxious. (3) The second person, whom we shall term the therapist, is congruent or integrated in the relationship. (4) The therapist experiences unconditional positive regard for the client. (5) The therapist experiences an empathic understanding of the client's internal frame of reference and endeavors to communicate this experience to the client. (6) The communication to the client of the therapist's empathic understanding and unconditional positive regard is to a minimal degree achieved." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The ethics of language and the language of ethics.

Responds to the comments of M. P. Nichols (see record 1989-40699-001) on the work of the present authors (see record 1989-40685-001), asserting that therapists work toward understanding the correctness of the view explained by the client in a never-ending process that changes both therapist and client. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Indicators of Client Engagement: Influences on Alcohol Treatment Satisfaction and Outcomes.

This investigation explored the relationship of client engagement variables (client expectations, therapeutic/working alliance, and session attendance) with treatment satisfaction and posttreatment drinking-related outcomes using data from 2 outpatient alcohol treatment studies (N = 208). Path analysis was used to test a model in which engagement variables jointly influence client satisfaction with treatment and subsequent drinking-related outcomes. The proposed model fit well with the data and accounted for 14-23% of the variance in posttreatment outcomes. The relationships in the model suggest that the link between treatment satisfaction and outcome is clarified by examining client engagement variables, which relate indirectly to outcome by means of client satisfaction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Client-assumed responsibility: A basis for contingent and noncontingent therapeutic responding.

Presents a teleological model of human behavior in which therapists can use contingent and noncontingent responses with the same or different clients. The level of client-developed responsibility should determine the nature of therapeutic responding. Increases in client-assumed responsibility, as reflected by changes in client language, should be accompanied by decreases in noncontingent responding. The effectiveness of this proposal depends on a collaborative relationship between therapist and client and on the client's ability to differentiate self from behavior. Client movement toward differentiating these two therapeutic elements is suggested as a prerequisite for perceptions of causality and responsibility. Using verbalized reasons to ascribe client responsibility is a potentially valuable technique, consistent with the suggestions of S. L. Halleck (see record 1983-03935-001) and L. Shawver (see record 1984-12829-001). It is suggested that continued noncontingent responding toward persons who have assumed responsibility is tantamount to treating persons without the human dignity that responsibility presupposes. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The present status of outcome studies: A reply to Frank.

J. D. Frank (see record 1979-29008-001) 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) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interracial and intraracial quasi-counseling interactions when counselors avoid discussing race.

Dyadic interactions composed of Black clients and White or Black race-avoidant counselors in 1-time quasi-counseling sessions were influenced by myriad factors, including how these clients responded to influential purveyors of a race-neutralizing climate. Using C. E. Thompson, R. Worthington, and D. R. Atkinson's (see record 1994-30597-001) data set, 24 of these interactions were analyzed to identify significant patterns in the counseling process. The following core categories related to interactional quality were uncovered: smooth, exasperated, constricted, and disjunctive. The following factors explicated these interactional quality categories: (1) whether and how the client introduced race or race-related concerns, (2) client racial identity perspectives; and (3) client affiliation (or lack thereof) with the counselor based on race. The implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex bias and the diagnosis of borderline personality disorder.

Criticizes D. Becker and S. Lamb's (see record 1994-29756-001) paper reporting that women are more likely than men to be diagnosed as having a borderline personality disorder (BPD). Results from the previous research of D. A. Adler et al (see record 1991-15353-001), K. A. Henry and C. I. Cohen (see record 1984-06917-001) and M. R. Ford and T. A. Widiger (see PA, Vol 76: 26071), indicate that the gender of a client does not have a statistically significant effect on whether the client is given a diagnosis of BPD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"The association between global and specific measures of the therapeutic relationship": Erratum.

Reports an error in "The association between global and specific measures of the therapeutic relationship" by Nick F. Coady and Elsa Marziali (Psychotherapy: Theory, Research, Practice, Training, 1994[Spr], Vol 31[1], 17-27). This article contained, as Figure 1, an SASB model. The authorship and copyrights for the model were not acknowledged. The following acknowledgement should have been included: "From Benjamin (1983), Intrex User's Manual. Intrex Interpersonal Institute, P.O. Box 581037, Salt Lake City, UT 84158. Reprinted by permission." An apology is offered to the author, Dr. Lorna Smith Benjamin. The particular version used in the article was developed in collaboration with Clinton W. McLemore. (The following abstract of the original article appeared in record 1994-46203-001.) Examined the association between global and specific measures of the therapeutic relationship in Sessions 3, 5, and 15 of 9 cases of time-limited psychodynamic psychotherapy. L. S. Benjamin's (see PA, Vol 53:2991; see also, 1984) structural analysis of social behavior (SASB) model provided the specific measure of relationship. There were more consistent associations between ratings of client contributions to the alliance and SASB ratings of client behaviors than there were for the same therapist variables. Additionally, analyses show that external (i.e., nonself) judgments of client and therapist contributions to the alliance, rather than therapist or client self-ratings of contributions to the alliance, were most frequently associated with the SASB behavior codes. Finally, different therapist and client behaviors seemed to be associated with quality of the therapeutic relationship at different points in the therapeutic process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The association between global and specific measures of the therapeutic relationship.

[Correction Notice: An erratum for this article was reported in Vol 31(3) of Psychotherapy: Theory, Research, Practice, Training (see record 2009-17141-001). This article contained, as Figure 1, an SASB model. The authorship and copyrights for the model were not acknowledged. The following acknowledgement should have been included: "From Benjamin (1983), Intrex User's Manual. Intrex Interpersonal Institute, P.O. Box 581037, Salt Lake City, UT 84158. Reprinted by permission." An apology is offered to the author, Dr. Lorna Smith Benjamin. The particular version used in the article was developed in collaboration with Clinton W. McLemore.] Examined the association between global and specific measures of the therapeutic relationship in Sessions 3, 5, and 15 of 9 cases of time-limited psychodynamic psychotherapy. L. S. Benjamin's (see PA, Vol 53:2991; see also, 1984) structural analysis of social behavior (SASB) model provided the specific measure of relationship. There were more consistent associations between ratings of client contributions to the alliance and SASB ratings of client behaviors than there were for the same therapist variables. Additionally, analyses show that external (i.e., nonself) judgments of client and therapist contributions to the alliance, rather than therapist or client self-ratings of contributions to the alliance, were most frequently associated with the SASB behavior codes. Finally, different therapist and client behaviors seemed to be associated with quality of the therapeutic relationship at different points in the therapeutic process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Five therapists and one client.

Reviews the book, Five therapists and one client by Raymond J. Corsini (see record 1993-97589-000). To address the question of how the course of therapy would differ depending on the therapist's basic orientation, Corsini created a fictitious client with relatively minor but persistent problems. Therapists from five major systems of psychotherapy were chosen to write very specifically about how they would treat this client. The five systems include Adlerian, person-centered, rationale-emotive, behavioral, and eclectic. The book is divided into six chapters with one chapter for each of the five systems and an introductory chapter in which the problems of the client are given. This is an informative book for professionals, students, and those who are simply interested in the process of psychotherapy and human growth. The book provides very practical, basic information about the therapeutic process from five different perspectives as well as deeper theoretical insight into these respective approaches. Even the sophisticated reader will find much of value in Corsini's book. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The defense rests?

Regarding Nickerson's letter ("Comments on The Brain Watchers," Amer. Psychologist, 1963, 18, 529-531), the author comments on the concept that personality test items should include an opportunity for the client to indicate (a) frequency, (b) intensity, (c) duration, and (d) probability in a specific stimulus situation, and gives reasons why the client should not be asked to make such judgments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Session depth and smoothness in relation to the concept of engagement in counseling.

Investigated the relation of client-counselor evaluation of initial interview to client return for another session. At the end of the initial session, 5 professionals, 5 practicum trainees, and their 290 college-student clients completed the depth and smoothness indexes of the Session Evaluation Questionnaire (W. B. Stiles; see record 1980-12384-001). Clients also completed the Client Satisfaction Questionnaire, and counselors completed items from the Pre-Counseling Assessment Blank (C. J. Gelso and D. H. Johnson, 1983). The duration of the intake interview was recorded. Client return was positively related to: longer interviews; deeper interviews, as rated by both client and counselor; and greater client satisfaction, disturbance, and motivation. The results are discussed in relation to the concept that the initial session represents an engagement session when clients return for more sessions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sequential analysis applied to counseling process and outcome: A case study revisited.

A case study presented by C. E. Hill et al (see record 1983-10832-001) was analyzed further with sequential analysis methods developed by B. E. Wampold (see PA, Vol 71:30503; in press) and Wampold and G. Margolin (see record 1983-04841-001) to demonstrate the usefulness of these methods for understanding counseling process and outcome. Several interactive patterns were investigated including unidirectional independence, bidirectional independence, and dominance. Process was linked to outcome by examining the relations of various interactive patterns and satisfaction with and evaluation of each session as rated by the client, the counselor, and observers. The present sequential analysis revealed several facets of the interaction between the counselor and the client that were undetected by Hill et al.'s analysis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of race and socioeconomic status on the perception of process variables in counseling.

Analyzed the effects of race and socioeconomic status (SES) on the perception of process variables in counseling, including judged counselor empathy, judged counselor–client cognitive similarity, and attraction. The study used a 2?×?12?×?2?×?6 design (race of S, tape order, SES of client, race of counselor and client) with repeated measures on the SES of client variable and the race of counselor and client variable. Following empathy training, 12 Black and 12 White undergraduate middle-class males listened to 12 specially prepared counselor–client taped dialogs and rated the counselor and client on each tape on the process variables being researched. All hypotheses were confirmed. Both Black and White Ss gave highest counselor empathy ratings, client–counselor attraction and cognitive similarity ratings, and client improvement ratings to matchings in which the counselor and client were similar over race and social class, and they gave lowest ratings when the counselor and client were dissimilar over race and social class. Effects of client accent were generally not significant. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The prediction of child psychotherapy outcome: Factors specific to treatment.

Examined the prediction of child psychotherapy outcome from client, parent, and process factors specific to the therapeutic relationship. 31 children (mean age 11 yrs) were assessed by some independent and therapist ratings, as were parental behaviors, at admission and at discharge from a community mental health center. The primary diagnoses were adjustment disorder (89%) and functional enuresis (11%). Process was evaluated by therapist ratings on the Psychotherapy Process Inventory by P. E. Baer et al (see record 1981-11629-001). Results support the importance of treatment dosage and client participation to global change in impairment and are consistent with findings of B. Gomes-Schwartz (see record 1979-26509-001). Change (decrease) in the severity of Ss' primary problem through treatment was predicted by less frequent parental psychological punishment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Cognitive-behavioral therapy for bipolar disorder and Cognitive therapy for delusions, voices, and paranoia.

Reviews the books, Cognitive-behavioral therapy for bipolar disorder by Monica Ramirez Basco and A. John Russo (see record 1996-98072-000) and Cognitive therapy for delusions, voices, and paranoia by Paul Chadwick, Max Birchwood, and Peter Trower (see record 1996-97983-000). The mental health service system is largely based on the oft encountered, often implicit, belief among professionals that, since Schizophrenia, Bipolar Disorder, and other severe forms of mental illnesses have been shown to have a biological basis, there is no point in providing psychotherapy for individuals afflicted with these disorders. These two books represent a welcome exception to this situation. While different in many ways, including their treatment goals and many of their theoretical underpinnings, both books represent an attempt to allow the severely mentally ill to benefit from techniques which have been demonstrated to be effective for less severely disturbed populations. Both approaches illustrate ways that the severely mentally ill may be able to be helped through psychosocial intervention, and both acknowledge the importance of client collaboration in treatment, a consideration easy to overlook when the client has a severe mental illness. The books are also similar in that neither one offers sufficient empirical data to support the effectiveness of its approach. The two books reviewed here represent, in the reviewer's opinion, significant contributions to the field of psychotherapy. Even if the clinician takes issue with the techniques presented or with the theoretical assumptions underlying the approaches, he/she should come away with a renewed appreciation of the importance of including the client in treatment planning, even if the client has a severe mental illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Different frames for change.

Briefly replies to writings by Whitaker (see record 1989-98357-000) and J. Bergman ([1985]. Fishing for barracuda. New York: W. W. Norton) on the topic of clinicians' facilitation of client change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of need and commitment on career exploration behaviors.

Tested the effects on social power of 2 aspects of client need: perceived need (high and low) and commitment to change (high and low). 48 undergraduates and 4 female counselors (25–30 yrs old) participated. Perceived need for assistance in career decision making was assessed through client self-report. Commitment to change was experimentally manipulated through interview procedures. ANOVAs indicated that perceived need had no significant effect on attitude change or information seeking. Commitment to change procedures had a significant effect on information-seeking behaviors. Results are discussed in relation to the definition of social power and perceived need as proposed by S. R. Strong and R. P. Matross (see record 1973-21636-001). (PsycINFO Database Record (c) 2010 APA, all rights reserved)