Comparison of patient and therapist evaluations of time-limited psychotherapy.

Obtained empirical data regarding the degree of congruence between therapists' and patients' evaluations of brief psychotherapy on a session-by-session basis and posttreatment and compared these data with predictions derived from J. Mann's (1973) model of the process of brief psychotherapy. 28 17–34 yr old students who were seen in brief psychotherapy (6–22 sessions) by 6 university mental health staff served as Ss. Patients and therapists completed an evaluative questionnaire at the conclusion of each session and at 1–4 wks posttreatment. Sessions were treated as falling into the early, middle or final phase of treatment by dividing the total number of sessions into equal thirds. Without exception, patients' evaluations were higher than those of therapists, both session-by-session and posttreatment. Therapists gave evidence of appreciating this discrepancy but underestimated its magnitude. Results are viewed as largely consistent with predictions derived from Mann's model of brief psychotherapy and as lending support to the model's validity. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Affection for patients as a factor in therapists' outcome judgements

This study was concerned with psychotherapists' evaluations of the outcome of therapy. Staff and resident psychiatrists employed in 23-item questionnaire to rate the seccess of psychotherapy with 85 of their inpatients. These were patients for whom psychotherapy constituted a significant part of the treatment that they received in the hospital. The therapists' responses to the questionnaire items were intercorrelated. The results indicated that a major aspect of a psychotherapist's judgment of the success of treatment-as these judgments usually are employed in current psychotherapy research-is the therapist's affective reaction to the patient, Better-liked patients were viewed as having improved more. However, when the therapists' responses were subjected to factor analysis, independent Improvement and Affection factors emerged. It is suggested that when therapists' ratings of success are used in psychotherapy research they should be treated or refined statistically to minimize potential confounding with their affection for patients.     

Reducing psychotherapy dropouts: Maximizing perspective convergence in the psychotherapy dyad.

Reviews 3 decades of research addressing premature termination of psychotherapy. Client, therapist, interpersonal dyadic, and administrative variables have been extensively investigated. Because of a variety of methodological problems, this literature is highly contradictory, and results are difficult to reconcile, with only socioeconomic status (SES) and ethnicity emerging as consistent predictors of dropout. Treatment matching studies have evaluated the effects of maximizing similarity (or convergence) and minimizing perspective divergence within the therapeutic dyad. Research looking at interactive and multidimensional factors such as working alliance, client satisfaction and expectations, client likability, and pretreatment preparation has proven useful. This research suggests that psychotherapy dropouts might be minimized if differences between therapists' and patients' perspectives on therapeutic enterprise are acknowledged and recognized as legitimate targets for intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapist burnout: A componential analysis.

A random sample of 68 practicing psychotherapists in Texas completed surveys that included the Maslach Burnout Inventory, demographic questions, and questions designed to assess their intent to leave the profession, their treatment orientation, and their perceived ideal caseload. Results indicated that demographic variables and treatment orientation were not accurate predictors of therapists' burnout. However, psychotherapists who worked for agencies had more symptoms of burnout than did colleagues who worked solely in private practice. The therapists' actual caseload was not associated with burnout, but their satisfaction with their caseload was. Therapists who indicated that their ideal caseload would be smaller than their current caseload were more burned out than those who were satisfied with their caseload. In addition, burnout was predictive of the therapists' reported intentions to leave psychotherapy for other professions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A-B therapist distinction, patient diagnosis, and outcome of brief psychotherapy in a college clinic.

Prior studies suggest that therapists' A-B status (types catagorized by the Whitehorn-Betz A-B scale) interacts with patient diagnosis in determining the outcome of psychotherapy (A > B with schizophrenics, B > A with neurotics). To discern whether the hypothesis would apply to brief psychotherapy in a college clinic, the "outcomes" obtained by 3 A and 3 B therapists with their schizoid and neurotic patients (N = 57) were examined in a 2 * 2 factorial design. Analysis of 3 dependent measures based on therapists' and patients' posttherapy ratings reveal considerable support for the hypothesis, particularly for therapists' appraisals of their own effectiveness (interaction, p     

Acceptance, values, and therapeutic change.

Studied the role of therapist acceptance of patient values, patient acceptance of therapist values, and value persuasion on outcome among 13 psychotherapy dyads. Therapists consisted of 13 graduate students in clinical psychology, all of whom had been trained in relationship/insight-oriented therapy. The 13 17–25 yr old patients were randomly selected, 1 from each therapist's caseload. Before beginning therapy all therapists completed a series of value questionnaires; patients completed the same scales after the 1st and 12th therapy sessions. A priori assessment of value acceptance was related to patients' perceptions of their therapists and ratings of improvement, with outcome being enhanced by selective value rejection as well as acceptance. A significant relationship was found between the patients' acquisition of their therapists' values and their ratings of improvement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of discipline in an organization: A field study.

526 hourly employees working in a refinery were surveyed about their perceptions of their immediate supervisor's disciplinary behavior as well as the kinds of factors supervisors take into account when applying discipline. Factor analytic and correlational procedures were explored to (a) determine the kinds of disciplinary factors that are perceived as operating in the organization; (b) determine the relationships between these disciplinary factors and other employee variables such as satisfaction with supervisor, disciplinary history, and grievances; and (c) determine the attributions that supervisors are perceived as forming within the disciplinary process and determine the relationships between these types of attributions and selected employee variables. Several reliable supervisory disciplinary factors are identified that showed high relationships with supervisory satisfaction and the evaluation of the organizational disciplinary program but low correlations with more distant and objective variables of disciplinary history, grievances, and absenteeism. Several attributional dimensions that Ss perceived their supervisor to be using when applying discipline were identified. However, these dimensions are not consistent with the kinds of attributional elements identified in previous literature. Both reward- and punishment-oriented supervisor behavior were independently and incrementally related to satisfaction with supervision, but reward-oriented behavior was more important. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Putative perception of rotating permanent magnetic fields following ingestion of LSD

We applied the Verbal Response Mode coding system to 80 medical interviews to characterize role dimensions of patient and physician and to assess the relation between physicians' role dimensions and patients' satisfaction. Role dimensions conformed closely to prior work. Physicians' acquiescence was positively correlated with satisfaction. This study suggests that the role dimensions generated by the Verbal Response Mode taxonomy are a useful measure of patients' and physicians' relationships.     

Therapists' emotional reactions to substance abusers: A new questionnaire and initial findings.

Developed and tested the Ratings of Emotional Attitudes to Clients by Treaters (REACT) scale. The REACT was administered to 52 therapists and 140 cocaine-dependent outpatients, at sessions 2, 5, and 24 of psychotherapy. It was found to have high internal consistency at each time point, moderately high convergent validity with therapists' (but not patients') therapeutic alliance ratings, and a factor structure that appeared to meaningfully derive 4 factors: "therapist in conflict with self," "therapist focused on own needs," "positive connection," and "therapist in conflict with the patient." Therapists' emotional responses were found to become more negative over the course of treatment, and, when compared by theoretical orientation, were found more positive for 12-step drug counselors than for cognitive or supportive-expressive therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interpersonal problems and the psychotherapy context: The construct validity of the Inventory of Interpersonal Problems.

This research investigated the construct validity of the Inventory of Interpersonal Problems (IIP; L. M. Horowitz, S. E. Rosenberg, B. A. Baer, G. Ure?o, & V. S. Villase?or, 1988) in the context of psychodynamic psychotherapy. The interpersonal circumplex was used to categorize patients reporting interpersonal distress into 1 of 4 problem quadrants: Friendly Dominant, Hostile Dominant, Hostile Submissive, and Friendly Submissive. At several points in treatment, therapists assessed their patients' personality disturbances, global functioning, and assets and liabilities for therapy. Patients described their in-session experiences using the Therapy Session Report (D. E. Orlinsky & K. I. Howard, 1975). The 4 problem types each had a coherent and distinctive set of correlates. Patients' interpersonal problems were articulated in therapists' perceptions and evaluations, and in the kinds of interpersonal and intrapsychic themes (wants, hopes, feelings, behaviors, etc.) that characterized patients' retrospective accounts of the therapy sessions. The results add to knowledge about the IIP, interpersonal problems, and the psychotherapy context. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding, prediction, and control as moderators of the relationships between perceived stress, satisfaction, and psychological well-being.

This study provides a preliminary test of a model proposed by Sutton and Kahn (1986). In the model, the ability to understand, predict, and control events in the work environment can reduce the potential adverse effects generally associated with certain work conditions. Using a sample of physicians, dentists, and nurses (N?=?206) from a large naval medical hospital, the present study examined the moderating effects of understandable, predictable, and controllable work situations on the relationship between perceived role stress, satisfaction, and psychological well-being. Understanding and control were found to have moderating effects on the relationship between perceived stress and satisfaction. Understanding, prediction, and control were found to have direct relationships with perceived stress, but only control had a significant direct relationship with satisfaction. None of these variables were found to have significant direct relationships with psychological well-being. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Client perception of treatment in crisis intervention and longer-term psychotherapies.

Investigated whether clients can perceive differences in the nature of the therapeutic relationship and in therapists' intervention techniques in 2 dynamically oriented treatment modalities. 40 patients (mean age 30.80 yrs) treated in crisis intervention and 40 patients (mean age 30.26 yrs) seen in longer-term psychotherapy were interviewed about their treatment experiences. Results indicate that, in these Ss (who had suffered from a generally equivalent degree of psychological disturbance), longer-term treatments were significantly more likely to promote patient change than were brief, crisis-intervention therapies. Client perception of the therapy relationship accounted for a significant amount of outcome variance. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Basic need satisfaction and identity formation: Bridging self-determination theory and process-oriented identity research.

The fulfillment of the basic psychological needs for autonomy, competence, and relatedness as postulated within self-determination theory was hypothesized to play an energizing role in identity formation, conceptualized as multiple dimensions of exploration and commitment. Two studies among high school and college students (N = 714) were conducted to investigate (a) the cross-sectional relationships between need satisfaction and the identity dimensions and (b) the direction of effects using cross-lagged analyses. Three competing longitudinal models were tested: a need satisfaction main-effects model, an identity main-effects model, and a reciprocal effects model. All 3 needs had meaningful relationships with the identity dimensions, and, although there was a predominance of paths from the needs to the identity dimensions, the reciprocal effects model received most support. Further, identity statuses (representing multivariate combinations of the identity dimensions) were meaningfully related to satisfaction of the 3 needs, with identity achievement scoring highest on all 3 indices of need satisfaction. Suggestions for future research and counseling implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological adjustment variables as predictors of mortality among nursing home residents

Mortality over a 4-year period was examined in relation to self-esteem, depression, life satisfaction, and meaning in life in a nonclinical sample of 129 intermediate-care nursing home residents. Survival was associated with the psychological adjustment variables, and the effect persisted after statistically controlling for age, sex, and physical health. Self-evaluations (self-esteem and depression) were stronger predictors of mortality than were general life evaluations (life satisfaction and meaning in life). Comparisons with previous studies suggest conditions under which psychological variables are likely to be associated with mortality.     

Therapist session intentions in cognitive–behavioral and psychodynamic–interpersonal psychotherapy.

Theories of psychotherapy are implemented by therapists' intentional actions within sessions. This study examined the structure and construct validity of the Therapist Session Intentions (TSI) form. Ten therapists rated their therapeutic intentions following each of 2,305 therapy sessions of cognitive–behavioral or psychodynamic–interpersonal therapy in the Second Sheffield Psychotherapy Project. Seven conceptually coherent clusters of intentions, or therapeutic foci, were identified: treatment context, session structure, affect, obstacles, encouraging change, behavior, and cognition-insight. Contrasting patterns of therapeutic focus across treatments and changes in focus across sessions within treatments appeared conceptually coherent. Correlations across a subsample of sessions confirmed correspondences of the TSI foci with dimensions found previously in observers' ratings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Direction of affective influence in psychotherapy.

Administered a structured response questionnaire to 45 patient-therapist pairs after each of a series of individual psychotherapy sessions in which feelings experienced by each during the session were reported. Causal analyses of nonexperimental data suggested that for relatively inexperienced therapists, the patients' positive feelings were a sufficient condition for the therapists' positive feelings. The reverse was the case for more experienced therapists. For negative feelings, however, therapists' feelings of uncertainty and apprehension were generally a sufficient condition for the patient to experience dysphoric affect. Extremely positive or negative affective experiences of either participant tended to preclude and be precluded by opposite experiences in the other. (17 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correlational tests of predictions from a process model of the interview.

We conducted a field study to test eight propositions derived from a process model of the selection interview (Dipboye, 1982; Dipboye & Macan, 1988). According to the model, interviewers' preinterview impressions of an applicant bias the subsequent conduct of the interview and processing of information in the direction of confirming these initial impressions. To test predictions from the model, we surveyed managers and the applicants they interviewed in each of 164 interviews. In support of the model, interviewers' preinterview evaluations were positively related to postinterview evaluations of applicant qualifications and process variables predicted to mediate this relation. Results also supported the model in that interviewers with favorable preinterview impressions were more likely to attribute good interview performances to the applicants' qualifications for the job and poor performances to external factors. Contrary to the model, confidence failed to moderate the above findings, and preinterview impressions were not predictive of applicant reports of interviewers' time spent in questioning. Some possible implications of the model for future research and for improving interview practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship between supervisors' and trainees' cognitive styles and the supervision process.

33 beginning counseling practicum students and their supervisors rated their supervisory relationship and satisfaction with supervision; supervisors also evaluated their trainees. Ss' cognitive styles were determined through the Myers-Briggs Type Indicator (MBTI). The Barrett-Lennard Relationship Inventory, Counselor Evaluation and Rating Scale, and individual Likert scales were used as measures of the independent variables. Trainees' scores on certain indices (most notably the Sensing–Intuition index) were related to supervisors' perceptions of the interpersonal nature of their relationship, supervisors' satisfaction with trainees' performances, and supervisors' evaluations of trainees. On the other hand, supervisors' cognitive styles were not related to the independent variables. Cognitive style similarity between supervisor and trainees on specific MBTI scales was related to mutual perceptions of their interpersonal relationships. (44 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clients', therapists', and judges' evaluations of psychotherapy.

Asked 41 patients and their 17 therapists to complete a questionnaire indicating problem areas and their severity before and after the 1st and last therapy session. 2 clinical psychologists served as independent judges rating the client questionnaires. The clients' evaluations were unrelated to their therapists' evaluations, but were highly related to the evaluations made by independent judges. Further analyses suggest that the disagreements between clients and therapists stemmed from the therapists' inaccuracy in perceiving the clients' problems and the therapists' tendency to overestimate the progress of therapy relative to clients and independent judges. The results and the broader issue of client-therapist disagreements are discussed in terms of the client as a "consumer." (l6 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Matchmaking in psychotherapy: Patient-therapist dimensions and their impact on outcome.

Patient–therapist matching was investigated using recent theoretical and methodological developments to overcome some of the limitations that have hindered similar past efforts. Two hypotheses were tested: (a) Therapeutic outcome is affected by the interaction between patients' and therapists' self-concepts, and (b) increasing anticomplementarity between therapist self-concept and therapists' perceptions of patients' behavior is negatively associated with patient improvement. Data from the first 2 cohorts of the Vanderbilt II Psychotherapy Project (H. H. Strupp et al; see record 1989-10009-001) were analyzed. They included the therapies of 16 experienced therapists, who saw a total of 48 patients (38 women and 10 men) in time-limited psychotherapy. Patients' ages ranged from 24 to 65 years (M age?=?40). Outcome was measured from the perspective of the patient, therapist, and evaluating clinician. Each hypothesis was supported, but not across all 3 outcome perspectives. (PsycINFO Database Record (c) 2010 APA, all rights reserved)