PSYCHOTHERAPY ENGAGERS VERSUS NON-ENGAGERS

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Tryon and Kane (1990) examined the relationship between strength of the helping alliance and type of client termination at a university counseling center. Counselors were 5 PhD psychologists (1 male, 4 female) with 9 to 19 years of counseling experience and 10 practicum trainees (7 women, 3 men). Clients were 102 college students (74 female, 28 male). All clients and therapists completed helping alliance measures during the same week during the semester, regardless of how many sessions had progressed in the therapy. The measures were completed after an average of eight sessions. Clients completed an average of 19 sessions. Clients completed the Penn Helping Alliance Questionnaire (HAQ; Alexander & Luborsky, 1986). Counselors completed the Penn Therapist Facilitating Behaviours Questionnaire (TFB; Alexander & Luborsky, 1986). Clients who terminated with mutual agreement of their counselors gave significantly higher alliance ratings than did clients who terminated unilaterally and prematurely, F(4, 70) = 3.03, p < .03. Notably, counselor ratings of helping alliance were only modestly related to client ratings of alliance, r(87 df) = .46, p < .01, and were not significantly related to the type of client termination. The results indicated that the clients' ratings were predictive of premature terminations, F(1, 73) = 9.4, p < .003, but counselors' ratings were not. Limitations of the study include the non-standard timing for the completion of the helping alliance measures (e.g., some clients may have completed it after the first session whereas other clients may have completed it after 15 sessions), the results may not apply to non-college student clients, the small sample of therapists, and that no effect- size information was reported. Pekarik (1992) investigated the post-treatment adjustment of early dropouts versus late dropouts. Clients were 94 outpatients (47 adults, 47 children) at a public 23
clinic in a medium-sized Midwestern city. Thirteen therapists (mostly master’s level) treated the clients. Eight of the thirteen therapists had 4 or more years of experience; the experience level was not reported for the other five therapists. Five therapists had a humanistic orientation and five had a family systems orientation; the other two therapist’s orientations were not reported. Adult measures of post-treatment adjustment were: the BSI, a client rating of overall improvement, and a therapist rating of overall improvement. Clients completed the BSI at intake; all the measures of adjustment were completed at a 4-month follow up. In the following report of the results, I only include the results for adults (not the children), since the present study will sample only adults. Results for the BSI indicated that significantly more late dropouts (3 or more visits) were better (his or her score improved from intake to follow up by at least half of his or her gender’s intake standard deviation), in comparison to early dropouts (one or two visits), χ 2 (1, n = 33) = 3.13, p < .05. Results for the BSI scores also indicated that a higher percentage of early drop-outs were worse (by at least half of his or her gender’s intake standard deviation) compared to late dropouts at follow-up, χ 2 (1, n = 33) = 7.59, p < .01. Results for the therapist ratings of overall improvement found that early dropouts had significantly lower ratings than late dropouts, t(26) = 2.02, p < .025. Results for the adult clients on client ratings of overall improvement comparing the early dropout, late dropout, and completer groups was not significant, [F(2, 39) = 1.78, p = .18]. Limitations of the study include the limited sample size of clients and limited therapist sample (need to sample therapists with other levels of experience and theoretical orientations). Another limitation was that better statistical methods could have been used for the BSI analyses. The chi-square analyses did not provide information about whether 24
Page 1 and 2: ABSTRACT Title of Document: PSYCHOT
Page 3 and 4: PSYCHOTHERAPY ENGAGERS VERSUS NON-E
Page 5 and 6: Table of Contents List of Tables ..
Page 7 and 8: Last Third of the Intake: Helping S
Page 9 and 10: List of Figures Figure 1: Approval-
Page 11 and 12: therapists (Hill & Lent, 2006), tha
Page 13 and 14: third of the intake) and types of t
Page 15 and 16: “completed treatment” - from a
Page 17 and 18: ange on the OQ-45.2 when beginning
Page 19 and 20: Wierzbicki and Pekarik (1993) condu
Page 21 and 22: Enabling factors or barriers refer
Page 23 and 24: MI evaluation were statistically si
Page 25 and 26: later dropout (Barrett et al., 2008
Page 27 and 28: male) at a university counseling ce
Page 29 and 30: = 12.3, p < .001, and lower rates o
Page 31: F(1, 261) = 40.64, p < .001. Limita
Page 35 and 36: Summary. In summary, there are seve
Page 37 and 38: quality of the technique (e.g., app
Page 39 and 40: therapist behaviors which may be be
Page 41 and 42: of the three judges. Based on an ex
Page 43 and 44: theoretical orientation. Furthermor
Page 45 and 46: occur after closed questions, and I
Page 47 and 48: Elliott’s (1985) system used in t
Page 49 and 50: 8 women who were interviewed to det
Page 51 and 52: lasted 20 minutes for each type, tr
Page 53 and 54: corresponded to similar categories
Page 55 and 56: does not provide restatements, refl
Page 57 and 58: presenting concerns, psychosocial h
Page 59 and 60: counselors was reported. Minimal fa
Page 61 and 62: (1991); and Tryon (2003). At the en
Page 63 and 64: counselor’s emphasis from gatheri
Page 65 and 66: composed of volunteer undergraduate
Page 67 and 68: Table 3 Tryon (2003) Mean Number an
Page 69 and 70: therapy service at the university (
Page 71 and 72: treatment outcome (which means the
Page 73 and 74: Chapter 3: Statement of the Problem
Page 75 and 76: engagement, and f) a definition of
Page 77 and 78: the intake session, and about 4% wi
Page 79 and 80: Research Question 9: Do proportions
Page 81 and 82: Chapter 4: Method The present study
Page 83 and 84:
Indian and Portuguese; aged 20-28,
Page 85 and 86:
or abandoned by romantic partners.
Page 87 and 88:
Intake sessions. When clients arriv
Page 89 and 90:
unitizer had a unit in a meaningful
Page 91 and 92:
Table 4 Proportions of Helping Skil
Page 93 and 94:
Table 6 Proportions of Helping Skil
Page 95 and 96:
to the last third of the session, a
Page 97 and 98:
second to last third, F(1, 3858) =
Page 99 and 100:
Estimated Likelihood (%) 12 10 8 6
Page 101 and 102:
significant, F(1, 3856) = 3.95, p =
Page 103 and 104:
Research Question 7: Do proportions
Page 105 and 106:
Page 107 and 108:
Research Question 10: Do proportion
Page 109 and 110:
Page 111 and 112:
Page 113 and 114:
Client Avoidant Attachment Scale Av
Page 115 and 116:
Client Outcome Expectations How con
Page 117 and 118:
minimal encouragers since the 2009
Page 119 and 120:
In contrast, information about the
Page 121 and 122:
duration. This null finding diverge
Page 123 and 124:
Limitations Although the present st
Page 125 and 126:
for need for therapy and “How con
Page 127 and 128:
Appendix A: Preliminary Tests of Th
Page 129 and 130:
Barrett, M., Chua, W., Crits-Christ
Page 131 and 132:
Dodd, J. (1970). A retrospective an
Page 133 and 134:
Hampton-Robb, S., Qualls, R. C., &
Page 135 and 136:
Hill, C. E. (2009). Helping skills:
Page 137 and 138:
Johansson, H., & Eklund, M. (2005).
Page 139 and 140:
Ligiero, D. P., & Gelso, C. J. (200
Page 141 and 142:
Pekarik, G. (1983). Follow-up adjus
Page 143 and 144:
Stiles, W. B. (1978). Verbal respon
Page 145:
Willer, J. (2009). The beginning ps
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PSYCHOTHERAPY ENGAGERS VERSUS NON-ENGAGERS

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