PSYCHOTHERAPY ENGAGERS VERSUS NON-ENGAGERS

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Sessions that were longer (Tryon, 1989a, 1989b, 1990), deeper (Tryon, 1990), and more satisfying to clients (Tryon, 1990) were more likely to result in clients returning for therapy rather than dropping out. Higher client-rated helping alliances also made early dropout less likely (Tryon & Kane, 1990). Several limitations can be noted in the existing research on early dropouts. The studies have all been conducted at university counseling center settings with university student samples, so the results may not apply to long-term therapy settings. In addition, few of the studies reported enough information to determine effect-sizes, so it is difficult to estimate how large of an effect the studies found. Furthermore, of the studies using intake-only dropouts, continuers were defined as those attending therapy beyond one session after the intake, which is a poor indicator of whether the continuers actually “bought” into the therapeutic treatment. Furthermore, few studies have investigated therapist verbal behavior in intake sessions, which is an important predictor variable given that therapists can only influence their clients through their verbal or nonverbal behaviors. Therapist Techniques Definition of therapist techniques. Therapist techniques are defined as tools or methods employed by therapists to facilitate effective therapy or positive behavior change in clients (Harper & Bruce-Sanford, 1981). Therapist techniques can be operationalized in various ways (e.g., Highlen & Hill, 1984; Schaffer, 1982): in terms of type or content, verbal versus nonverbal expression, intentionality, the manner in which the technique is implemented (e.g., level of warmth, empathy, and genuineness), and the 27
quality of the technique (e.g., appropriate timing, matching the needs of the client) (Hill, 2005). Hill (1982) proposed that one can analyze therapist behaviors at six levels, ranging from the most observable and easily rated to the more abstract and inferential categories. The six levels are: (a) ancillary behaviors (extralinguistic, linguistic, nonverbal, and physiological), (b) response modes (i.e., helping skills), (c) content (topic of discussion), (d) ratings of behavior (attituted, involvement), (e) covert behaviors (thoughts, perceptions, feelings, attitudes), and (f) clinical strategies (interventions, techniques). Overriding these six levels would be the philosophical or theoretical approach of the therapist (Hill, 1982). Thus, verbal response categories (or helping skills) are among the more observable and easily rated methods for analyzing therapist behaviors. There are two common ways of systematizing therapist techniques: molecular methods (examining therapist techniques on a phrase, sentence, or speaking-turn level) and molar or global methods (examining therapist techniques across larger segments or sessions) (Hill & Williams, 2000). The most typical molecular method for measure therapist techniques focuses on verbal response modes, which are types of therapist verbal responses independent of the topic or content of the speech (Hill, 1986). Examples of verbal response modes are: open questions, reflections of feeling, interpretation, and direct guidance (Hill & Williams, 2000). Elliot et al. (1987) compared six widely used response modes systems and found that six response modes (question, information, advisement, reflection, interpretation, and self-disclosure) were included in all six systems and could be reliably assessed. 28
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 and 32: F(1, 261) = 40.64, p < .001. Limita
Page 33 and 34: clinic in a medium-sized Midwestern
Page 35: Summary. In summary, there are seve
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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