PSYCHOTHERAPY ENGAGERS VERSUS NON-ENGAGERS

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Molar or global methods, on the other hand, assess therapist techniques through global ratings after watching entire counseling sessions, or larger segments of sessions. Examples of molar methods include measures that estimate how frequently techniques were used in entire sessions (e.g., The Therapeutic Procedures Inventory-Revised; TPI-R; McNeilly & Howard, 1991), and rankings of how much each technique is used relative to other techniques (e.g., Q-Set; Jones, Cumming, & Horowitz, 1988). Heaton, Hill, and Edwards (1995) compared the molecular (HCVRCS; Hill, 1993) and molar (TPI-R and Q-Set) approaches and found that the directive, paraphrase, and interpretation clusters of items on the two molar measures (Q-Set and TPI-R) were significantly related to each other, but neither were related to the corresponding HCVRCS categories, which suggests that the molar and molecular methods assess different things. Molecular methods allow for greater specificity than molar measures and allow researchers to study the immediate effects of interventions, while molar methods allow for the assessment of variables that occur across longer periods of time (Hill & Williams, 2000). Molecular methods of teaching therapist techniques may be beneficial for doctoral training programs in therapy. Indeed, Hill, Stahl, and Roffman (2007) point out the usefulness of teaching therapist techniques at a micro level since it allows students to learn or improve their abilities in a helpful manner while decreasing problematic or unhelpful behaviors (e.g., interrupting, excessive talking, promiscuous self-disclosure, and advice-giving). Thus, there are both advantages and limitations when using the Helping Skills System (HSS; Hill, 2009). Advantages include that it allows for greater specificity than more global methods of analyzing therapist techniques, it allows for micro-analysis of 29
therapist behaviors which may be beneficial for the training of therapists, and since it is an observer-rated measure, the ratings may be more objective. However, the HSS does have limitations as well. Since it only measures verbal response modes, it does not provide information about therapist non-verbal behavior, the topic of what is being talked about during therapy sessions, or covert processes (attitudes, intentions, etc.). In addition, since the HSS is an observer-rated measure, it does not provide information from the perspective of the therapist or the client. History and development of the HCVRCS/HSS. The HSS was originally developed in 1978 as the Counselor Verbal Response Category System (Hill, 1978). The system was developed to classify the different types of therapist verbal responses during a counseling session. The categories are intersubjective, meaning that they are based on the syntactic or grammatical structure of the language, which implies a relationship between the communication and the recipient (e.g., a question), rather than based on the topic of discussion or the extralinguistic characteristics (e.g., vocal noises, tonal qualities, speech disfluencies) of therapist verbal communications (Hill, 1986). The original HCVRCS (Hill, 1978) was developed by incorporating components from 11 existing systems in six stages. In the first stage, two people examined similarities and differences between the categories in the 11 systems and found that all the categories in the 11 systems could be covered by 25 distinct categories (e.g., reassurance, persuasion). Definitions were written for each category, and several examples from the 11 systems were included in the description of each category. In the second stage, two judges used the 25-category system to categorize counselor responses on two practice sessions and deleted two categories and added one category (deleted 30
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 and 36: Summary. In summary, there are seve
Page 37: quality of the technique (e.g., app
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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