PSYCHOTHERAPY ENGAGERS VERSUS NON-ENGAGERS

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helping skills used in intake sessions; those studies will be included in later sections. At the end of this section, I provide a summary paragraph of the findings and limitations in the literature. Hill, Thames, and Rardin (1979) compared three male therapists, Rogers, Perls, and Ellis, using the HCVRCS (Hill, 1978). There was just one female client, Gloria. Rogers, Perls, and Ellis each conducted separate demonstration first sessions with Gloria. Three judges (one male graduate student, one female graduate student, one female faculty member in counseling psychology) were trained until they reached 95% agreement on practice transcripts from another study. Rogers used mainly minimal encouragers, restatements, interpretations, reflections, and information. Perls employed mostly direct guidance, information, interpretations, open questions, minimal encouragers, closed questions, confrontations, approval-reassurance, and nonverbal referents. Ellis seemed to be the most active compared to the other counselors, using mostly information, direct guidance, minimal encouragers, interpretations, closed questions, and restatements. Relatively high inter-judge agreement levels were obtained (interrater kappas for all possible combinations of the three judges were .68, .71, and .73). The results provide evidence that the HCVRCS is able to distinguish behavioral differences in theoretical orientations between counselors. Limitations include the very small sample size – there was only one female client with her unique presenting concerns, so the results may not be applicable to other women (because she is only one woman out of millions of women in the United States), or to male clients, or to clients with other presenting concerns or other individual client differences. Since only one therapist from each theoretical orientation was represented, the results may not generalize across all therapists for a particular 33
theoretical orientation. Furthermore, since all the therapists were men, it is possible that the results would not be applicable for female therapists. Hill, Carter, and O’Farrell (1983) was the first study to use predominant coding with the HCVRCS/HSS. This study examined the process and outcome of a 12-session case of counseling. The client was a 20-year-old white female senior at a large university. The counselor was a 31-year-old PhD counseling psychologist with 5 years of postdoctoral experience in counseling. The HCVRCS (Hill, 1978, Hill et al., 1981) was used to analyze counselor response modes each of the 12 sessions. The Client Verbal Response Category System (Hill et al., 1981) was used to analyze client response modes in each of the 12 sessions. The client response mode measure includes nine nominal, mutually exclusive categories: simple responses, requests, description, experiencing, insight, discussion of plans, discussion of client-counselor relationship, silence, and other. The Client Verbal Response Category System has demonstrated adequate face and content validity, and high inter-rater agreement levels have been obtained in previous studies. Other process and outcome measures were also used but are not as relevant to the present study; they can be found in the original Hill et al. (1983) article. For the Hill et al. (1983) analyses, the regular unitizing method was used with the HCVRCS for comparing the first four sessions to the last eight sessions; predominant coding was used only for sequential analysis of the immediate effects of the counselor response modes on the client responses. Results indicated that counselors used more minimal encouragers in the first four sessions compared to the last eight sessions, and more information and interpretation in the final eight sessions compared the first four sessions (here, “more” means the difference exceeded one standard deviation). Minimal 34
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 and 38: quality of the technique (e.g., app
Page 39 and 40: therapist behaviors which may be be
Page 41: of the three judges. Based on an ex
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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