PSYCHOTHERAPY ENGAGERS VERSUS NON-ENGAGERS

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diagnosis and treatment, and make referrals. Willer also included two additional goals if there is time after covering the first seven goals: obtain an overview of current life problems the client is having, and gather social, medical, and mental health histories (includes information-gathering about psychological symptoms over time and past involvement in mental health care). According to Willer, the order of the tasks would ideally proceed according to the following: start the session, obtain informed consent/provide information about confidentiality and provide an opportunity for questions; establish rapport; determine the presenting problem; obtain an overview of client’s current life problems; diagnose any mental illnesses; assess for suicide and other crises; obtain social, medical, and mental health histories (including information about psychological symptoms over time and past mental health care); provide feedback to client about diagnoses and treatment; make referrals; and end the session. Based on Willer (2009), I can make several predictions about the helping skills patterns to be expected in intake sessions. Open questions and closed questions might especially be used early on when obtaining information about the client’s problems, symptoms, and histories. Information about the process of helping may be used early on when obtaining informed consent and providing information about confidentiality. Establishing rapport might occur throughout with self-disclosures of facts, (e.g., “I have 3 years of experience providing psychotherapy”), restatements, reflections, or interpretations. Information in the form of facts/data/opinions may be used toward the end to provide information about diagnoses, treatment, and referrals. Perhaps clients would be more likely to drop out if the therapist asks too many closed as compared with open questions; does not provide facts about him/herself that help to establish credibility; 45
does not provide restatements, reflections, or interpretations; and does not provide information relevant to the treatment of the client’s problems. Cavanagh and Levitov (2002) also discussed intake sessions. They located intake interviews as part of the information-gathering stage among six stages of counseling: Therapeutic Alliance (Stage 1), Information Gathering (Stage 2), Evaluation and Feedback (Stage 3), Counseling Agreement (Stage 4), Change(s) in Behavior (Stage 5), and Termination (Stage 6). They stated that an intake interview is one of the most common ways of obtaining information from clients, and that the intake process may take three sessions (gathering information, making diagnoses and formulating treatment recommendations). They noted that closed questions can be efficient and direct, but can limit the amount of information gathered: “the posing of specific questions illuminates some aspects of the client’s life but leaves others in darkness” (p. 27). In contrast, open questions that are non-directive allow more of the client’s values and priorities to surface, and allow clients to provide the information in the way that is most meaningful to them, rather than in a form structured by the counselor. Closed questions may be necessary to obtain specific, important pieces of information (for example, with a potentially suicidal client, asking whether a client has weapons in his/her home), whereas open questions may allow clients to explore their thoughts and feelings about their issues in more depth. Based on Cavanagh and Levitov (2002), I surmise that the basic tasks of the initial intake session might involve alliance-building (Stage 1), information gathering (Stage 2), as well as making diagnoses and formulating treatment recommendations. Alliance-building could involve restatements, reflections, self-disclosure of facts enhancing a counselor’s credibility, approval-reassurance, interpretations, information in 46
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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 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: corresponded to similar categories
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:
Estimated Likelihood (%) 60 50 40 3
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
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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
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Stiles, W. B. (1978). Verbal respon
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Willer, J. (2009). The beginning ps
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