PSYCHOTHERAPY ENGAGERS VERSUS NON-ENGAGERS

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Lonborg et al. (1991) examined counselor and client verbal response mode changes during initial counseling sessions. The study used the Classification System for Counseling Responses (CSCR; Highlen, Lonborg, Hampl, & Lassiter, 1982), a counselor response mode system very similar to the HCVRCS. For data analyses, the original 18 categories of the CSCR were collapsed into 9 categories: minimal responses, requests, approval/reassurance, information, instruction, restatement, empathy, interpretation, and confrontation. Clients were 13 volunteer undergraduate students enrolled in psychology courses (6 male, 7 female), who were offered extra credit for their participation. Counselors were 8 first year master’s degree students (4 female, 4 male) enrolled in an introductory practicum course. There were three judges (1 male, 2 female; two graduate students in counseling psychology and one PhD counseling psychologist) for the CSCR. Altogether, there were 13 cases of 50-minute initial sessions analyzed. Each session was divided into thirds, and 8-minute segments were analyzed from the middle of each third. The average kappa coefficient for inter-judge agreement on the counselor response modes categories was .81. As shown in Table 2, the numbers of minimal responses, information, and confrontation increased significantly across thirds of the initial sessions. A limitation of the study is that only the middle 8 minutes of each third was analyzed, which means that 26 minutes of the 50 minute session were not analyzed – so no overall percentages of the verbal response modes for the initial sessions could be reported. Another limitation is the use of a therapist sample of beginning counselor trainees who may or may not have had prior experience receiving or providing counseling (the article did not indicate experience level of the counselors). Thus, the results may not necessarily apply with more experienced counselors. A further limitation is the client sample being 55
composed of volunteer undergraduate clients who were offered extra credit for their participation – this sample is unlikely to be representative of clients who seek therapy in real-life counseling agencies. Table 2 Lonborg et al. (1991) Means Numbers and Standard Deviations of Helping Skills Helping Skill 1 st third M (SD) Part of Intake Session 2 nd third M (SD) 56 3 rd third M (SD) F changes across 3 rds Approval-Reassurance 0.09 (0.23) 0.16 (.032) 0.25 (0.69) 0.19 .83 Closed Question not in Lonborg et al. (1991) measure Open Question not in Lonborg et al. (1991) measure Restatement 0.52 (0.82) 0.57 (0.89) 1.01 (1.26) 1.08 .36 Reflection (Empathy) 3.41 (1.91) 5.77 (2.43) 5.19 (3.97) 3.05 .07 Challenge (Confrontation) 0.00 (0.00) 0.31 (0.62) 0.92 (1.23) 4.19* .03 Interpretation 2.44 (2.25) 3.88 (3.52) 4.62 (4.42) 1.89 .17 Self-Disclosure not in Lonborg et al. (1991) measure Immediacy not in Lonborg et al. (1991) measure Information 1.56 (1.81) 3.55 (3.27) 6.35 (6.38) 6.32** .01 Direct Guidance Requests 3.48 (2.30) 3.96 (2.86) 5.82 (5.40) 1.23 .31 Instruction 0.05 (0.19) 0.77 (1.40) 0.67 (1.63) 2.41 .11 Other not in Lonborg et al. (1991) measure Minimal encourager Minimal responses 12.63 (6.09) 14.13 (7.32) 18.71 (7.34) 16.67*** < .001 Note. Italics represent the name of the category used by Lonborg et al. (1991). For all F analyses df = 2, 24 *p < .05. **p < .01. ***p < .001 Tryon (2003) investigated what helping skills therapists used during the intake for engagers versus non-engagers. The helping skills that Tryon (2003) looked at were from an older version of the Hill (2009) Helping Skills System: the Hill Therapist Verbal Response Category System (HCVRCS; Hill, 1993). The HCVRCS (Hill, 1993) contained 12 helping skills: minimal encouragers, silence, approval, information, direct guidance, closed questions, open questions, paraphrases, interpretations, confrontations, self disclosures, and other. Participants were 1 female psychologist as the therapist and 11 clients (8 female, 3 male; 7 undergraduates, 4 graduate students; 4 were intake-only p
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ABSTRACT Title of Document: PSYCHOT
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PSYCHOTHERAPY ENGAGERS VERSUS NON-E
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Table of Contents List of Tables ..
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Last Third of the Intake: Helping S
Page 9 and 10:
List of Figures Figure 1: Approval-
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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 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: counselor’s emphasis from gatheri
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 107 and 108: Research Question 10: Do proportion
Page 113 and 114: Client Avoidant Attachment Scale Av
Page 115 and 116:
Client Outcome Expectations How con
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minimal encouragers since the 2009
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In contrast, information about the
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duration. This null finding diverge
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Limitations Although the present st
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for need for therapy and “How con
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Appendix A: Preliminary Tests of Th
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Barrett, M., Chua, W., Crits-Christ
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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).
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Ligiero, D. P., & Gelso, C. J. (200
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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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PSYCHOTHERAPY ENGAGERS VERSUS NON-ENGAGERS

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