PSYCHOTHERAPY ENGAGERS VERSUS NON-ENGAGERS

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Summary. In summary, all three of the reviewed studies found differences in the usage of helping skills across thirds of intake sessions (Hill, 1978; Lonborg et al., 1991; Tryon, 2003). Information increased across thirds of intake sessions for all three studies. Closed questions decreased as the intake sessions progressed for two of the studies (Hill, 1978, Tryon, 2003); the third study (Lonborg et al., 1991) did not examine closed questions. In the study that examined helping skills in relation to engagement, client return for therapy after intake was related to a decrease in the number of closed questions from the therapist as the intake session progressed and an increase in the number of information-giving statements across thirds of the intake (Tryon, 2003). In addition, client return was related to therapist giving higher amounts of information and fewer minimal encouragers during the intake session (Tryon, 2003). Limitations of the existing research on helping skills used across thirds of intake sessions include: only a few studies have examined helping skills in thirds of intake sessions, all of the reviewed studies had small samples of clients and therapists, and thus far the studies have only been conducted in university counseling centers (except Lonborg et al., 1991, in which volunteer clients were used). Limitations of the literature also include that only one study thus far has examined helping skills in relation to dropout. Furthermore, this one study that does investigate therapist verbal behavior in intake sessions has its own limitations: the sample of therapists was very small since only one therapist (a 38 year-old Caucasian female clinical psychologist with 5 years of post-Ph.D therapy experience, who had a psychodynamic theoretical orientation) participated in the study, the client sample consisted of only 11 university student clients (seven undergraduates, four graduate students) at a large private eastern university, the setting of the study was a short-term 59
therapy service at the university (the results may not apply to long-term therapy settings), and the statistical methods may be confounded by differing levels of therapist verbal activity (i.e. some therapists talk more than others) since the analyses were based on raw numbers of the helping skills used rather than percentages. Adult Attachment Style: A Meta-Analysis In this section, I summarize a recent meta-analysis of adult pre-treatment attachment style and psychotherapy outcome conducted by Levy, Ellison, Scott, and Bernecker (2011). The definition of adult attachment categories used in Levy et al. was based on the two underlying dimensions of attachment organization: anxiety and avoidance. An anxiously attached adult tends to have fears of abandonment by important people in his/her life and tends to worry about his/her significant relationships (Brennan, Clark, & Shaver, 1998). An avoidantly attached adult tends to avoid closeness with important people in his/her life, and does not like to depend on others (Brennan et al., 1998). Levy et al.’s meta-analysis included 19 separate therapy samples from 14 studies, with a combined N of 1,467. This sample included clients with a variety of diagnoses and presenting problems, including but not limited to: major depression, borderline personality disorder, marital problems, and post-traumatic stress disorder. Clients were a variety of ages (the average client age in the 14 individual studies ranged from 24.6 to 44.98 years), and included both males and females (percentages of females in individual studies ranged from 0 to 100). Therapists in the meta-analysis had various theoretical orientations, including cognitive-behavioral, psychodynamic/interpersonal, eclectic, and integrative. Therapy treatment duration ranged from 6 to 52 weeks in individual studies 60
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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
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List of Figures Figure 1: Approval-
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therapists (Hill & Lent, 2006), tha
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third of the intake) and types of t
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“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 and 64: counselor’s emphasis from gatheri
Page 65 and 66: composed of volunteer undergraduate
Page 67: Table 3 Tryon (2003) Mean Number an
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
Page 117 and 118: 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
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Hampton-Robb, S., Qualls, R. C., &
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Hill, C. E. (2009). Helping skills:
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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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