PSYCHOTHERAPY ENGAGERS VERSUS NON-ENGAGERS

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sessions were videotaped with client consent for participating in the research, and clients completed research measures prior to receiving therapy, after every session, and at post- therapy. The therapy was open-ended with no maximum number of sessions clients could attend (although there were limits on how long they could see a particular therapist, depending on therapist length of participation in the clinic). Video-recorded sessions were typically 45 to 60 minutes in length. Clients. Data from 16 clients were used in this study, with two engagers and two non-engagers for each of the four therapists. Eight were non-engagers (5 female, 3 male; ages ranged from 27 to 55, M = 34.8 years old, SD = 9.5 years; 3 Caucasian, 2 African American, 2 Hispanic, 1 Middle Eastern); eight of the 16 were engagers (3 female, 5 male; ages 22-46, M = 29.1 years old, SD = 8.9 years; 5 Caucasian, 2 Hispanic, 1 African American). Client presenting problems, as reported in screening and intake interviews, included anxiety/depression (n = 8), interpersonal relationship issues (n = 11), and career issues (n = 7); some clients had more than one presenting problem. None of the clients in the study were currently in psychotherapy elsewhere. None of the clients had current alcohol/drug abuse or psychosis. Any clients taking medication had been stabilized on psychotropic medication (i.e. taking it for over 2 months) prior to starting services at the MPCRL. Clients were not informed of the hypotheses of the study. Therapists. Four therapists (3 female, 1 male; ages 27 to 48, M = 34.8 years old, SD = 9.5 years, 2 Caucasian, 2 Asian) participated in the study. All four were counseling psychology doctoral students who had completed at least two years of practicum training. Judges. Five research assistants (four upper-level undergraduate research assistants, one graduate student; 2 male, 3 female; 3 Caucasian, 1 Middle Eastern, 1 73
Indian and Portuguese; aged 20-28, M = 22.8, SD = 3.2) and the primary investigator (graduate student, female, Asian American, age 24) served as judges for the Helping Skills System. Measures Client demographics. A computer-administered questionnaire asked clients about their age, sex, race/ethnicity, highest educational level obtained, current job, and whether they had ever consulted a mental health practitioner for any problem. Therapist demographics. A computer-administered questionnaire asked therapists about their age, sex, race/ethnicity, educational level, year in doctoral program, and number of years providing counseling. Judge demographics. A computer-administered questionnaire asked helping skills judges about age, sex, race/ethnicity, educational level, and year in school. The Helping Skills System. The Helping Skills System (HSS; Hill, 2009) is a revision of the Hill Counselor Verbal Response Category System (HCVRS; Hill, 1978; 1986). The HSS consists of 20 nominal, mutually exclusive categories of therapist verbal behavior: approval and reassurance, closed questions, open questions about thoughts, open questions about feelings, open question for insight, open question for action, restatements, reflection of feelings, challenge, interpretation, disclosure of feelings, disclosure of insight, disclosure of strategies, immediacy, information about the process of helping, information in the form of facts/data/opinions, information providing feedback to the client, process advisement, direct guidance, and other (Hill, 2009). For the present study, an additional category for disclosure was added since many of the therapists used disclosures for things such as the therapist’s name, level of training, or 74
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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
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ange on the OQ-45.2 when beginning
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Wierzbicki and Pekarik (1993) condu
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Enabling factors or barriers refer
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MI evaluation were statistically si
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later dropout (Barrett et al., 2008
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male) at a university counseling ce
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= 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 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: Chapter 4: Method The present study
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
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).
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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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