PSYCHOTHERAPY ENGAGERS VERSUS NON-ENGAGERS

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similarities to the client—we titled this category disclosure-miscellaneous. Thus, the present study utilized a 21-category version of the HSS. The original HSS was developed by combining categories from 11 existing response modes systems and having professional therapists of differing theoretical orientations match examples to the definitions (Hill, 1978). Concurrent validity for previous versions of the HSS was established with similar categories on other response mode systems (Elliot et al., 1987). When categories in six different rating systems were compared at the same level of specificity, moderate to strong convergence was found for the six modes that were included in all six systems: question, information, advisement, reflection, interpretation, and self-disclosure (Elliot et al., 1987). Average kappas between pairs of judges with the HCVRCS/HSS have ranged from .71 (Hill et al., 1979) to .91 (Hess et al., 2006). For the present study, average kappa between pairs of judges using the 21-category HSS was .75, ranging from .61 to .84 for individual cases. Since the present study used consensus to determine the final HSS coding for each case, the inter-rater kappas were calculated on the independent codings that were done prior to the consensus discussions. Client attachment style. The Experiences in Close Relationships Scale (ECR; Brennan et al., 1998) is a 36-item self-report measure assessing adult romantic attachment style. The ECR uses a 7-point Likert scale (1 = disagree strongly, 7 = agree strongly) and is currently the most widely used paper-and-pencil measure of adult attachment style. The Avoidance subscale measures an individual’s level of discomfort with emotional closeness, openness, and interdependence in romantic relationships. The Anxiety subscale measures the extent to which a person fears being rejected, neglected, 75
or abandoned by romantic partners. Both subscales have had high internal consistency estimates (.90 to .94 for Avoidance, .88 to .91 for Anxiety; Brennan et al., 1998; Mohr, Gelso, & Hill, 2005) and high 6-month test-retest reliabilities (.68 for anxiety and .71 for avoidance; Lopez & Gormley, 2002). In the present sample N = 15 because one engager was missing ECR data. High internal consistency was found in the present sample for Avoidance (α = .93) and Anxiety (α = .92). Intake session duration. Intake session duration was determined by recording the total length of each DVD recording for each of the 16 cases. Client pre-therapy need for therapy. Prior to scheduling their intake session, clients were verbally asked screening questions by clinic staff to determine their appropriateness for the clinic. One of the screening questions assessed client pre-therapy need for therapy, “How much do you need to be in psychotherapy now?” and clients responded verbally on a scale of 1 (not at all) to 5 (it’s essential). Client pre-therapy outcome expectations. Another question asked at the time of screening was, “How confident are you that you can eventually overcome your problems and have a satisfying life?” and clients verbally responded on a scale of 1 (not at all) to 5 (extremely confident). Procedures Client recruitment. Clients were recruited from the community for the research clinic through advertisements in local newspapers, flyers on campus and in the local community, referrals from professionals in the local area, word of mouth, and the clinic’s website. Clients were screened to determine if they met the eligibility criteria. If so, they were scheduled for an intake session with one of the therapists. If not, they were given a 76
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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
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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 and 82: Chapter 4: Method The present study
Page 83: Indian and Portuguese; aged 20-28,
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).
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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PSYCHOTHERAPY ENGAGERS VERSUS NON-ENGAGERS

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