Multilevel Exploratory Factor Analysis of the Feeling Word Checklist–24

Abstract

Emotional reactions are a vital part of the therapeutic relationship. The Feeling Word Checklist-24 (FWC-24) is an instrument asking the clinician (or the patient) to report to what degree he or she has experienced various feelings during a therapeutic interaction. The aim of this study was to assess the factor structure of the clinician-rated FWC-24 when taking dependencies in the data into account. The sample was deliberately heterogeneous and consisted of 4,443 ratings made by 101 psychotherapists working with different psychotherapy methods in relation to 191 patients of different ages, genders, and with different primary diagnoses. A random intercept-only model revealed large intraclass correlation coefficients at the therapist level, indicating that a multilevel analysis was warranted. A two-level exploratory factor analysis with therapists as the between level and patients plus sessions as the within level was conducted. The items from FWC-24 were found to be best represented by four factors on the between level and four factors on the within level. The factor structures were largely similar on the two levels and were labeled Engaged, Inadequate, Relaxed, and Moved. The different factors explained different amounts of variance on different levels, indicating that some factors are more therapist dependent and some more patient dependent.

Countertransference feelings and personality disorders: A psychometric evaluation of a brief version of the Feeling Word Checklist (FWC-12)

“…The mean scores range from 0.47 (Inadequate) to 1.12 (Idealised) to 2.74 (Confident).. The scores are in a similar range to that seen in many other FWC studies-that is, quite low scores are consistently reported (9,14,17,18). However, the patients in the present study are mainly poorly functioning PD patients, and one might have expected stronger feelings to be reported.…”

“…Generally, all studies have found at least one factor reflecting positive feelings and at least one reflecting negative feelings (9). One goal in the CT research is to find many of the same feeling factors, as this may support that important aspects of CT have been captured.…”

“…The statistical methods used to evaluate them have also varied; while most studies have used principal component analyses, some have used factor analyses (9). Furthermore, the studies conducted have involved therapists of diverse professions, different patient populations and large heterogeneous groups.…”

“…The first studies using FWC were performed in inpatient departments. More recent studies have examined the factor structure when FWC is applied in individual therapy (9,(17)(18)(19). There is still no consensus about which FWC version best captures the CT phenomenon.…”

“…A main challenge in the development of systematic research has been the lack of a common definition of CT. Additionally, CT is partly an unconscious phenomenon and is therefore difficult to assess. Nevertheless, the existing empirical research shows that CT can be measured in ways that capture much of the complexity of what the therapist is experiencing (5,8,9).…”