Structural analysis of social behavior: Application to a study of interpersonal process in differential psychotherapeutic outcome.

Abstract

Research strategies employing Structural Analysis of Social Behavior (SASB) were demonstrated in a study comparing 4 therapists, each of whom saw a good and a poor outcome case (N = 8), on interpersonal process variables in the third session. SASB represents complex interactive processes in a manner that is both theoretically cogent and empirically sound. Good versus poor therapeutic outcome was differentiated on the basis of the following interpersonal process variables: greater levels of "helping and protecting" and "affirming and understanding*' and significantly lower levels of "blaming and belittling" were associated with high-change cases. Patient behaviors of "disclosing and expressing" were significantly more frequent in high-change cases, whereas "walling off and avoiding" and "trusting and relying" were significantly more frequent in low-change cases. Additionally, negative complementarity was greater in poor outcome cases. Implications for research methodology and interpersonal theory are discussed.

Patient and therapist introject, interpersonal process, and differential psychotherapy outcome.

“…Henry, Schacht, & Strupp (1986) demonstrated a precise method for operational!zing the therapeutic relationship that allowed the therapist's relationship contribution to be seen as a specific technique in itself. Moment-by-moment transactions between therapist and patient were measured with Structural Analysis of Social Behavior (SASB; Benjamin, 1974Benjamin, ,1982Benjamin, ,1984 and compared across good versus poor outcome cases seen by the same therapists.…”

The therapeutic relationship in cognitive-behavioral therapy: Patient perceptions and therapist responses

“…We agree with Bordin and others (Butler & Strupp, 1986;Connor-Greene, 1993;Goldfried et al, 1990;Henry et al, 1986;Safran, 1990) that the therapeutic alliance is a complex phenomenon that influences and is influenced by treatment tasks, goals, and content. Thus, our efforts to fully engage patients in effective treatment relationships can be facilitated by recognizing and responding to the broad context of factors that can influence the therapeutic bond.…”

“…Negative complementarity is a hostile and controlling exchange, while positive complementarity is a friendly, autonomy enhancing exchange (Henry et al, 1986). Positive complementarity has been associated with a higher degree of desirable patient changes than negative complementarity, or mixed communications (Henry et al, 1986;Svartberg & Stiles, 1992). In the case of mixed communication, these authors suggest that therapists should attempt to respond in complementary fashion only to the positive portion of the patient's message.…”

“…Thus, technical and relationship factors are interdependent parts within a single process in psychotherapy . In a similar vein, other investigators (Butler & Strupp, 1986;Henry, Schacht, & Strupp, 1986;Safran, 1990) have argued that interpersonal interaction is the context in which techniques gain meaning and effectiveness. Behaviorists have traditionally emphasized the use of specific technology rather than interpersonal sensitivity to influence patients.…”

“…A complementary fit occurs when there is reciprocity on control (dominance from one is followed by submission from the other and vice versa), and correspondence on affiliation (friendliness followed by friendliness, and hostility followed by hostility). Negative complementarity is a hostile and controlling exchange, while positive complementarity is a friendly, autonomy enhancing exchange (Henry et al, 1986). Positive complementarity has been associated with a higher degree of desirable patient changes than negative complementarity, or mixed communications (Henry et al, 1986;Svartberg & Stiles, 1992).…”