The structure of intersession experience in psychotherapy and its relation to the therapeutic alliance

Abstract

During the days-long or week-long intervals between their therapy sessions, patients typically recollect, reflect on, practice, and imaginatively elaborate on experiences they had during sessions with their therapists. These "intersession experiences" (IE) have been studied for some time with the Intersession Experience Questionnaire (IEQ) in Germany and the United States. This study aims to compare the factor structure of the English and the German versions of the IEQ and to explore the relation of IE to the therapeutic alliance, as a key process variable usually associated with outcome. Factor analyses on a total of 7,550 IEQ reports from 769 patients in outpatient, day hospital, and inpatient treatment showed almost identical factor structures in both countries and across different therapy settings. Significant associations were found between certain IE factors and therapeutic alliance, varying in strength (0.27≤r(2) ≤0.66) by treatment duration and country. Theoretical, clinical and research implications of the findings are discussed.

The impact of technology on therapeutic alliance and engagement in psychotherapy: The therapist's perspective

“…Therapists noticed that through using goACT, the therapeutic work became more "present" in their patients' minds, which led to greater involvement in the therapy process. This finding is consistent with previous research which suggests that availability and frequency of interactive inter-session experiences (i.e., time spent recreating the therapeutic dialogue between sessions) is associated with enhanced treatment outcomes (e.g., Hartmann, Orlinsky, & Zeeck, 2011;Shingleton, Richards, & Thompson-Brenner, 2013). Furthermore, our findings provide support for previous reports suggesting that the "always on" nature of the technology facilitates increased access to the therapeutic service between sessions and allows for ecological momentary disclosures that may not otherwise be captured by the intermittent nature of face-to-face sessions (cf.…”

Psychotherapists Growing Older: A Study of Senior Practitioners

“…It is well known that therapists’ perceptions do not fully align with those of clients, supervisors, or independent raters. Yet some degree of correspondence between experiential and external observational perspectives does exist, as indicated in the following recent studies: Hartmann and colleagues (e.g., Hartmann, Joos, Orlinsky, & Zeeck, ; Hartmann, Orlinsky & Zeeck, ); Heinonen and colleagues (e.g., Heinonen, Lindfors, Härkänen, Virtala, Jääskeläinen, & Knekt, ; Heinonen, Lindfors, Laaksonen, & Knekt, ); and Nissen‐Lie and colleagues (e.g., Nissen‐Lie, Havik, Høglend, Monsen, & Rønnestad, ; Nissen‐Lie, Monsen, & Rønnestad, ; Nissen‐Lie, Monsen, Ulleberg, & Rønnestad, ).…”

The Intersession Process in Psychotherapy for Anorexia Nervosa: Characteristics and Relation to Outcome

“…Therapy‐related intersession process was assessed using the German version of the IEQ (Hartmann et al., , ; Orlinsky & Geller, ). The IEQ contains 52 items, which participants completed before each psychotherapy session.…”

“…Items of the first subscale (IEQ‐A) are rated on a 6‐point scale ranging from 0 ( never think about it ) to 5 ( an hour or more ), whereas items of all other subscales are rated on a 5‐point scale, ranging from 0 ( not at all ) to 4 ( very often ) in the German version of the instrument (Hartmann et al., ). The reliabilities of the factors (Hartmann et al., ) were deemed sufficient (all Cronbach's α > 0.7, except for IEQ‐B2, α = 0.53). Table lists descriptive statistics, Cronbach's α, and factor intercorrelations in this sample.…”

“…Orlinsky and Geller () described the following dimensions of the ISP, which can be measured by the Intersession Experience Questionnaire (IEQ; Orlinsky & Geller, ; Hartmann, Orlinsky, Geller, & Zeeck, ; Hartmann, Orlinsky, & Zeeck, ): (a) intensity of the ISP; (b) the context in which intersession experiences occur; (c) its content (comprising relationship fantasies, recreating the therapeutic dialogue, and applying therapeutic learning); and (d) its emotional tone.…”