Therapist verbal behavior in the multidimensional system for coding behaviors in therapeutic interaction (SiMCCIT)

Abstract

Therapeutic interaction has been considered one of the main factors of change in psychotherapy, and its investigation is called process research. Audio and video recording sessions are used to code behaviors which, subsequently, permit the analysis of interaction patterns. The objectives of the study were the presentation of part of a coding system called "Multidimensional System for Categorization of Behaviors in Therapeutic Interaction" and the evaluation of agreement between observers in its use. From a systematic assessment of the literature regarding the classification of vocal verbal behavior, it was found that the existing category systems were not satisfactory for the study of behavior analytic therapy, thus requiring the construction of a new system. A System for Coding Verbal Therapist Behavior was developed containing 16 categories, nine of vocal verbal behavior, three for non-vocal verbal behavior and four residual categories. A standardized training for observers was also developed. Its application to one participant produced satisfactory Kappa indexes of agreement ranging from 0.67 to 0.84. The implications of using the system for process research in behavior analytic therapy and in other therapeutic modalities in its different stages are discussed as well as the possibility of using the instrument and its training software for teaching therapeutic skills.Keywords: research on psychotherapy process, categorization of behaviors, client-therapist interaction, behavior-analytic therapy. Therapeutic interaction has been an object of study for researchers ranging from various theoretical approaches and fields of knowledge. Process research (Greenberg & Pinsof, 1986;Russel & Trull, 1986) aims at characterizing the interaction (verbal and non-verbal) between therapist and client in order to identify the processes of change which occur within this interaction. According to Luna (1997), the clinic is a favorable environment for the development of research. Within this setting we have access to data from verbal accounts which would rarely be gathered otherwise. In this research environment the researcher is able to keep track of the context in which such behavior occurs; furthermore, a researcher may have access to research participants who provide regular attendance for long periods of time, thus providing repeated observations of the phenomenon of interest.One of the most frequently employed methods for achieving this goal is the direct observation of audio and\or video recordings of sessions and the classification of this data into the categories of behavior. After the categorization of the observed behavior, a cross-relational analysis amongst these categories is conducted so as to identify the possible effects that different classes of behavior concerning one member of the dyad may have over the other (Russel & Trull, 1986;Wampold, 1986).Over the past decades, an expressive number of researchers have dedicated themselves to this kind of research (e.g., Almásy, 2004;Baptistussi, 2001;Barbosa,...

Functional Coding System for Verbal Interaction in Clinical Contexts

“…As we have seen, the coding systems currently used in clinical research are completely topographical. Although some advantages have already been addressed previously, it is important to notice that some authors consider that a functional observational system drawback the therapeutic interaction study (Johnston et al, 2008;Zamignani & Meyer, 2011). The problem is that using a functional coding involves a great degree of inference, which would end up interfering with the generalization of the data.…”

“…All of them can be coded simultaneously to form 16 coding categories (e.g., information request, facilitation, empathy, approval, information, etc.). Although this system shows and good to excellent interobserver agreement (Zamignani & Meyer, 2011), and has proved its utility among several years of research in the METAC team (Meyer & Oshiro, 2019), it is based on topographical descriptions, is not psychometric validated, and the only validity provided is the sequential analysis once the data is gathered from specific studies. Additionally, coding with these 16 response classes categories is highly time demanding, and the system has been used for analyzing FAP interventions.…”

El papel de las verbalizaciones en forma de regla: análisis topográfico del discurso del terapeuta

“…La mayoría de estas clasificaciones contienen categorías nominales que pueden ser útiles para identificar modos de respuesta del terapeuta independientes del tema del discurso (Hill, 1978) asociados al regreso del cliente para continuar el proceso (Tryon, 2003). También pueden ser útiles para evaluar tipos de intervenciones del terapeuta en un tipo particular de terapia (Connolly, Crits-Christoph, Shappell, Barber, & Luborsky, 1998); estudiar la interacción terapéutica desde una perspectiva topográfica teniendo en cuenta la relación con su contexto de ocurrencia y enseñar habilidades del terapeuta (Zamignani & Meyer, 2011), identificar cómo el terapeuta responde de manera contingente y apropiada a los problemas del cliente (Callaghan, Summers, & Weidman, 2003); analizar el proceso de cambio emocional (Gumz, Lucklum, Herrmann, Geyer, & Bräler, 2011); identificar modos de respuesta del terapeuta (Elliott et al, 1987;Stiles 1992) y patrones temporales que caractericen distintos enfoques (Stiles & Shapiro, 1995). Con el fin de realizar una clasificación analítico funcional de la conducta verbal del terapeuta, Froján y su grupo de investigación (Froján-Parga, Montaño-Fidalgo, Calero-Elvira, & Ruíz-Sancho, 2008;Froján-Parga, Ruiz-Sancho, & Calero-Elvira, 2014) desarrollaron un sistema de categorías basadas en las conducta básicas de Catania.…”