Using interpersonal process recall to compare patients’ accounts of resistance in two psychotherapies for generalized anxiety disorder

Morrison, Nicholas R.; Constantino, Michael J.; Westra, Henny A.; Kertes, Angela; Goodwin, Brien J.; Antony, Martin M.

doi:10.1002/jclp.22527

Cited by 10 publications

(12 citation statements)

References 14 publications

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“…With respect to related therapist actions, clients have indicated that they benefit when therapists listen, affirm, validate, empathize, reassure, demonstrate positive regard, and convey acceptance. Additionally, clients have expressed that therapists collaborating with them on the goals and tasks of therapy and granting them autonomy over the treatment's direction is helpful (e.g., Levitt et al, 2016;Morrison et al, 2017). These findings corroborate the robust quantitative literature that links similar researcher-or therapist-constructed factors, including the higher quality alliance (Flückiger et al, 2018) and goal consensus or collaboration (Tryon et al, 2018) with adaptive treatment outcomes.…”

Section: Helpful Eventsmentioning

confidence: 65%

Clients’ own perspectives on psychotherapy outcomes and their mechanisms.

Constantino¹,

Gaines²,

Coyne³

2022

The Other Side of Psychotherapy: Understanding Clients’ Experiences and Contributions in Treatment.

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H aving read, lauded, and concurred with Fuertes and Williams's (2017) call for more client-focused psychotherapy research, we eagerly agreed to contribute this chapter on clients' own views of psychosocial treatment outcomes and their mechanisms. That said, we also appreciated the inherent challenge in identifying this chapter's unique and complementary scope within the overall volume. In its broadest sense, client-focused psychotherapy research could conceivably cover any outcome construct or variable that pertains to the client (whether defined by researchers, therapists, or clients), with data collected in any number of ways. After having recently contributed a comprehensive review of the research on the client, therapist, and relational factors to Bergin and Garfield's Handbook of Psychotherapy and Behavior Change (seventh ed.; Constantino, Boswell, & Coyne, 2021), we were acutely aware of how vast and unwieldy a review of "all things client related" could get! However, to us, truly client-focused outcome research requires more than an examination of any inherently client-related factors that change or predict change. Rather, such research needs to explicitly draw out and privilege the client's voice or narrative to understand these primary outcome-related elements. To draw on McLeod et al.'s (2009) rubric of stakeholder positions, such focus reflects user-constructed outcomes and their mechanisms, as opposed to researcher-or therapist-constructed outcomes and mechanisms. Accordingly, we discuss herein research that has, in both content and method, directly asked adult clients (this age criterion is consistent with the volume's overall

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Section: Helpful Eventsmentioning

confidence: 65%

Clients’ own perspectives on psychotherapy outcomes and their mechanisms.

Constantino¹,

Gaines²,

Coyne³

2022

The Other Side of Psychotherapy: Understanding Clients’ Experiences and Contributions in Treatment.

Self Cite

View full text Add to dashboard Cite

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“…Data were extracted and analysed using a combination of grounded theory analysis (GTA; Glaser, 1978;Glaser & Strauss, 1967) and consensual qualitative research methods (CQR; Hill, 2012), a hybrid approach used in other qualitative studies of psychotherapy constructs (e.g. Morrison et al, 2017;Westra et al, 2010). As was done in these studies, this blended method allowed us to take advantage of the open coding of grounded theory, while using CQR methods to obtain multiple perspectives on the data.…”

Section: Discussionmentioning

confidence: 99%

Determinants of psychotherapy outcome expectations: Qualitative accounts from socially anxious college students

Morrison

Constantino

Santorelli

et al. 2021

Couns and Psychother Res

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Aim: Patients' prognostic psychotherapy outcome expectations are robustly associated with post-treatment outcomes. However, little is known about the determinants of such expectancies, especially in college students whose beliefs have yet to be influenced by prior therapy experiences. Understanding factors that relate to such truly 'baseline' predictive beliefs can have implications for addressing undergraduate students' willingness to begin a course of, engage in, and benefit from mental health treatment, beyond simply having had prior positive or negative experiences. In this qualitative study, we examined socially anxious college students' first-hand accounts of the primary determinants of their baseline treatment outcome expectations. Methods:Semi-structured interviews focused on participants' personal, cultural and contextual outcome expectancy determinants were they to begin a course of psychotherapy in the future. Data were analysed according to grounded theory and consensual qualitative research principles.Results: Categories including coursework, media and the experiences of important others were considered positive expectancy determinants in some cases and negative expectancy determinants in others, depending on whether the related depictions in class, on the screen, or in discussions were positively or negatively valenced.Although there was balance among most of these predictors, coursework was more commonly considered a positive versus negative expectancy determinant. More unique negative expectancy determinants were based on incorrect information regarding mental health and/or psychotherapy or stigma surrounding mental illness.Discussion: Findings contribute to the currently scant literature on determinants of college students' baseline treatment beliefs.

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“…Research suggests that ambivalence levels are higher at the beginning of therapy and in most of the cases are essential to initiate the process of change (Button et al, 2014; Miller & Rollnick, 2002; Morrison et al, 2017; Oliveira et al, 2021). However, a decrease in ambivalence has been observed in recovered clients, while unchanged clients tended to experience the same levels of ambivalence throughout treatment (Braga et al, 2019; Braga, Ribeiro, et al, 2018).…”

Section: Ambivalence In Psychotherapy: a Predictor Of Premature Termi...mentioning

confidence: 99%

Premature termination of the unified protocol for the transdiagnostic treatment of emotional disorders: The role of ambivalence towards change

Oliveira

Sousa

Ribeiro

et al. 2021

Clin Psychology and Psychoth

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Ambivalence towards change is an expected, recurrent process in psychological change. However, the prolonged experience of ambivalence in psychotherapy contributes to client disengagement, which could result in treatment dropout. Considering the negative effects of premature termination of therapy and the convenience of the identification of clients who are at risk of dropping out before achieving good‐outcome, the current study explored the predictive power of ambivalence for premature therapy termination using a multilevel time‐backwards model (i.e., considering the session of the dropout as session zero and then modelling what occurred from the dropout until session 1). Participants included a total of 96 psychotherapy clients (38 dropouts) treated in a university‐based clinic following the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. Multilevel modelling using a time‐backwards model to analyse dropout data provided evidence of the predictive power of ambivalence evolution throughout treatment on the decision to prematurely discontinue treatment (p < .0001; R2adj = .29). Specifically, good‐outcome dropouts presented a decreasing ambivalence trend throughout treatment, whereas poor‐outcome dropouts tended to experience the same levels of ambivalence before deciding to drop out (time × dropout; β11 = .64, p = .014). Additionally, poor‐outcome dropouts presented higher levels of ambivalence (β01 = 9.92, p < .0001) in the last session. The results suggest that the pattern of client ambivalence towards change is a predictor of premature termination of therapy. Implications for clinical and research contexts are discussed.

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Using interpersonal process recall to compare patients’ accounts of resistance in two psychotherapies for generalized anxiety disorder

Cited by 10 publications

References 14 publications

Clients’ own perspectives on psychotherapy outcomes and their mechanisms.

Clients’ own perspectives on psychotherapy outcomes and their mechanisms.

Determinants of psychotherapy outcome expectations: Qualitative accounts from socially anxious college students

Premature termination of the unified protocol for the transdiagnostic treatment of emotional disorders: The role of ambivalence towards change

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