Measuring silence

Levitt, Heidi M.; Morrill, Zenobia

doi:10.4324/9780429350900-19

Cited by 4 publications

(11 citation statements)

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“…Only three of the chapters offered research evidence for the effects of client cultural diversity on treatment outcome (and again, these results were based on few studies):Levitt and Morrill (in press) cited a study in which male therapists and clients more often than female therapists and clients used silence as a “shield” or boundary between each other in therapy (Hill et al, 2003). Swift et al (in press) found that role induction was generally more effective in samples that had more non-Hispanic White clients than diverse racial and ethnic minorities.Ezawa and Hollon (in press) reported a study in which White therapists delivered less cognitive restructuring to Black than White patients even though cognitive restructuring has been found to be equally effective for Black and White patients (Ezawa & Strunk, 2022a).…”

Section: Research Evidence For the Effectiveness Of The Skills/methodsmentioning

confidence: 99%

“…Reassure clients that they are welcome to take their time with introspective silence. Clients sometimes cut short productive silence because they are worried about therapists waiting for them, so reassurance can prove useful (Levitt & Morrill, in press). Allow yourself to move flexibly in and out of synchrony with patients.…”

Section: Therapeutic Practicesmentioning

confidence: 99%

“…These research reviews, along with a review of four skills/methods (affirmation/validation, self-disclosure, immediacy, rupture repair; Farber et al, in press) included in the task force on psychotherapy relationships that work (Norcross & Lambert, 2019), were recently published as chapters in Hill and Norcross (2023). In this special issue of Psychotherapy , we include abbreviated versions of 12 chapters (Aschieri et al, in press; Ezawa & Hollon, in press, Hill et al, in press; Levitt & Morrill, in press; McMullen & Tay, in press; Pascual-Leone & Baher, in press; Peluso & Freund, in press; Ryum et al, in press; Spangler & Sim, in press; Swift et al, in press; Williams, in press; Zilcha-Mano et al, in press). The remaining eight abbreviated versions of chapters (Atzil-Slonim et al, in press; Barkham et al, in press; Cuijpers et al, in press; Elliott et al, in press; Flückiger et al, 2023; Goldberg et al, in press; Iwakabe et al, in press; Overholser & Beale, 2023) appear in a companion special section of Psychotherapy Research .…”

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confidence: 99%

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Skills and methods that work in psychotherapy: Observations and conclusions from the special issue.

Hill¹,

Norcross²

2023

Psychotherapy

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We draw recommendations and conclusions from the articles presented in this special issue and the companion special section in Psychotherapy Research on evidence-based therapist skills and methods. For distal (end-of-treatment) outcome, 10 skills/methods were judged to be demonstrably effective (affirmation/validation, paradoxical interventions, homework, routine outcome monitoring, strength-based methods, emotional regulation, imagery rehearsal therapy and exposure relaxation and rescripting therapy for nightmares, meditation/mindfulness/acceptance, behavioral activation, cognitive restructuring) and four were probably effective (rupture repair, role induction, collaborative assessment methods, chairwork). For intermediate (postsession or midtreatment) outcome, one method was judged to be demonstrably effective (cognitive-experiential dreamwork) and two methods probably effective (paradoxical interventions, homework). For immediate (in-session) outcomes, five skills/methods were judged to be probably effective (in-dialog silences, extended silences, role induction, strength-based methods, and emotion regulation). For the rest of the immediate, intermediate, or distal outcomes for skills/methods, there was either no or insufficient research available upon which to base judgments. Possible harmful effects, diversity considerations, and research limitations are summarized. The article ends with training implications, therapeutic practices, and the formal conclusions of the interorganizational Task Force on Psychotherapy Skills and Methods that Work.

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Section: Research Evidence For the Effectiveness Of The Skills/methodsmentioning

confidence: 99%

Section: Therapeutic Practicesmentioning

confidence: 99%

mentioning

confidence: 99%

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Skills and methods that work in psychotherapy: Observations and conclusions from the special issue.

Hill¹,

Norcross²

2023

Psychotherapy

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“…The current meta-analytic review has advanced the previous narrative review (Levitt & Morrill, 2021) by examining extended silences and including more recent studies. Limitations include that some silent processes have only been examined in a few studies.…”

Section: Limitations Of the Researchmentioning

confidence: 99%

“…Thus, we came to consensus that 30 articles should be admitted into the meta-analysis. In addition, because of a prior review we had conducted (Levitt & Morrill, 2021), we knew of an additional three articles that had not been located in this search process and added them to the tally. In total, 33 articles were reviewed, including 17 studies on in-dialogue silences that examined silences between 276 clients and 192 therapists and 16 studies focused on extended silences within 33 clients and 17 therapists.…”

Section: Research Reviewmentioning

confidence: 99%

Silences in psychotherapy: An integrative meta-analytic research review.

Levitt¹,

Morrill²

2023

Psychotherapy

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There is research evidence, from both qualitative and quantitative studies, that silences in psychotherapy have established associations with good and poor outcomes that include and extend beyond symptom measures to processes such as insight, symbolization, and disengagement. Research also has demonstrated that therapists attend to clients’ silences, seeking to comprehend the processes therein and intentionally support productive silent processes. This chapter synthesizes this research and examines features of silence processes to provide psychotherapists with the skills to differentiate the functions of both productive and obstructive forms of pausing. It includes a review of 33 quantitative and qualitative studies on silences in individual psychotherapy (from 309 clients and 209 therapists). Our qualitative and integrative meta-analytic evidence indicated that it enhanced their ability to intervene responsively and enhance therapy outcomes when psychotherapists’ responded strategically to the specific functions of silences. We consider research limitations, training implications, and therapeutic practices based on the research evidence.

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Silence

Levitt¹,

Morrill²

2023

Psychotherapy Skills and Methods That Work

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There is research evidence, from both qualitative and quantitative studies, that silences in psychotherapy have established associations with good and poor outcomes that extend beyond symptom measures to processes such as insight, symbolization, and disengagement. Research also has demonstrated that therapists attend to clients’ silences, seeking to comprehend the processes therein and intentionally support productive silent processes. This chapter synthesizes this research and examines features of silence processes to provide psychotherapists with the skills to differentiate the functions of both productive and obstructive forms of pausing. It includes a review of 33 quantitative and qualitative studies on silences in individual psychotherapy (from 309 clients and 209 therapists). The qualitative and integrative meta-analytic evidence indicated that when psychotherapists skillfully identified the specific function of silences, they responded effectively to enhance therapy outcomes. The chapter concludes with research limitations, diversity considerations, training implications, and therapeutic practices based on the research evidence.

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Measuring silence

Cited by 4 publications

References 0 publications

Skills and methods that work in psychotherapy: Observations and conclusions from the special issue.

Skills and methods that work in psychotherapy: Observations and conclusions from the special issue.

Silences in psychotherapy: An integrative meta-analytic research review.

Silence

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