Process and outcome in psychotherapy and behavior therapy.

Abstract

Three behavior therapists and three analytically oriented psychotherapists treated a total of CO neurotic outpatients for 4 months. Measures of Rogers-Truax factors, nonlcxical speech characteristics, therapist informational specificity, and a content analysis of therapist activity were taken from recordings of the fifth interview. Therapists rated their feelings toward their patients, and patients completed the Relationship Questionnaire and the Lorr Inventory. In psychotherapy, patients who were most liked by their therapists and those with greater total speech time showed greatest symptomatic improvement. Patients who used longer average speech durations improved most in both treatments. It was concluded that patient improvement was more a function of patient characteristics than of specific therapist interventions.Controversy over the effective ingredients of psychotherapy has long been a characteristic feature of the field. Clinical beliefs predominate since research studies have not isolated those therapist behaviors that lead to improved outcome with sufficient consistency or precision. Even the apparently wellestablished triumvirate of accurate empathy, unconditional positive regard, and therapist self-congruence is currently undergoing critical reevaluation (Bergin & Suinn, 1975;Mitchell, Truax, Bozarth, & Krauft, 1973).The question is confounded by the plethora of different therapies, each with idiosyncratic treatment strategies. Do the different therapies share some common features that lead to success regardless of theoretical differences? Or has each grasped some unique therapeutic truth sufficiently potent by itself to produce improvement?We found behavior therapy and analyti-

Influence of group cohesion on the behavioral treatment of smoking.

“…In a carefully evaluated clinical study. Staples, Sloane, Whipple, Cristol, and Yorkston (1976) found that for clinical outpatients who received various behavioral treatments, a clear trend emerged in which clients who perceived higher levels of nonpossessive warmth and accurate empathy evidenced more improvement thar. those who did r.ct.…”

Control in Counseling: Intrapersonal Versus Interpersonal Definitions

“…At the other extreme are more directive counselors such as Haley (1963) and Ellis (1972), who advocate more active control over what the client is to do in counseling. Researchers have found that, indeed, counselors who espouse less directive positions behave in ways fitting their beliefs (i.e., they exhibit fewer directive type behaviors), as do those who hold to more directive theories (Hill, Thames, & Rardin, 1979;Lee & Uhlemann, 1984;Staples, Sloane, Whipple, Cristol, & Yorkston, 1976). From these results, it has been concluded (Pope, 1977;Staples et al, 1976) that some counselors are more controlling than others because they exhibit more of these directive, controlling type behaviors.…”

“…These different definitions were examined by studying who determined the topic of conversation. This topic control variable has been used previously in the literature as a process measure of control (Staples et al, 1976;Verplanck, 1955) and seems especially important in counseling, given that the primary activity is verbal discourse. Specifically, the proportion of topic initiations, the intrapersonal definition of control, was correlated to the proportion of topic initiations that were subsequently followed, the interpersonal definition.…”

Language in Psychotherapy

“…However, in a follow-up paper, Staples, Sloane, Whipple, Cristol, and Yorkston (1976) extended this earlier N of 17 to 60 patients, choosing their additional 43 patients from among those seen by behavior therapists as well as by psychotherapists. Although reporting their findings in this follow-up paper by bar graphs rather than by correlations, they found with this larger N what appear to be even stronger relationships between speech and empathy than those shown in our Table 1 from their initial study.…”