Interventions on client behaviors that produce negative feelings in the therapist

Author(s)

Marcia Kameyama

• Document type: Master's Dissertation
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Instituto de Psicologia (IP/SBD)
• Defense date: 2012-04-10

Examining board members

Sonia Beatriz Meyer; Juliana Cristina Donadone; Maria de Jesus Dutra dos Reis

• Advisor: Sonia Beatriz Meyer

Abstract

In psychotherapy, as the therapist creates the necessary conditions for an intimate relationship with the client, some problem behaviors may appear in session, which can be of the same class of those that the clients display in their natural environment. These behaviors may be unproductive responses to the therapeutic process (aggressive or avoidance responses). The way the therapist responds to these behaviors may have different effects on the therapeutic alliance, which is regarded as a predictor of therapeutic results. Studies have indicated that therapists would present a tendency to respond to resistant and hostile clients with counter-hostility, coldness and detachment. Therapists who have been successful in handling such situations made interpretative and non directive interventions, focusing on the therapeutic relationship. However, it was difficult to find studies which investigated the therapist behavior through direct observation in situations in which he had negative feelings. This study proposed to investigate the therapeutic interaction in sessions which produce negative feelings in therapist. Thus it intends to examine (1) whether the therapist, having supervision, changes his behavior over the course of the therapeutic process, in response to the clients behaviors that generate negative feelings and (2) whether these clients behaviors decrease, which can be an indirect measure of efficacy of therapeutic interventions. Sessions of three behavior-analytic therapists and a psychology student were videotaped. The therapists completed a questionnaire after each session in order to identify if any adverse situation had occurred. The therapist behaviors were coded with the Multidimensional System for Coding Behaviors in Therapist-Client Interaction. Clients behaviors categories were developed based on audio transcripts of supervisions. The results indicated that four behaviors were observed as eliciting negative feelings for all therapists: Lack of Dialogue, Superficial Talk, Opposition and Attenuation. In general, interactions of this type correspond to a third part of the session. There was a prevalence of categories Facilitation, Empathy and Request Report for all therapists in response to these behaviors, confirming literature data for difficult clients. Facilitation and Empathy often showed different patterns of occurrence, being Empathy a more active intervention than Facilitation. The category Facilitation indicates problems in conducting the case, when it presents very marked predominance among the categories or when it presents very low percentages. In situations with better results Facilitation had proportions similar to other therapist categories. The remaining categories were grouped into Interventional and showed different trends depending on the outcome of therapy. T1 tended to increase the Interventional category during the sessions, and it was the only case that has continued in therapy and showed significant improvement during sessions. The therapists responses differed according to client categories. It is possible to infer that each therapist deals best with some client behaviors than with others (AU)

• FAPESP's process: 09/07067-8 - EFFECTS OF REPORTED FEELINGS IN SUPERVISION ON THE PERFORMANCE OF ANALYTIC BEHAVIOR THERAPIST
• Grantee: Marcia Kameyama
• Support Opportunities: Scholarships in Brazil - Master