Development of the family therapy enactment rating scale.

This report describes the development of a new scale designed to establish how therapists intervene and clients respond during effective enactments in family therapy sessions. The Family Therapy Enactment Rating Scale (FTERS) was developed by clinically trained investigators who observed 27 videotaped family therapy sessions and listed therapist interventions and client responses during four phases of enactments: pre-enactment preparation, initiation, facilitation, and closing commentary. Interrater reliabilities for the FTERS were calculated by training 6 undergraduate volunteers to rate independently a sample of 12 enactments. When reliabilities were found to be relatively low, a second study was conducted in which the FTERS was revised and reliabilities were calculated with a different sample of 21 videotaped enactments and a new group of 6 undergraduate raters. Reliability for the FTERS was found to be sufficiently robust to make this measure of therapist interventions and client responses a useful instrument for evaluating what takes place during enactments. Findings on the FTERS were used to offer tentative guidelines for effective initiation and facilitation of enactments in family therapy sessions.

The effective use of enactments in family therapy: a discovery-oriented process study.

In this investigation we examine the elements of enactments--in-session dialogues used to observe and modify family interactions in structural family therapy. Twenty-one videotaped segments of 18 therapy sessions with different families were used to compile detailed descriptions of therapist techniques and client responses. Enactments were analyzed as consisting of three distinct phases--initiation, facilitation, and closing--each of which required more numerous and complex interventions than are usually described in the clinical literature. Judges were able to reliably describe therapist interventions that led to successful enactments as well as what therapists did or failed to do that led to unproductive outcomes. Clinical implications of these findings are discussed.

Success of cathartic therapy as a function of patient variables.

Treated sample of 42 patients with cathartic psychotherapy and evaluated differential effectiveness on types of patients. Patients without mental disorders experienced more emotional catharsis than all others, and those with obsessive compulsive personality disorders improved more than all others as a result of emotive treatment. Contrary to popular notions, neither women nor hysterics experienced more catharsis or improved more in cathartic therapy. Although women and hysterics may cry more easily in daily life, obsessives are apparently more able to maintain focus on unhappy experiences and are therefore able to express more emotion in cathartic therapy. Furthermore, it seems that cathartic treatment is beneficial by disrupting long-standing defenses against emotional experiences, rather than by releasing stored-up affects.

Refining computerized test interpretations: an in-depth approach.

Comprehensive individual psychological evaluations of a small sample of subjects were used to identify shortcomings and suggest improvements in a computerized system for interpreting 16PF and CAQ scores. This approach is offered as a supplement, rather than an alternative, to the usual large sample correlational method. It is argued that such procedures mask desirable refinements by substituting a large number of subjects for detailed and accurate assessment of individual cases. Results of this analysis supported the general accuracy of the computerized system, but revealed gaps in the information provided and suggested alternatives for perfecting the system.

The delayed impact of group therapists' interventions.

The direct and delayed impact of therapist interventions on 21 clients in three outpatient therapy groups was examined. Sessions one and five of each group were taped with every therapist intervention analyzed according to the Group Therapist Interventions Scale and every client utterance rated on the Experiencing Scale and categorized by the Group Immediacy Scale. It was hypothesized that therapists would have a delayed rather than direct influence on group process measures. When pairs of therapist-patient statements were examined; little immediate impact was evident. However, a profound delayed impact of group leaders was inferred from the finding that astherapist interventions became more forceful over the first five sessions, patients' level and immediacy of experiencing became more intense.

Impact of therapist interventions on early sessions of group therapy.

A methodology for studying the effect of therapist style on the process of group therapy was developed and applied to two early sessions in two different therapy groups. In general, the results supported the hypothesis that individually directed, confrontative interventions would lead to emotionally focused and immediate client responding. The results failed to confirm the hypothesis that relatively interpretive interventions would be the most productive. In fact, simple facilitations tended to produce higher mean focusing than all other types of interventions. Perhaps in very early sessions the most productive interventions are those designed simply to encourage patients to talk and interact. The decisive technique of a group therapist may be interpretation, which helps patients to comprehend the significance of personally relevant, emotionally charged interactions. However, in the fledgling group, the therapist may be most helpful by simply facilitating members' speaking up and interacting. Indeed, clarifications and interpretations may turn out to be the group therapist's most productive interventions, but perhaps not until after group cohesiveness is developed in early sessions.