Hostname: page-component-7dd5485656-wlg5v Total loading time: 0 Render date: 2025-10-30T22:44:24.607Z Has data issue: false hasContentIssue false
  • English
  • Français

Client Perceptions of Helpfulness in Therapy: a Novel Video-Rating Methodology for Examining Process Variables at Brief Intervals During a Single Session

Published online by Cambridge University Press:  22 May 2017

Alexandra A. Cocklin ,
Warren Mansell ,
Richard Emsley ,
Phil McEvoy ,
Chloe Preston ,
Jody Comiskey  and
Sara Tai
Alexandra A. Cocklin
Affiliation:
School of Health Sciences, University of Manchester
Warren Mansell*
Affiliation:
School of Health Sciences, University of Manchester
Richard Emsley
Affiliation:
School of Health Sciences, University of Manchester
Phil McEvoy
Affiliation:
Six Degrees Social Enterprise, Regents Road, Salford
Chloe Preston
Affiliation:
Six Degrees Social Enterprise, Regents Road, Salford
Jody Comiskey
Affiliation:
Six Degrees Social Enterprise, Regents Road, Salford
Sara Tai
Affiliation:
School of Health Sciences, University of Manchester
*
Correspondence to Warren Mansell, Reader in Clinical Psychology, CeNTrUM (Centre for New Treatments and Understanding in Mental Health), Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, 2nd Floor Zochonis Building, Brunswick Street, Manchester M13 9PL. E-mail: warren.mansell@manchester.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: The value of clients’ reports of their experiences in therapy is widely recognized, yet quantitative methodology has rarely been used to measure clients’ self-reported perceptions of what is helpful over a single session. Aims: A video-rating method using was developed to gather data at brief intervals using process measures of client perceived experience and standardized measures of working alliance (Session Rating Scale; SRS). Data were collected over the course of a single video-recorded session of cognitive therapy (Method of Levels Therapy; Carey, 2006; Mansell et al., 2012). We examined the acceptability and feasibility of the methodology and tested the concurrent validity of the measure by utilizing theory-led constructs. Method: Eighteen therapy sessions were video-recorded and clients each rated a 20-minute session of therapy at two-minute intervals using repeated measures. A multi-level analysis was used to test for correlations between perceived levels of helpfulness and client process variables. Results: The design proved to be feasible. Concurrent validity was borne out through high correlations between constructs. A multi-level regression examined the independent contributions of client process variables to client perceived helpfulness. Client perceived control (b = 0.39, 95% CI .05 to 0.73), the ability to talk freely (b = 0.30, SE = 0.11, 95% CI .09 to 0.51) and therapist approach (b = 0.31, SE = 0.14, 95% CI .04 to 0.57) predicted client-rated helpfulness. Conclusions: We identify a feasible and acceptable method for studying continuous measures of helpfulness and their psychological correlates during a single therapy session.

Keywords

Perceptual Control Theorytherapeutic allianceclient perceptionshelpfulnessMethod of Levelstherapy process

Information

Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 45 , Issue 6 , November 2017 , pp. 647 - 660
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

*

Alexandra A. Cocklin is now at Barnsley Adult Learning Disability Service.

References

Bachelor, A. (1995). Clients’ perception of the therapeutic alliance. Journal of Counselling Psychology, 42, 323–337.Google Scholar
Bedi, R. P. (2006). Concept mapping the client's perspective on counselling alliance formation. Journal of Counselling Psychology, 53, 26–35.Google Scholar
Bedi, R. P., Davis, M. D. and Meris, W. (2005). Critical incidents in the formation of the therapeutic alliance from the client's perspective. Psychotherapy: Theory, Research, Practice, Training, 43, 311–323.Google Scholar
Blackburn, I. M., James, I. A., Milne, D. L., Baker, C., Standart, S., Garland, A. and Reichelt, F. K. (2001). The revised cognitive therapy scale (CTS-R): psychometric properties. Behavioural and Cognitive Psychotherapy, 29, 431–446.Google Scholar
Bordin, E. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research, and Practice, 16, 252–260.Google Scholar
Carey, T. A. (2006). Method of Levels. Hayward, CA: Living Control Systems Publishing.Google Scholar
Carey, T. A., Mansell, W. and Tai, S. (2015). Principles-Based Counselling and Psychotherapy: A Method of Levels Approach. Routledge: London.Google Scholar
Castonguay, L. G., Boswell, J. F., Baker, S., Boutselis, M. A., Chiswick, N. R. et al. (2010). Helpful and hindering events in psychotherapy: a practice research network study. Psychotherapy Theory, Research, Practice, Training, 47, 327–344.Google Scholar
Duncan, B. L., Miller, S. D., Sparks, J. A., Claud, D. A., Reynolds, L. R., Brown, J. and Johnson, L. D. (2003). The Session Rating Scale: preliminary psychometric properties of a working alliance measure. Journal of Brief Therapy, 3, 3–12.Google Scholar
Elliott, R. (1985). Helpful and non-helpful events in brief counseling interviews: an empirical taxonomy. Journal of Clinical Psychology, 32, 301–322.Google Scholar
Elliott, R. (1986). Interpersonal process recall (IPR) as a psychotherapy process research method. In Greenberg, L. S. and Pinsof, W. M. (eds), The Psychotherapeutic Process: A Research Handbook. New York: Guilford Press.Google Scholar
Elliott, R. and Wexler, M. (1994). Measuring the impact of sessions in process experiential therapy of depression: the Session Impacts Scale. Journal of Counseling Psychology, 41, 166–174.Google Scholar
Green, B. L., Gleser, G. C, Stone, W. N. and Seifert, R. F. (1975). Relationships among diverse measures of psychotherapy outcome. Journal of Consulting and Clinical Psychology, 43, 689– 699.Google Scholar
Hardy, G. E., Cahill, J. L. and Barkham, M. (2007). Active ingredients of the therapeutic relationship that promote client change. In Gilbert, P. and Leahy, R. L. (eds), The Therapeutic Relationship in the Cognitive Behavioral Psychotherapies. London: Routledge.Google Scholar
Heck, R. H. and Thomas, S. L. (2009). An Introduction to Multi-level Modelling Techniques. Hove: Routledge.Google Scholar
Hill, C. E. (2005). Therapist techniques, client involvement, and the therapeutic relationship. Psychotherapy: Theory, Research, Practice, Training, 42, 431–442.Google Scholar
Horvath, A. O. and Greenberg, L. S. (1989). The development and validation of the Working Alliance Inventory. Journal of Counseling Psychology, 36, 223–233.Google Scholar
Knaup, C., Koesters, M., Schoefer, D., Becker, T. and Puschner, B. (2009). Effect of feedback of treatment outcome in specialist mental healthcare: a meta-analysis. British Journal of Psychiatry, 195, 15–22.Google Scholar
Kroenke, K., Spitzer, R. L. and Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613.Google Scholar
Levitt, H., Butler, M. and Hill, C.E. (2006). What clients find helpful in psychotherapy: implications for mentoring relationships. Journal of Counseling Psychology, 53, 314–324.Google Scholar
Llewelyn, S. P., Elliott, R., Shapiro, D. A., Hardy, G. and Firth-Cozens, J. (1988). Client perceptions of significant events in prescriptive and exploratory periods of individual therapy. British Journal of Clinical Psychology, 27, 105–114.Google Scholar
Luborsky, L., Barber, J. P., Siqueland, L., Johnson, S., Najavits, L. M., Frank, A. and Daley, D. (1996). The Revised Helping Alliance Questionnaire (HAQ-II) : psychometric properties. Journal of Psychotherapy Practice and Research, 5, 260–271.Google Scholar
Mansell, W. Carey, T. A. and Tai, S. J. (2012). A Transdiagnostic Approach to CBT Using Method of Levels Therapy: The CBT Distinctive Features Series. Routledge: London.Google Scholar
Mohr, J. J. and Woodhouse, S. S. (2001). Looking inside the therapeutic alliance: assessing clients’ visions of helpful and harmful psychotherapy. Psychotherapy Bulletin, 36, 15–16.Google Scholar
McLeod, J. (2001). Qualitative Research in Counselling and Psychotherapy. London: Sage.Google Scholar
Nguyen, T. D., Attkisson, C. C. and Stegner, B. L. (1983). Assessment of patient satisfaction: development and refinement of a sense evaluation questionnaire. Evaluation and Program Planning, 6, 299–313.Google Scholar
Norcross, J. C. (2011). Psychotherapy Relationships that Work, Evidence Based Responsiveness. New York: OUP.Google Scholar
Owen, J., Reese, R. J., Quirk, K. and Rodolfa, E. (2013). Alliance in Action: a new measure of clients’ perceptions of therapists’ alliance activity. Psychotherapy Research, 23, 67–77.Google Scholar
Paulson, B. L., Truscott, D. and Stuart, J. (1999). Clients’ perceptions of helpful experiences in counseling. Journal of Counseling Psychology, 46, 317–324.Google Scholar
Powers, W. (1973). Behavior: The Control of Perception, Chicago: Aldine de Gruyter.Google Scholar
Rogers, C. R. (1951). Client-Centred Therapy. Boston: Houghton Miffin.Google Scholar
Rogers, C. R. (1958). The characteristics of a helping relationship. The Personnel and Guidance Journal, 37, 6–16.Google Scholar
Simpson, A. J. and Bedi, R. P. (2013). The therapeutic alliance: clients’ categorization of client-identified factors. Canadian Journal of Counselling and Psychotherapy, 46, 344–366.Google Scholar
Spitzer, R. L., Kroenke, K., Williams, J. B. W. and Lowe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine, 166, 1092–1097.Google Scholar
SPSS Inc. (2007). SPSS for Windows, version 16.0. Chicago.Google Scholar
Stata, Corp. (2011). Stata Statistical Software: Release 12. College Station, TX: StataCorp LP.Google Scholar
Strupp, H. H. (2001). Implications of the empirically supported treatment movement for psychoanalysis. Psychoanalytic Dialogues, 11, 605–619.Google Scholar
Timulak, L. (2010). Significant events in psychotherapy: an update of research findings. Psychology and Psychotherapy: Theory, Research and Practice, 83, 421–447.Google ScholarPubMed
Timulak, L. and Lietaer, G. (2011). Moments of empowerment: a qualitative analysis of positively experienced episodes in brief person centred counselling. Counselling and Psychotherapy Research, 1, 62–73.Google Scholar
Watson, J. C., Cooper, M., McArthur, K. and McLeod, J. (2012). Helpful therapeutic processes: client activities, therapist activities and helpful effects. European Journal of Psychotherapy and Counselling, 14, 77–89.Google Scholar
Submit a response

Comments

No Comments have been published for this article.