Browsing by Author "Sousa, Daniel"
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- Development and validation of the facilitative interpersonal skills scale for clientsPublication . Santos, João M.; Barata, Matilde; Rathenau, Sara; Amaro, Inês; Vaz, Alexandre; Sousa, Daniel; Severino, Margarida; Taveira, Mafaldapsychotherapist development, psychotherapy expertise, statistical methodology, test development, therapist effects1| INTRODUCTION The role of the therapist in psychotherapy research has a controversial history. The widespread focus on investigating specific treatment protocols for specific psychological disorders made the study of individual differences among therapistsalong‐neglected research topic (e.g., Beutler et al.,2004;Castonguay&Hill,2017). However, despite the historicallygreater emphasis on randomized controlled trials to understand differences between specific treatment models, researchhas consistently shown thattherapistscontribute more to therapy outcomes than the type of treatment or level ofadherence to a particular protocol (Wampold & Imel,2015). It seems that therapist effects can explain 5%–9% of theoutcome variance (Baldwin & Imel,2013). These results overshadow the 0%–1% variability attributable to specifictreatment models (Miller et al.,2013; Wampold & Imel,2015).The existing literature suggests that the therapeutic alliance is one of the best predictors of clinical outcomes identified to date, along with the therapist's ability to convey empathy (Nor cross &Lambert,2019; Nor cross & Wampold,2019; Wampold & Imel,2015). The therapeutic alliance is described by Bordin (1979) as a collaborative relationship intended to overcome the client's suffering. This relation shipe incompasses three important aspects: (a) agreement on the goals of the treatment, (b) agreement on thetasks, and (c) the development of a mutual bond betweentherapist and client. The therapeutic alliance isconsidered a common factor or a nonspecific factor in psychotherapy. These factors include therapeuticqualities (such as empathy and the therapist's ability to be persuasive and to create compelling expectations)foundintherapistsandprofessionalsacrosstherapeutic approaches and helping professions (Frank &Frank,1993).Commonfactorsaresubjecttovariousdefinitionswhichposessomechallengestocontrolledexperimental research (Anderson & Patterson,2013). Following the need to measure and operationalizethese factors, Anderson and Patterson (2013) created the facilitative interpersonal skills (FIS) rating scale,which assesses several relational therapist skills relevant to therapeutic effectiveness (Anderson &Patterson,2013). These skills play an important role in the ability to develop and maintain a solid therapeutic alliance and might go beyond the therapist's use of a particular treatment model or technique(Wampold & Imel,2015).The FIS rating scale (Anderson & Patterson,2013)isaperformance‐based measure of eight therapist interpersonalskills, namely verbal fluency, emotional expression, persuasiveness, warmth/positive regard, hopefulness, empathy, alliancebond capacity, and alliance–rupture–repair responsiveness. This measure was designed for the assessment of thetherapist's performance by an external observer. More specifically, it evaluates participants' responses to a performance‐based task where they provide therapeutic responses to standardvideostimulithatportraychallenging psychotherapeuticevents. In these clips, one actor/actress plays the role of a client explaining a certain problem to which the participantshave to respond in a therapeutic manner as if they were in session. The FIS‐in session (FIS‐IS) rating scale (Uhlin,2011)isan adaptation of the original FIS ratingscale applied to actual recorded or observed therapy sessions. Similarly to theoriginal FIS, an external coder rates the therapist's performance. Our goal is to create a new FIS scale (the FIS‐clientversion [FIS‐C]) where clients evaluate their therapists' performance.Anderson et al. (2009) found that therapists' observer‐rated FIS predicted those therapists' real‐lifeclinical outcomes. Subsequent studies confirmed that FIS scores predicted outcome and alliance (Anderson,Crowley, et al.,2016; Anderson, McClintock, et al.,2016) and that these skills were trainable throughdeliberate practice(Anderson et al.,2020;Rousmaniereetal.,2017). The effects of observer‐rated therapist 2|SANTOS ET AL.
- Does deliberate practice surpass didactic training in learning empathy skills? – A randomized controlled studyPublication . Larsson, Johannes; Werthén, David; Carlsson, Jan; Salim, Osame; Davidsson, Edvin; Vaz, Alexandre; Sousa, Daniel; Norberg, JoakimA large body of research identifies therapist expressed empathy as one of the most important predictors of psychotherapy outcome. Deliberate practice (DP) is an effective method to improve skills in many fields. We asked if DP also can be used to enhance the skill of expressing empathy. Objective: The aim was to compare the efficacy of DP to didactical learning methods (DLM) in enhancing the skill of empathic expression in students. Method: A repeated measures randomized controlled group design was used. Novice students (N¼36) from psychologist-, medicine-, social work-, and nursing programs received two training sessions of either DP (n¼21) or DLM (n¼15). Participants’ skills in empathic expression were assessed with the Measure of Expressed Empathy (MEE) on three occasions: before the first, between, and after the last training session. Results: Participants in the DP-group showed improved empathic expression, whereas participants in the DLM-group did not. Conclusions: These findings suggest that DP is an effective training method for therapeutic skills such as empathic expression and holds implications for the future development of educational practices to incorporate active skill training methods.
- Existential psychotherapy supervision: The supervisor’s perspectivePublication . Silva, Sara; Sousa, DanielSupervision is a cross-disciplinary practice among various professional groups. This study focuses on clinical supervision as a practice linked to psychology and psychotherapy. The literature highlights the need to expand and consolidate knowledge in this area. Specifically, in the few existing approaches to research on existential supervision, the need for the systematization of knowledge is clear. The use of qualitative methods is recognized as an approach that is likely to enrich knowledge of supervision. Objective: The aim of this study was to explore the theme of clinical supervision, particularly as it relates to existential psychotherapy, from the supervisor’s perspective to assess insights from the experience of each participant. Method: The three participants are both existential psychotherapists and supervisors that apply the same approach, in group mode, in the context of psychotherapist training. The data were collected using phenomenological interviews. A comprehensive analysis of the transcripts of the interviews was performed using the phenomenological method. Results: Emerging themes presented a general meaning structure that represents eidetic dimensions and how they are related. The eidetic dimensions, relationship and responsiveness, arise in the existential approach as the foundational and promotional aspects of successful supervision.
- Existential psychotherapy supervision: the supervisor’s perspectivePublication . Silva, Sara; Sousa, Daniel: Chronic illnesses cause considerable burden in quality of life, often leading to physical, psychological, and social dysfunctioning of the sufferers and their family. There is a growing need for flexible provision of home-based psychological services to increase reach even for traditionally underserved chronic illness sufferer populations. Digital interventions can fulfill this role and provide a range of psychological services to improve functioning. Despite the potential of digital interventions, concerns remain regarding users’ engagement, as low engagement is associated with low adherence rates, high attrition, and suboptimal exposure to the intervention. Human–computer interaction (e.g., theoretical models of persuasive system design, gamification, tailoring, and supportive accountability) and user characteristics (e.g., gender, age, computer literacy) are the main identified culprits contributing to engagement and adherence difficulties. To date, there have not been any clear and concise recommendations for improved utilization and engagement in digital interventions. This paper provides an overview of user engagement factors and proposes research informed recommendations for engagement and adherence planning in digital intervention development. The recommendations were derived from the literature and consensualized by expert members of the European Federation of Psychology Associations, Psychology and Health Standing Committee, and e-Health Task Force. These recommendations serve as a starting point for researchers and clinicians interested in the digitalized health field and promote effective planning for engagement when developing digital interventions with the potential to maximize adherence and optimal exposure in the treatment of chronic health conditions.
- Inside the consulting room of a highly effective therapist: An analysis of first sessionsPublication . Caçador, Sílvia; Sousa, Daniel; Cooper, MickAim: The aim of this study was to capture the most salient aspects of first-session activities by a therapist who consistently had good clinical outcomes.Method: Constructivist grounded theory was used to analyse the first three audio-recorded psychotherapy sessions with two clients.Results: The analysis generated 12 categories organised into three major domains: (a) promoting clients' sense of agency and the collaborative nature of the therapeutic process; (b) supporting clients' exploration of meaningful contents, balancing respon-sively between following clients and introducing new dimensions; and (c) creating a climate of emotional security based on empathic presence, authenticity and positive regard.Conclusions: The results show key aspects of the therapist's performance, such as distinguished clinical skills, responsiveness and strong relational abilities. The results support the literature on highly effective therapists. They also contribute to practice and psychotherapist training. Domains and categories from this study may be the basis for a checklist of some essential features to be included in psychotherapists' deliberated practice programmes.KEYWORDSexpertise, first sessions, grounded analysis, psychotherapeutic efficacy, psychotherapy
- Self-Awareness, verbalization and new meanings as the heart and soul of significant events in Existential PsychotherapyPublication . Sousa, Daniel; Pestana, Ana Marta Quina; Tavares, António Tiago PereiraThis study aimed to qualitatively analyze the significant events that occur during existential psychotherapy sessions from the perspective of the patient. Ten patients completed the HAT—helpful aspects of therapy—shortly after existential psychotherapy sessions during existential psychotherapy treatment, which lasted 1 year and consisted of 48 sessions. The data were analyzed using grounded theory. The results emphasized the following categories: the promotion of self-awareness, the possibility of verbalizing experiences, and the deepening of meanings. In addition to emphasizing human relationships, the patients also emphasized a preference for interventions by existential therapists that were more directive, such as providing feedback, challenging personal beliefs, and asking questions. The results emphasize the integrated use of the two phenomenological methods, specifically, the static and the genetic methods.
- Significant events identified by clients engaged in Existential Psychotherapy: A descriptive phenomenological explorationPublication . Sousa, Daniel; Vaz, AlexandreThis research focuses on the descriptions of significant events experienced in the context of existential psychotherapy as described by five clients. The results include a set of eidetic dimensions in which the human relationship stands out as being particularly meaningful. Clients considered the therapy process to be significant for a number of different reasons, ranging from the development of the capacity to cope with difficulties to a basic sense of increased self-understanding. Significant events in therapy are sometimes preceded by tensions between the therapist and the client, which, in turn, promote turning points and breakthroughs in the therapeutic relationship. The results also seem to corroborate the affect and interdependence of the relational dimensions of psychotherapy, such as common factors, and more specific ingredients, such as the techniques used by the therapist. However, the experience of significant events is multifaceted and dynamic, and only a holistic perspective would seem to do justice to the complexity of these interrelated phenomena. Implications for practice and research are discussed.
- The relationship between lifelong learning and professional development activities in a Portuguese samplePublication . Ponces Coelho, Rodrigo; Pires, António A. Pazo; Neimeyer, Greg; Vaz, Alexandre; Dias Neto, David; Sousa, DanielObjective: A dispositional commitment to lifelong learning (LL) is an important aspect of continuing professional development for practicing psychotherapists. Equally important is the dedication of psychotherapists to engaging in professional development activities to foster growth and maintain competence. However, there are limited available data on the range of practices and factors influencing psychotherapists' commitment to these activities. The primary objective of this study was to examine whether a higher commitment to LL would significantly predict greater participation in a range of different professional development activities. Method: A sample of 166 Portuguese psychotherapists completed an online survey on professional development. The survey included two key measures: the Jefferson Scale of Psychotherapist Lifelong Learning and a list of professional development activities based on the Retrospective Analysis of Psychotherapists' Involvement in Deliberate Practice. Exploratory factorial analysis was conducted to determine an alternative and suitable grouping for the list of activities, and structural equation modelling was utilised to assess the relationship between the commitment to LL and engagement in these activities. Findings: Results provided valuable insight into the diverse levels of participation among therapists across five categories of activities: (1) supervision and case discussion; (2) recording-related activities; (3) reading and focussed learning; (4) reflecting; and (5) workshops supporting ongoing professional competence. Findings indicated that a stronger commitment to LL significantly predicted increased dedication to reading, focussed learning activities and attendance to training workshops. The implications and limitations of the study are discussed concerning their practical application for professional psychologists, counsellors and psychotherapists