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TherapistĀ“s facilitative interpersonal skills and persuasiveness in psychotherapy
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Abstract(s)
A evidĆŖncia empĆrica demonstra uma associaĆ§Ć£o robusta entre as competĆŖncias interpessoais do psicoterapeuta e os seus resultados clĆnicos. No entanto, existe um foco predominante no estudo de algumas competĆŖncias interpessoais (por exemplo, empatia) em detrimento de outras. Especificamente, existe uma falta de contributos teĆ³ricos e cientĆficos focados na persuasĆ£o do psicoterapeuta, uma competĆŖncia interpessoal que engloba os comportamentos verbais e nĆ£o-verbais do terapeuta que influenciam as expectativas e credibilidade do cliente quanto Ć intervenĆ§Ć£o psicolĆ³gica. Os estudos aqui apresentados visam aumentar a base de conhecimento teĆ³rico e empĆrico para as competĆŖncias interpessoais do terapeuta no geral, e para a persuasĆ£o terapĆŖutica em particular.
No primeiro estudo, revemos os principais contributos teĆ³ricos e literatura empĆrica sobre a persuasĆ£o do psicoterapeuta. Com base na investigaĆ§Ć£o disponĆvel, apresentamos um consenso sobre os principais comportamentos verbais e nĆ£o-verbais do terapeuta que parecem influenciar as expectativas e credibilidade do cliente em relaĆ§Ć£o Ć psicoterapia. Este estudo sugere que o fornecer de racionais clĆnicos dentro de sessĆ£o, tanto para a origem dos problemas do cliente como para a sua soluĆ§Ć£o, Ć© a tarefa persuasiva mais relevante no qual os terapeutas poderĆ£o ser treinados de modo a aumentar a eficĆ”cia clĆnica. ConcluĆmos com implicaƧƵes para o treino e investigaĆ§Ć£o de persuasĆ£o psicoterapĆŖutica. Destacamos a necessidade de desenvolver diretrizes de prĆ”tica deliberada para persuasĆ£o clĆnica, e a anĆ”lise de processo das competĆŖncias interpessoais do terapeuta dentro de sessĆ£o.
No segundo estudo, propomos diretrizes com suporte empĆrico para o treino de psicoterapeutas focado no fornecer de racionais clĆnicos convincentes. Apresentamos critĆ©rios para o treino sistemĆ”tico desta competĆŖncia, bem como um exemplo de implementaĆ§Ć£o dessas diretrizes. ConcluĆmos com implicaƧƵes sobre como os mĆ©todos de prĆ”tica deliberada poderĆ£o contribuir para o treino tradicional de psicoterapeutas.
No Ćŗltimo estudo, investigamos as competĆŖncias interpessoais e persuasĆ£o terapĆŖutica numa amostra de 18 psicoterapeutas de trĆŖs modalidades clĆnicas e 54 sessƵes gravadas em vĆdeo. Os resultados indicam que as competĆŖncias interpessoais do terapeuta sĆ£o um preditor positivo significativo do envolvimento emocional e cognitivo do cliente
(āexperienciaĆ§Ć£oā) dentro de sessĆ£o. Foi tambĆ©m encontrado que fornecer racionais clĆnicos foi um preditor negativo significativo da experienciaĆ§Ć£o do cliente. Nenhuma diferenƧa foi encontrada para as competĆŖncias interpessoais do terapeuta entre diferentes modalidades, mas diferenƧas foram encontradas para a experienciaĆ§Ć£o do cliente e o fornecer de racionais clĆnicos.
Os contributos decorrentes destes estudos fornecem implicaƧƵes para o treino de psicoterapeutas e investigaĆ§Ć£o empĆrica futura, sugerindo prĆ³ximos passos que poderĆ£o, em Ćŗltima instĆ¢ncia, contribuir para o aumento da eficĆ”cia clĆnica de psicoterapeutas.
There is robust evidence that psychotherapistās facilitative interpersonal skills are a significant predictor of client outcomes. However, there has been a prevalent focus in the study of some interpersonal skills (e.g., therapistās accurate empathy) to the detriment of others. Specifically, therapistās persuasiveness, an interpersonal skill encompassing the verbal and nonverbal therapist behaviors that influence clientās treatment expectations and credibility, has lagged in theoretical, training, and research contributions. The studies presented aim at increasing the theoretical and empirical knowledge base for therapistās interpersonal skill in general, and therapeutic persuasiveness in particular. In the first study, we reviewed the theoretical and empirical literature on psychotherapistās persuasiveness. Based on the available research, we present a consensus on the main verbal and nonverbal therapist behaviors that might influence therapy clientās treatment expectations and credibility. Our review found that the delivery of cogent treatment rationales, both for the origin of clientās distress and tasks to alleviate said distress, is arguably the most supported persuasiveness-related task therapists can train to increase treatment outcomes. We conclude with therapy training and research implications, namely, that deliberate practice training guidelines are a necessary next step in the development of therapistās persuasiveness, and that process analysis on therapistās in-session interpersonal skills is warranted. The remaining studies presented here address these two issues. In the second study, we propose empirically supported guidelines for therapist training in providing cogent treatment rationales. We provide step-by-step description and criteria for systematic training, as well as a case example implementing these guidelines. We conclude with implications for how deliberate practice methods augment traditional therapist training. In the last study, we investigated therapistās in-session interpersonal skills and persuasiveness for a sample of 18 therapist and 54 videorecorded sessions from three treatment modalities. Results indicate that therapistās interpersonal skills are a significant positive predictor of clientās emotional and cognitive engagement (āexperiencingā) in session. We also found that providing cogent treatment rationales was a significant negative predictor of client experiencing. No differences were found for therapistās interpersonal skills across modalities, but differences were found for client experiencing and provision of treatment rationales. The novel contributions stemming from these studies provide implications for future therapist training and empirical research, thereby suggesting next steps that may ultimately aid in increasing psychotherapy training effects and client outcomes.
There is robust evidence that psychotherapistās facilitative interpersonal skills are a significant predictor of client outcomes. However, there has been a prevalent focus in the study of some interpersonal skills (e.g., therapistās accurate empathy) to the detriment of others. Specifically, therapistās persuasiveness, an interpersonal skill encompassing the verbal and nonverbal therapist behaviors that influence clientās treatment expectations and credibility, has lagged in theoretical, training, and research contributions. The studies presented aim at increasing the theoretical and empirical knowledge base for therapistās interpersonal skill in general, and therapeutic persuasiveness in particular. In the first study, we reviewed the theoretical and empirical literature on psychotherapistās persuasiveness. Based on the available research, we present a consensus on the main verbal and nonverbal therapist behaviors that might influence therapy clientās treatment expectations and credibility. Our review found that the delivery of cogent treatment rationales, both for the origin of clientās distress and tasks to alleviate said distress, is arguably the most supported persuasiveness-related task therapists can train to increase treatment outcomes. We conclude with therapy training and research implications, namely, that deliberate practice training guidelines are a necessary next step in the development of therapistās persuasiveness, and that process analysis on therapistās in-session interpersonal skills is warranted. The remaining studies presented here address these two issues. In the second study, we propose empirically supported guidelines for therapist training in providing cogent treatment rationales. We provide step-by-step description and criteria for systematic training, as well as a case example implementing these guidelines. We conclude with implications for how deliberate practice methods augment traditional therapist training. In the last study, we investigated therapistās in-session interpersonal skills and persuasiveness for a sample of 18 therapist and 54 videorecorded sessions from three treatment modalities. Results indicate that therapistās interpersonal skills are a significant positive predictor of clientās emotional and cognitive engagement (āexperiencingā) in session. We also found that providing cogent treatment rationales was a significant negative predictor of client experiencing. No differences were found for therapistās interpersonal skills across modalities, but differences were found for client experiencing and provision of treatment rationales. The novel contributions stemming from these studies provide implications for future therapist training and empirical research, thereby suggesting next steps that may ultimately aid in increasing psychotherapy training effects and client outcomes.
Description
Tese apresentada para cumprimento dos requisitos necessĆ”rios Ć obtenĆ§Ć£o do grau de Doutor em Psicologia na Ć”rea de especializaĆ§Ć£o Psicologia ClĆnica apresentada no ISPA - Instituto UniversitĆ”rio no ano de 2021.
Keywords
Psicoterapia Capacidades interpessoais do psicoterapeuta PersuasĆ£o do psicoterapeuta Racionais psicoterapĆŖuticos Psychotherapy Therapistās facilitative interpersonal skills Therapistās persuasiveness Psychotherapeutic rationales