How Can We Study Change Processes in Psychotherapy While Addressing Its Interactive Nature
DOI:
https://doi.org/10.55414/97bvad97Keywords:
Observational coding system , Sequential microanalysis , Moment-to-moment analysis , Change process research, Clinical behavior analysisAbstract
Does the empathy or personality of psychotherapists influence the way they do therapy? Is the therapeutic relationship the key to success? Questions such as these are commonly shared in Change Process Research (CPR) and outcome studies. However, these statements, posed in descriptive cross-sectional terms, often imply the use of strategies grounded in causal-linear explanatory models. The present study offers an alternative tool to measure elements of psychotherapy in dynamic, interactive, and interdependent terms. With nine observational categories defined under analytical-behavioral lens, the Acoveo System is an instrument designed to detect the potential functions of verbal exchanges that take place in the psychotherapeutic context from any theoretical orientation. A guide to its application is provided, and its usefulness is elaborated on two of the pivotal common factors in change process research: empathy and therapeutic alliance.
References
Alonso-Vega, J. (2021). Análisis funcional de la interacción verbal entre terapeuta y cliente con diagnóstico de Trastorno Mental Grave (tesis doctoral). Universidad Autónoma de Madrid.
Anderson, T., Ogles, B.M., Patterson, C.L., Lambert, M.J. y Vermeersch, D.A. (2009). Therapist effects: Facilitative interpersonal skills as a predictor of therapist success. Journal of Clinical Psychology, 65(7), 755-768. https://doi.org/10.1002/jclp.20583
Ardito, R.B. y Rabellino, D. (2011). Therapeutic alliance and outcome of psychotherapy: Historical excursus, measurements, and prospects for research. Frontiers in Psychology, 2, 270. https://doi.org/10.3389/fpsyg.2011.00270
Baier, A.L., Kline, A.C. y Feeny, N.C. (2020). Therapeutic alliance as a mediator of change: A systematic review and evaluation of research. Clinical Psychology Review, 82, 101921. https://doi.org/10.1016/j.cpr.2020.101921
Bardin, L. (1977). Análise de conteúdo. Ediçoes 70 Persona.
Barrington, B.L. (1961). Prediction from counselor behavior of client perception and of case outcome. Journal of Counseling Psychology, 8, 37-42. https://doi.org/10.1037/h0041817
Bonow, J.T., Maragakis, A. y Follette, W.C. (2012). The challenge of developing a universal case conceptualization for Functional Analytic Psychotherapy. International Journal of Behavioral Consultation and Therapy, 7(2-3), 2-8. https://doi.org/10.1037/h0100930
Bordin, E.S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice, 16, 252-260. https://doi.org/10.1037/h0085885
Bordin, E.S. (1994). Theory and research on the therapeutic working alliance: New directions. En A.O. Horvath y L.S. Greenberg (Eds.), The working alliance: Theory, research, and practice (pp. 13-37). John Wiley & Sons.
Botella-Ausina, J. y Caperos-Montalbán, J.M. (2019). Metodología de investigación en psicología general sanitaria. Síntesis.
Callaghan, G.M., Naugle, A.E. y Follette, W.C. (1996). Useful constructions of the client-therapist relationship. Psychotherapy: Theory, Research, Practice, Training, 33(3), 381-390. https://doi.org/10.1037/0033-3204.33.3.381
Castonguay, L.G., Barkham, M., Youn, S.J. y Page, A.C. (2021). Practice-based evidence. Findings from routine clinical settings. En M. Barkham, W. Lutz y L.G. Castonguay (Eds.) LG. (Eds.), Bergin and Garfield’s handbook of psychotherapy and behavior change: 50th anniversary edition, 7th Ed. (pp. 191-222). John Wiley & Sons, Inc.
Chamberlain, P., Davis, J.P., Forgatch, M., Frey, J., Patterson, G.R., Ray, J., Rothschild, A. y Trombley, J. (1985). The therapy process code: A multidimensional system for observing therapist and client interactions (manual de codificación no publicado).
Chow, D.L., Miller, S.D., Seidel, J.A., Kane, R.T., Thornton, J.A. y Andrews, W.P. (2015). The role of deliberate practice in the development of highly effective psychotherapists. Psychotherapy, 52, 337-345. https://doi.org/10.1037/pst0000015
Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20(1), 37-46. https://doi.org/10.1177/001316446002000104
Cook, T.D. y Campbell, D.T. (1979). Quasi-experimentation. Design & analysis issues for field settings. Rand McNally College Publishing Company.
Day, W.F. (1969). Radical behaviorism in reconciliation with phenomenology. Journal of the Experimental Analysis of Behavior, 12(2), 315-328. https://doi.org/10.1901/jeab.1969.12-315
De Pascual-Verdú, R. y Trujillo-Sánchez, C. (2018). Estudio de la relación entre las verbalizaciones motivadoras y el seguimiento de instrucciones en la terapia psicológica [A study of the relation between motivational utterances and instruction compliance]. Revista Clínica Contemporánea, 9(e14). https://doi.org/10.5093/cc2018a11
De Pascual-Verdú, R., Trujillo-Sánchez, C., Gálvez-Delgado, E., Andrés-López, N., Castaño-Hurtado, R. y Froxán-Parga, M.X. (2019). Sistema ACOVEO: una propuesta funcional para el análisis de la interacción verbal en terapia. Conductual, 7(2), 69-82.
Duan, C. y Hill, C.E. (1996). The current state of empathy research. Journal of Counseling Psychology, 43(3), 261-274.
Elliott, R. (2010). Psychotherapy change process research: Realizing the promise. Psychotherapy Research, 20(2), 123-135. https://doi.org/10.1080/10503300903470743
Follette, W.C. y Bonow, J.T. (2009). The challenge of understanding process in clinical behavior analysis: The case of functional analytic psychotherapy. The Behavior Analyst, 32(1), 135-148. https://doi.org/10.1007/BF03392179
Follette, W.C., Naugle, A.E. y Callaghan, G.M. (1996). A radical behavioral understanding of the therapeutic relationship in effecting change. Behavior Therapy, 27(4), 623-641. https://doi.org/10.1016/S0005-7894(96)80047-5
Frank, G.H. y Sweetland, A. (1962). A study of the process of psychotherapy: The verbal interaction. Journal of Consulting Psychology, 26(2), 135-138. https://doi.org/10.1037/h0047799
Freud, S. (1912). The dynamics of the «transference». En The standard edition of the complete psychological works of Sigmund Freud, (J. Starchey, Vol. 12, pp. 99-108). Hogarth.
Froján-Parga, M.X. (2011). Introducción. ¿Por qué funcionan los tratamientos psicológicos? Clínica y Salud, 22(3), 201-204. https://doi.org/10.5093/cl2011v22n3a1
Froján, M.X., Montaño-Fidalgo, M. y Calero-Elvira, A. (2006). ¿Por qué la gente cambia en terapia? Un estudio preliminar. Psicothema, 18(4), 797-803.
Froján, M.X., Montaño-Fidalgo, M., Calero-Elvira, A., García Soler, A., Garzón Fernández, A. y Ruiz Sancho, E. (2008). Sistema de categorización de la conducta verbal del terapeuta. Psicothema, 20, 603-609.
Froxán-Parga, M.X. (2020). Análisis funcional de la conducta humana: concepto, metodología y aplicaciones. Pirámide.
Froxán-Parga, M.X., Pereira, G.L. & Andrés-López, N. (2023). Tratamiento psicológico de un caso de dolor por una lesión cervical. En J.P. Espada, M. Orgilés y F.X. Méndez (Coords.), Tratamiento paso a paso de los problemas psicológicos en adultos (pp.533-552). Pirámide.
Galván-Domínguez, N., Alonso-Vega, J. y Froxán-Parga, M.X. (2020). Verbal aversive control in clinical interaction. Psicothema, 32(2), 182-188. https://doi.org/10.7334/psicothema2019.171
Gumz, A., Treese, B., Marx, C., Strauss, B. y Wendt, H. (2015). Measuring verbal psychotherapeutic techniques: A systematic review of intervention characteristics and measures. Frontiers in Psychology, 6, 1705. https://doi.org/10.3389/fpsyg.2015.01705
Hayes, S.C. (1988). Contextualism and the next wave of behavioral psychology. Behavior Analysis, 23, 7-22.
Hall, J.A. y Schwartz, R. (2019). Empathy present and future. The Journal of Social Psychology, 159(3), 225-243. https://doi.org/10.1080/00224545.2018.1477442
Hermansson, G.L., Webster, A.C. y McFarland, K. (1988). Counselor deliberate postural lean and communication of facilitative conditions. Journal of Counseling Psychology, 35, 149-153. https://doi.org/10.1037/0022-0167.35.2.149
Hofmann, S.G. y Hayes, S.C. (2019). The future of intervention science: Process-based therapy. Clinical Psychological Science, 7(1), 37-50. https://doi.org/10.1177/2167702618772296
Horvath, A.O. y Luborsky, L. (1993). The role of the therapeutic alliance in psychotherapy. Journal of Consulting and Clinical Psychology, 61(4), 561-573. https://doi.org/10.1037/0022-006X.61.4.561
Iannaccone, J.A., Hagopian, L.P., Javed, N., Borrero, J.C. y Zarcone, J.R. (2020). Rules and statements of reinforcer loss in differential reinforcement of other behavior. Behavior Analysis in Practice, 13(1), 81-89. https://doi.org/10.1007/s40617-019-00352-7
Insel, T.R. (2017). Digital phenotyping: Technology for a new science of behavior. JAMA, 318(13), 1215-1216. https://doi.org/10.1001/jama.2017.11295
Johnston, J.M. y Pennypacker, H.S. (2008). Strategies and tactics of behavioral research (Vol. 3). Routledge.
Kohlenberg, B.S., Yeater, E.A. y Kohlenberg, R.J. (1998). Functional Analytic Psychotherapy, the therapeutic alliance, and brief psychotherapy. En The therapeutic alliance in brief psychotherapy (pp. 63-93). American Psychological Association. https://doi.org/10.1037/10306-003
Kohlenberg,R.J. y Tsai.,M. (1991). Functional Analytic Psychotherapy: Creating intense and curative therapeutic relationships. Plenum Pres. https://doi.org/10.1007/978-0-387-70855-3
Kohlenberg, R.J., Tsai, M. y Dougher, M.J. (1993). The dimensions of clinical behavior analysis. The Behavior Analyst, 16(2), 271-282. https://doi.org/10.1007/BF03392636
Landis, J.R. y Koch, G.G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33(1), 159-174. https://doi. org/10.2307/2529310
Lejuez, C.W., Hopko, D.R., Levine, S., Gholkar, R. y Collins, L.M. (2005). The therapeutic alliance in behavior therapy. Psychotherapy: Theory, Research, Practice, Training, 42, 456-468. https://doi.org/10.1037/0033-3204.42.4.456
Luborsky, L., Singer, B. y Luborsky, L. (1975). Comparative studies of psychotherapies: Is it true that «Everyone has won and all must have prizes»? Archives of General Psychiatry, 32(8), 995-1008. https://doi. org/10.1001/archpsyc.1975.01760260059004
Marchena-Giráldez, C., Calero-Elvira, A. y Galván-Domínguez, N. (2013). La importancia de las instrucciones del psicólogo para favorecer la adhesión terapéutica. Clínica y Salud, 24(2), 55-65. https://doi.org/10.5093/cl2013a7
Meyer, S.B. (2009). Análise de ‘solicitação de informação’ e ‘recomendação’ em banco de dados de terapias comportamentais (tesis doctoral). Universidade de São Paulo (Brasil).
Michael, J., Palmer, D.C. y Sundberg, M.L. (2011). The Multiple Control of Verbal Behavior. The Analysis of Verbal Behavior, 27(1), 3-22. https://doi.org/10.1007/BF03393089
Molenaar, P.C.M. (2008). On the implications of the classical ergodic theorems: Analysis of developmental processes has to focus on intra-individual variation. Developmental Psychobiology, 50(1), 60-69. https://doi.org/10.1002/dev.20262
Norcross, J.C. y Lambert, M.J. (2018). Psychotherapy relationships that work III. Psychotherapy, 55(4), 303-315. https://doi.org/10.1037/pst0000193
Pérez-Álvarez, M. (1996). La psicoterapia desde el punto de vista conductista. Biblioteca Nueva.
Reandeau, S.G. y Wampold, B.E. (1991). Relationship of power and involvement to working alliance: A multiple-case sequential analysis of brief therapy. Journal of Counseling Psychology, 38(2), 107-114. https://doi.org/10.1037/0022-0167.38.2.107
Ribeiro, E., Ribeiro, A. P., Gonçalves, M.M., Horvath, A.O. y Stiles, W.B. (2013). How collaboration in therapy becomes therapeutic: The therapeutic collaboration coding system. Psychology and Psychotherapy: Theory,
Research and Practice, 86(3), 294-314. https://doi.org/10.1111/j.2044-8341.2012.02066.x
Rogers, C. (1951). Client centered therapy. Hachette.
Ruiz-Sancho, E., Froján-Parga, M.X. y Calero-Elvira, A. (2013). Análisis de la conducta verbal del cliente durante el proceso terapéutico. Anales de Psicología, 29(3), 779-790. https://doi.org/10.6018/analesps.29.3.135401
Russell, R.L. y Stiles, W.B. (1979). Categories for classifying language in psychotherapy. Psychological Bulletin, 86(2), 404–419. https://doi.org/10.1037/0033-2909.86.2.404
Russell, R.L. y Trull, T.J. (1986). Sequential analyses of language variables in psychotherapy process research. Journal of Consulting and Clinical Psychology, 54(1), 16-21. https://doi.org/10.1037/0022-006X.54.1.16
Sandoz, E.K. (2020). Interbehavior as a clinical focus in CBS: A response to Hayes and Fryling (2019). Journal of Contextual Behavioral Science, 18, 273-275. https://doi.org/10.1016/j.jcbs.2020.10.006
Santacreu, J. y Hernández, J.M. (2019). Reflexiones finales: Lograr un psicólogo clínico experto. En La clínica universitaria del Centro de Psicología Aplicada de la Universidad Autónoma de Madrid (CPAUAM) (pp. 119-129). Universidad Autónoma de Madrid (CPA).
Sexton, H.C., Hembre, K. y Kvarme, G. (1996). The interaction of the alliance and therapy microprocess: A sequential analysis. Journal of Consulting and Clinical Psychology, 64(3), 471-480. https://doi.org/10.1037/0022-006X.64.3.471
Sidman, M. (1960). Tactics of scientific research. Basic Books. https://doi.org/10.1126/science.1225244
Simon, C. (2022). The ontogenetic evolution of verbal behavior. European Journal of Behavior Analysis, 21(2), 364-381. https://doi.org/10.1080/15021149.2019.1710034
Sousa, A. y Banaco, R. (2000). Investigação sobre os efeitos do reforçamento na sessão terapêutica sobre três classes de respostas verbais do cliente. Revista Brasileira de Terapia Comportamental e Cognitiva, 2(2), 123-136.
Stiles, W.B. (1999). Signs and Voices in Psychotherapy. Psychotherapy Research, 9, 1-21. https://doi.org/10.1093/ptr/9.1.1
Sturmey, P. (2020). Functional analysis in clinical treatment (Second edition). Academic Press, Elsevier.
Sulzer, S.H., Feinstein, N.W. y Wendland, C.L. (2016). Assessing empathy development in medical education: A systematic review. Medical Education, 50(3), 300-310. https://doi.org/10.1111/medu.12806
Titchener, E.B. (1909). Lectures on the experimental psychology of the thought-processes. Macmillan.
Vargas-de la Cruz, I., Pardo-Cebrián, R., Martínez-Sánchez, H., & Froján-Parga, M.X. (2018). Rule emission: A possible variable for improved therapeutic practice. The Spanish Journal of Psychology, 21. https://doi.org/10.1017/sjp.2018.42
Waltz, T.J. y Follette, W.C. (2009). Molar functional relations and clinical behavior analysis: Implications for assessment and treatment. The Behavior Analyst, 32(1), 51-68. https://doi.org/10.1007/BF03392175
Wampold, B.E. (2019). The basics of psychotherapy: An introduction to theory and practice (2nd Ed.). American Psychological Association. https://doi.org/10.1037/0000117-000
Wigutoff, D. (1988). The language of change: A sequential analysis of matched mode utterances in the speech of therapists and clients as a test of the effect of congruence and responsibility in the process of psychotherapy (tesis doctoral). University of Reno.
Xavier, G.S., Espíndola, P.S., Córdova, L.F. y Mota da Silva, N.N.F. (2017). Método Reno: Uma proposta para análise comportamental do discurso. Perspectivas em Análise do Comportamento, 8(1), 120-134. https://doi.org/10.18761/pac.2016.037
Zamignani, D.R. (2007). O desenvolvimento de um sistema multidimensional para a categorização de comportamentos na interação terapêutica (tesis doctoral). Universidade de São Paulo. https://doi.org/10.11606/T.47.2008.tde-21052009-091808
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Apuntes de Psicología
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
