A theoretical and methodological proposal for the descriptive assessment of therapeutic interactions

Abstract

Objective: The goal of this study is to show the development of a strategy for a descriptive assessment of the therapeutic interaction. Method: In this study, we develop an observational methodology to analyze the dialogues that took place during 92 sessions conducted in a psychological center in Madrid, Spain, in which 19 adults were treated for various psychological problems by 9 behavioral therapists. A system was developed to codify vocal behavior of both the therapists and the clients; the software The Observer XT was used for recording. Therapeutic interactions were analyzed using sequential analysis. Results: There are three main sequences that synthesize the therapist–client interaction: first, an utterance by the client preceded by a therapist's verbalization, specifically a question (discriminative morphology) and followed by an expression of approval (reinforcement morphology); second, verbalizations of failure or discomfort uttered by the client, followed most often by verbalizations of disapproval (punishing morphology) uttered by the therapist; and third, verbalizations uttered by the client that are discriminated by the therapist after an in-depth explanation and followed by different therapist's utterances (expressions of approval, technical information, etc.). Conclusions: Depending on how the client responds the results in this study present a starting point for the study of the functional sequences that form the basis of therapeutic change.