Gabalda Isabel Caro, Stiles William B, Pérez Ruiz Sergio
a Departamento de Personalidad, Evaluación y Tratamientos Psicológicos , Universidad de Valencia , Valencia , Spain.
b Department of Psychology , Miami University , OH , USA.
Psychother Res. 2016 Nov;26(6):653-64. doi: 10.1080/10503307.2015.1104422. Epub 2015 Nov 7.
This study examined the therapist activities immediately preceding assimilation setbacks in the treatment of a good-outcome client treated with linguistic therapy of evaluation (LTE).
Setbacks (N = 105) were defined as decreases of one or more assimilation stages from one passage to the next dealing with the same theme. The therapist activities immediately preceding those setbacks were classified using two kinds of codes: (a) therapist interventions and (b) positions the therapist took toward the client's internal voices.
Preceding setbacks to early assimilation stages, where the problem was unformulated, the therapist was more often actively listening, and the setbacks were more often attributable to pushing a theme beyond the client's working zone. Preceding setbacks to later assimilation stages, where the problem was at least formulated, the therapist was more likely to be directing clients to consider alternatives, following the LTE agenda, and setbacks were more often attributable to the client following these directives shifting attention to less assimilated (but nevertheless formulated) aspects of the problem.
At least in this case, setbacks followed systematically different therapist activities depending on the problem's stage of assimilation. Possible implications for the assimilation model's account of setbacks and for practice are discussed.
本研究考察了在对一名接受评估性语言疗法(LTE)且治疗效果良好的患者进行治疗时,紧接同化挫折之前的治疗师活动。
挫折(N = 105)被定义为在处理同一主题时,从一段内容到下一段内容,一个或多个同化阶段出现下降。紧接这些挫折之前的治疗师活动使用两种编码进行分类:(a)治疗师干预措施;(b)治疗师对患者内心声音所采取的立场。
在早期同化阶段出现挫折之前,此时问题尚未明确表述,治疗师更常进行积极倾听,且挫折更常归因于将某个主题推进到患者的工作区域之外。在后期同化阶段出现挫折之前,此时问题至少已得到明确表述,治疗师更有可能引导患者考虑其他选择、遵循LTE议程,且挫折更常归因于患者遵循这些指令,将注意力转移到问题中同化程度较低(但已明确表述)的方面。
至少在这种情况下,根据问题的同化阶段不同,挫折之后会出现系统性不同的治疗师活动。文中讨论了同化模型对挫折的解释以及对实践可能产生的影响。