何时治疗师的元沟通会带来更多的来访者合作？时机和情境的调节作用。
When is therapist metacommunication followed by more client collaboration? The moderation effects of timing and contexts.
作者信息
Li Xu, Jauquet Carol A, Kivlighan Dennis M
机构信息
Department of Counseling, Higher Education, and Special Education.
Independent Practice.
出版信息
J Couns Psychol. 2016 Nov;63(6):693-703. doi: 10.1037/cou0000162. Epub 2016 Jul 21.
OBJECTIVE
Using propositions from Kiesler (1988)'s model of therapeutic metacommunication, this study investigated the relationship between therapist metacommunication and subsequent client collaboration and how this relationship was moderated by timing, therapist control, and affiliation. Building on Curran and Bauer (2011)'s data disaggregation approach, we examined the interaction of timing, between-session therapist control and affiliation, and within-session (between speaking-turn) therapist metacommunication.
METHOD
The first 4 sessions from counseling dyads for 2 advanced students in an APA-accredited counseling psychology doctoral program and 1 licensed psychologist were recorded, transcribed, and coded for analysis. Client statements were coded for collaboration and therapist statements were coded for metacommunication, approach-avoidance (level of affiliation), and dominance-submission (level of control).
RESULTS
(a) There was a significant 3-way interaction of metacommunication, time, and between-session dominance-submission, such that metacommunication significantly predicted subsequent client collaboration in later speaking turns within a session, and when the therapist generally showed low dominance in that session. (b) There was a significant 3-way interaction of metacommunication, time, and between-session approach-avoidance. Specifically, early in sessions therapist approach buffered the negative effect of metacommunication on collaboration, and later in sessions therapist neutrality (less approaching) facilitated a positive effect of metacommunication on client collaboration. (c) There was a significant 2-way interaction of between-speaking-turn metacommunication and within-session time in predicting subsequent client collaboration, such that early in sessions metacommunication did not predict collaboration, whereas later in sessions more metacommunication was associated with higher collaboration. These results were discussed in relation to the therapeutic metacommunication model proposed by Kiesler (1988). (PsycINFO Database Record
目的
本研究运用基斯勒（1988年）的治疗性元沟通模型中的命题，探讨治疗师元沟通与后续来访者合作之间的关系，以及这种关系如何受到时间、治疗师控制和亲和度的调节。基于柯伦和鲍尔（2011年）的数据分解方法，我们考察了时间、疗程间治疗师控制与亲和度以及疗程内（轮次间）治疗师元沟通之间的相互作用。
方法
对美国心理学会认可的咨询心理学博士项目中的2名高年级学生和1名执业心理学家的咨询二元组的前4次疗程进行录音、转录和编码分析。对来访者的陈述进行合作编码，对治疗师的陈述进行元沟通、接近-回避（亲和度水平）和主导-服从（控制水平）编码。
结果
（a）元沟通、时间和疗程间主导-服从存在显著的三向交互作用，即元沟通能显著预测在疗程内后续轮次中来访者的合作情况，且当治疗师在该疗程中总体表现出较低主导性时。（b）元沟通、时间和疗程间接近-回避存在显著的三向交互作用。具体而言，在疗程早期，治疗师的接近缓冲了元沟通对合作的负面影响，而在疗程后期，治疗师的中立（较少接近）促进了元沟通对来访者合作的积极影响。（c）轮次间元沟通与疗程内时间在预测后续来访者合作方面存在显著的双向交互作用，即疗程早期元沟通无法预测合作情况，而在疗程后期，更多的元沟通与更高的合作相关。这些结果结合基斯勒（1988年）提出的治疗性元沟通模型进行了讨论。（《心理学文摘数据库记录》
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