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从心理治疗经验、知识谦逊和情绪调节预测耐药性管理能力。

Predicting resistance management skill from psychotherapy experience, intellectual humility and emotion regulation.

机构信息

Department of Psychology, York University, Toronto, ON, Canada.

出版信息

Psychother Res. 2024 Sep;34(7):885-898. doi: 10.1080/10503307.2023.2280240. Epub 2023 Nov 14.

Abstract

Resistance management in psychotherapy remains a foundational skill that is associated with positive client outcomes (Westra, H. A., & Norouzian, N. (2018). Using motivational interviewing to manage process markers of ambivalence and resistance in cognitive behavioral therapy. , (2), 193-203). However, little is known about which therapist characteristics contribute to successful management of resistance. Research has suggested that psychotherapy performance does not improve with experience (Goldberg, S. B., Rousmaniere, T., Miller, S. D., Whipple, J., Nielsen, S. L., Hoyt, W. T., & Wampold, B. E. (2016). Do psychotherapists improve with time and experience? A longitudinal analysis of outcomes in a clinical setting. , (1), 1-11), that psychotherapists lack humility (Macdonald, J., & Mellor-Clark, J. (2015). Correcting psychotherapists' blindsidedness: Formal feedback as a means of overcoming the natural limitations of therapists. , (3), 249-257), and that difficult therapeutic moments may dysregulate therapist emotions (Muran, J. C., & Eubanks, C. F. (2020). . American Psychological Association). This study aimed to 1) identify whether psychotherapy experience (i.e., training versus no training and number of years of psychotherapy experience) was associated with resistance management skill, and 2) identify whether humility and difficulties regulating emotions among trained individuals were each associated with resistance management. A sample of 76 trained and 98 untrained participants were recruited for the present study. All participants completed the Comprehensive Intellectual Humility Scale (CIHS, Krumrei-Mancuso, E. J., & Rouse, S. V. (2016). The development and validation of the comprehensive intellectual humility scale. , (2), 209-221), the Difficulties in Emotion Regulation Scale (DERS; Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. , (1), 41-54), and the Resistance Vignette Task (RVT; Westra, H. A., Nourazian, N., Poulin, L., Hara, K., Coyne, A., Constantino, M. J., Olson, D., & Antony, M. M. (2021). Testing a deliberate practice workshop for developing appropriate responsivity to resistance markers: A randomized clinical trial. , , 175-185 ) which was used to assess resistance management skill. Trained individuals performed significantly better on resistance management than untrained individuals; however, years of experience within the trained sample were not associated with resistance management. Conversely, lower humility and greater difficulties regulating emotions were each associated with significantly poorer resistance management in trained individuals. These findings suggest the possibility of improving training to focus on key skills, like resistance management, through supporting humility and emotion regulation in training, as opposed to simply acquiring more experience.

摘要

心理治疗中的抵抗管理仍然是一项基本技能,它与积极的客户结果相关(Westra,H. A.,& Norouzian,N.(2018)。使用动机性访谈来管理认知行为治疗中的犹豫和抵抗的过程标记。 ,(2),193-203)。然而,对于哪些治疗师特征有助于成功管理抵抗,人们知之甚少。研究表明,心理治疗效果不会随着经验的增加而提高(Goldberg,S. B.,Rousmaniere,T.,Miller,S. D.,Whipple,J.,Nielsen,S. L.,Hoyt,W. T.,& Wampold,B. E.(2016)。心理治疗师是否随着时间和经验的增加而提高?临床环境中结局的纵向分析。 ,(1),1-11),治疗师缺乏谦逊(Macdonald,J.,& Mellor-Clark,J.(2015)。纠正心理治疗师的盲目性:正式反馈是克服治疗师自然局限性的一种手段。 ,(3),249-257),并且困难的治疗时刻可能会使治疗师的情绪失调(Muran,J. C.,& Eubanks,C. F.(2020)。 。美国心理学会)。本研究旨在:1)确定心理治疗经验(即培训与非培训以及心理治疗经验的年限)是否与抵抗管理技能相关;2)确定训练有素的个体的谦逊和情绪调节困难是否与抵抗管理相关。 本研究招募了 76 名受训者和 98 名未受训者参加本研究。所有参与者都完成了综合智力谦逊量表(CIHS,Krumrei-Mancuso,E. J.,& Rouse,S. V.(2016)。综合智力谦逊量表的开发和验证。 ,(2),209-221),困难情绪调节量表(DERS;Gratz,K. L.,& Roemer,L.(2004)。多维情绪调节和失调评估:发展,结构和困难情绪调节量表的初步验证。 ,(1),41-54)和抵抗情节任务(RVT;Westra,H. A.,Nourazian,N.,Poulin,L.,Hara,K.,Coyne,A.,Constantino,M. J.,Olson,D.,& Antony,M. M.(2021)。测试针对抵抗标记发展适当反应性的刻意实践研讨会:一项随机临床试验。 , ,175-185),用于评估抵抗管理技能。 与未受训者相比,受过训练的个体在抵抗管理方面表现明显更好;然而,受过训练的样本中的经验年限与抵抗管理无关。相反,较低的谦逊和更大的情绪调节困难与受过训练的个体中明显较差的抵抗管理相关。 这些发现表明,通过在培训中支持谦逊和情绪调节,而不是仅仅积累更多经验,有可能改善培训以专注于关键技能,例如抵抗管理。

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