UBC Theses and Dissertations
Empathy, client depth of experiencing, and goal attainment scaling : a within-session examination of the client-centered therapy process Colistro, Frank Peter
This is an analogue study of process and outcome in client-centered therapy focusing chiefly on empathy. Therapist experienced, therapist communicated, and client received empathy were interrelated, and their impact on client depth of experiencing and problem resolution was examined. Thirty subjects engaged in one session of Client-Centered treatment in which they dealt with "splits", internal conflicts characterized by personal incongruence.. Before the sessions the subjects prepared a Goal Attainment Scale, which specified five personalized stages of behavioral and affective change regarding the split. During sessions audio recordings were made which were, later rated for therapist communicated empathy and client depth of experiencing. Subjects also rated therapist empathy, and seven days later they assessed change on their Goal Attainment Scales. Session scores for therapist experienced empathy, therapist communicated empathy, client received empathy, client depth of experiencing, and treatment outcome were then intercorrelated and analyzed in a manner analogous to path analysis. A similar process was applied to the combined results of similar research, and the path generated from this integrative summary and the results of the present study were compared to gain a clearer perspective on the causal flow among the process and outcome variables. As well, scores on the three empathy phases were compared for therapists across the two subjects they interacted with, and the interaction of therapist communicated empathy and client depth of experiencing was examined by a content analysis of each session. The path results suggest that therapist empathic communications lead to client perceptions of therapist empathy, which directly facilitates treatment outcome. Client depth of experiencing was remote from the empathy phases and outcome, failing to demonstrate that experiencing is an intervening variable between therapist empathy and outcome, These results are tentative since only one correlation, communicated by received empathy, was significant at .05. However the pattern is highly supported: by the relations among empathy, experiencing, and outcome derived from the integrative summary. The content analysis of therapist communicated empathy and client depth of experiencing suggested that client self-expression and exploration can be inhibited by therapists making an excessive number of reflections based on inaccurate or insufficient understanding of the client. This implied that there are some cases in which empathy and experiencing may be causally related, although this causal linkage is not consistent when examined across all client-therapist interaction. Comparison of the correlations between the three empathy phases and process and outcome measures, in conjunction with the correlations among the phases, suggested that the phases were related but distinct constructs. Therapist experienced empathy appeared to be a relationship variable that was essentially unrelated to treatment process and outcome. Therapist communicated empathy and client received empathy were relatively stable across clients, suggesting that these variables reflect therapist trait empathy. Of the three phases, client received empathy was most strongly predictive of treatment outcome. Overall, the study suggests that, within first sessions of client-centered treatment, therapist empathic communications are related to the client's perceptions of the therapist's empathy level in the relationship. These perceptions in turn positively influence treatment outcome. Changes in the level of client depth of experiencing may also be affected to a minor degree by communicated empathy, but experiencing does not appear to powerfully influence the treatment process at this early stage. The results suggest that client received empathy, being the empathy phase most predictive of treatment outcome, should be the phase most highly stressed in client-centered treatment. Frequent CRE ratings could furnish the therapist with a valuable index of the efficacy of the treatment process. A further implication for training of Rogerian therapists is that the overall concept of empathy encompasses therapist verbal and kinesic actions beyond the scope of scales measuring communicated empathy, the empathy phase most often stressed in>the training process. Finally, this study points to the potential value of an extensive meta-analysis of client-centered treatment research which would quantitatively integrate and summarize the extant findings regarding this school of psychotherapy.
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