Open Door Review

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8)<<$!=>_!G!A$*D$2%&$!V>![+,,\^>!"#0!8)<<23)%2($Y0!;*(0%27($)*6!Q72<0?!=!*0Z!(%2*67%$1(E3260&!90(#)&!:)%!(#0! 26606690*(!):!(#0%210B($7!2<<$2*70!%B1(B%06!2*&!%06)! '(A?-",-%#@:A&3%(%@#?- _! Id _! d-bEdP]>! A$*D$2%&$!V>_!8)<<$!=>_!S0*($<0!O>_!G!"2*C$<<$!=>![+,--^>!'c1<)%2($)*!):!6066$)*!1%)7066?!50<2($)*6#$1!()!&01(#!2*&!! 2<<$2*70>! '(A?-",-%#@:A _! le _!P\-E],,>! A$*D$2%&$!V>![+,-P^>!"%4$*D!()!30!B60:B! '(A?-",-%#@:AO&JH _!]-PE]-b>! >-001(3! The goal of our studies was to investigate the relationship between psychotherapy process, therapeutic alliance, and therapist activity using an assessment method based on therapy sessions’ transcripts. The research design implied that independent raters evaluated psychotherapy sessions of various theoretical approaches (mostly psychodynamic and cognitive– behavioral) with different process measures. In a first study, we presented the validation and the application of a new rating system for the assessment of alliance ruptures and repairs in psychotherapy: the Collaborative Interactions Scale (CIS; Colli, Lingiardi, 2009). The CIS (composed of two main scales: one for the evaluation of patient rupture and collaborative processes, CIS-P, and one for the evaluation of therapist positive and negative contributions to the therapeutic relationship, CIS-T) furnishes a great deal of information about: 1) the patient capacity to self-disclose intimate and salient information in session, to experience emotions in a modulated fashion, to work actively with the therapist’s comments, or to deepen the exploration of salient themes; and 2) two main aspects of therapist activities: the quality of the intervention (timing, attunement, tactfulness, comprehensibility) and their form (e.g., clarification, confrontation, interpretation). The CIS is a reliable rating system, useful in both empirical research and clinical assessments. In the second study, we explored the relationship between the depth of elaboration, the therapeutic alliance, and some dimensions of psychotherapy process (including the therapist’s interventions, the patient’s contributions, and patient/therapist’s patterns of interaction) evaluated with the Psychotherapy Process Q-Set (PQS; Jones, 1985, 2000). In line with the findings of Blagys and Hilsenroth (2000), our research showed the importance of therapist interventions that focus on the patient’s affects (particularly those regarded as unacceptable emotions and feelings), recurring and enduring interpersonal patterns, and the “here and now” of the relationship in the increase of the depth of elaboration and patient/therapist alliance (see also Lingiardi, 2013). @)15-1.*$#! The aims of these studies were to study in a clinically articulated and empirically grounded way the psychotherapy process in order to clarify what happens during the session, which kind of therapist interventions are more effective in relation to specific process factors (such as the depth of elaboration, or ruptures and resolutions processes), and which kind of patient/therapist dynamics are related to a good therapeutic relationship. The main limitations is that for the moment we studied only the observer perspective of evaluation; even if our findings are in line with previous studies that use both patient and therapist perspectives, in the future it will be necessary to investigate all the three perspectives simultaneously.

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