REALITY CREATION VERSUS REALITY CONFIRMATION: A PROCESS STUDY IN MARITAL THERAPY (FAMILY THERAPY, PSYCHOTHERAPY, PROVERS RESEARCH, MENTAL HEALTH)

MARCIA DOROTHY BROWN STANDRIDGE, Purdue University

Abstract

Purpose of the Study. This study examined in-therapy client behaviors before and after use of two marital therapy interventions, reflection and reframing, and made comparisons. In addition, observations of couple-therapist interactions were compared with therapists' own awareness and assessment. Procedure. A coding system was developed for coders to track observations of husband-wife and couple-therapist patterns prior to and immediately following use of reflection and reframing. Six experienced therapists were trained for effective delivery of these techniques. Only effective interventions were isolated for coding from 26 early-session videotapes. Coders were trained to an interrater reliability criterion of 91% agreement. Videotapes of two sessions were coded for each of 13 cases, resulting in the coding of a total sample of 628 pre- and post-intervention sequences. In addition to examining statistically the conditional probability of resulting behaviors and patterns, a questionnaire was administered to the therapists to examine their own impressions regarding clinical decision of when to use reflections and reframes. Quantitative Findings. (1) Reliability tests supported use of the coding system in future research. (2) Spouses typically talked about each other to the therapist. (3) Wives were speakers more often before and after intervention. (4) Therapists tended to use more reframing following positive spousal behavior and more reflection following negative spousal behavior. (5) Husbands were more likely to disqualify or ignore reflections and to agree with reframes; for wives, the reverse was true. (6) Husbands were more likely to have a negative response to reframes from females, and to reflections from males. (7) Male therapists proportionately used more reflections than female therapists with Nonattentive husbands. (8) Reframes were significantly more common during Later Sessions. Qualitative Findings. (1) Therapists were aware that they used reflection more when spouses were not as "open" to what they had to say. They used reframing more when they felt "joined" enough to venture new ideas. (2) Therapists were typically not aware of treating husbands and wives differently. Conclusions. The results of this process study suggest that experienced therapists choose to reflect or reframe based on the valence of spouses' pre-intervention behaviors. Spousal response may be tied to client/therapist gender differences.

Degree

Ph.D.

Subject Area

Psychotherapy|Mental health

COinS