Compliance with Clinical Supervision Guidelines and its Relations with Confidence of the Supervisees / Cumplimiento de las pautas de supervisión clínica y su relación con la confianza de los supervisados

Background: Clinical supervision is a procedure for the training of health psychologists based on the guidance of more expert professionals, who provide guidelines for action. Using observational methodology, the aim of this paper is to study compliance with the guidelines and probably related variables, such as the confidence of the therapists with supervision and its methods. Method: Six novice therapists, seven supervisors, and 31 users participated in the study; all of them belonged to the university clinic of the Universidad Autónoma de Madrid (CPA-UAM). Confidence was assessed using a self-report questionnaire and compliance with the guidelines using an observational rating-scale. Results: The most common method of supervision was discussion; confidence with supervision and its methods were associated with greater compliance with the guidelines. Conclusions: The results of this study open the door to the development of a guide for action for supervisors, helping them in their task. (AU)

Antecedentes: La supervisión clínica es un procedimiento para la formación de psicólogos clínicos y de la salud basado en la guía de profesionales más experimentados, quienes proporcionan pautas de acción. El objetivo de este artículo es estudiar, utilizando metodología observacional, el cumplimiento de las pautas y variables probablemente relacionadas, como la confianza de los terapeutas en la supervisión y sus métodos. Método: Participaron seis terapeutas noveles, siete supervisores y 31 usuarios, todos ellos de la clínica de psicología de la Universidad Autónoma de Madrid (CPA-UAM). La confianza se evaluó mediante un cuestionario de autoinforme y el cumplimiento de las pautas mediante una escala de calificación observacional. Resultados: El método más común de supervisión fue la discusión de casos; la confianza en la supervisión y sus métodos se asoció con un mayor cumplimiento de las pautas. Conclusiones: Los resultados de este estudio abren la puerta al desarrollo de una guía de acción para los supervisores, ayudándolos en su tarea. (AU)

Quantitative Indices of Student Social Media Engagement in Tertiary Education: A Systematic Review and a Taxonomy.

Recent studies have evaluated the use of social media as learning aids in tertiary education. Emerging research in this area has focused primarily on non-quantitative approaches to student social media engagement. However, quantitative engagement outcomes may be extracted from student posts, comments, likes, and views. The goal of the present review was to provide a research-informed taxonomy of quantitative and behavior-based metrics of student social media engagement. We selected 75 empirical studies comprising a pooled sample of 11,605 tertiary education students. Included studies used social media for educational purposes and reported student social media engagement outcomes (source databases: PsycInfo and ERIC). We used independent raters and stringent interrater agreement and data extraction processes to mitigate bias during the screening of references. Over half of the studies (52%, n = 39) utilized ad hoc interviews and surveys to estimate student social media engagement, whereas thirty-three studies (44%) used some form of quantitative analysis of engagement. Based on this literature, we present a selection of count-based, time-based, and text-analysis metrics. The proposed taxonomy of engagement metrics resulting provides the methodological basis for the analysis of social media behavior in educational settings, particularly, for human operant and behavioral education studies. Implications for future research are discussed. Supplementary Information: The online version contains supplementary material available at 10.1007/s10864-023-09516-6.

Asignación de tareas terapéuticas y revisión de su cumplimiento desde una perspectiva conductual: las secuencias verbales entre terapeuta y cliente / Assignment of therapeutic tasks and review of their fulfillment from a behavioral perspective: the verbal sequences between therapist and client

Las tareas terapéuticas (tareas para casa) constituyen una estrategia propia de la psicología conductual para conseguir el cambio clínico. El presente estudio tiene como objetivo determinar cómo los terapeutas conductuales asignan las tareas terapéuticas y cómo revisan el cumplimiento. Se analizó la interacción verbal entre el terapeuta y el cliente en 211 sesiones grabadas (19 casos completos de éxito) mediante metodología observacional, a través del uso de un sistema de categorización (SIS-INTER-INSTR). Los valores de fiabilidad inter e intrajueces fueron entre buenos y excelentes. Los resultados muestran que los psicólogos conductuales emiten verbalizaciones motivadoras cuando asignan tareas terapéuticas. En la revisión del cumplimiento, frecuentemente refuerzan el cumplimiento de las tareas, pero dejan de evaluar el cumplimiento cuando el cliente informa que las ha realizado de forma parcial. Las secuencias verbales obtenidas proporcionan información sobre cómo los terapeutas conductuales dan instrucciones sobre las tareas terapéuticas y como revisan su cumplimiento. Esta información es un primer paso en el estudio de cómo esas secuencias pueden predecir o contribuir al establecimiento de una óptima colaboración terapéutica y a la eficacia del tratamiento. (AU)

Therapeutic (homework) tasks are a characteristic strategy in behavioral psychology to achieve clinical change. The aim of the present study is to determine how behavioural therapists assign therapeutic tasks and review their compliance. Observational methodology was used to analyse the verbal interaction of therapists and clients in 211 recorded sessions (19 complete successful cases) using a validated coding system (SIST-INTER-INSTR). The values for inter- and intra-judge reliability were from good to excellent. The study shows that behavioural psychologists offer motivating verbalisations when assigning therapeutic tasks. During the review of task compliance, therapists frequently provide positive reinforcement when clients report complete compliance with the assigned task but stop the review of tasks when clients report non-compliance or only partial compliance with the task. These sequences provide information about how behavioural therapists provide instructions for therapeutic tasks and review their compliance. This is a first step to study how these verbal sequences favour the establishment of TC and the effectiveness of treatment. (AU)

Comparativa de indicadores clínicos entre terapia presencial y terapia online por videoconferencia: éxito, adherencia al tratamiento y eficiencia / Comparison of clinical indicators between face-to-face therapy and online therapy via videoconference: success, adherence to treatment and efficiency

La terapia psicológica online por videoconferencia ha sido una alternativa ampliamente utilizada tras la pandemia por COVID-19. Este estudio tiene los propósitos de seguir estudiando el éxito de esta modalidad además de otros indicadores clínicos menos estudiados, como la eficiencia y la adherencia al tratamiento en comparación con la terapia en modalidad presencial. Se utilizaron los datos de 174 participantes, 87 de cada modalidad. Ambas modalidades de tratamiento resultaron exitosas, sin haber diferencias entre ellas salvo en el porcentaje de objetivos terapéuticos cumplidos, mayor en la modalidad online. No se encontraron diferencias en adherencia al tratamiento. La eficiencia fue mayor en la modalidad presencial en la fase de tratamiento y en la terapia en su conjunto, no siendo así en la fase de evaluación. Se plantean hipótesis que intentan explicar estas diferencias, entre ellas las referidas a la relación terapéutica, además de abrir la puerta al planteamiento de futuros estudios que continúen en esta línea de investigación. (AU)

Videoconferencing psychotherapy has been a widely used alternative in the aftermath of the COVID-19 pandemic. This study aims to further study the success of this modality and other less studied clinical indicators, such as adherence to treatment and efficiency, compared to the face-to-face modality. Data from 174 participants, 87 of each modality were used. Both treatment modalities were successful, with no differences between them except for the percentage of therapeutic objectives achieved, which was higher in the online modality. No differences were found in adherence to treatment. Efficiency was higher in the face-to-face modality both in the treatment phase and in the therapy as a whole, but not in the assessment phase. We put forward several hypotheses to try to explain these differences, some of them related to the therapeutic relationship. The conclusions of this study open the door to future research lines in the same direction. (AU)

Verbal Behavior Analysis of Expert and Inexperienced Therapists Applying the Socratic Method.

The Socratic method, as an eminently verbal procedure, will be analyzed from a behavioral perspective in order to clarify how verbal conditioning works within. This work compares the verbalizations that expert and inexperienced therapists emit during Socratic method to find out which and why certain therapist verbalizations are most successful in changing client responses. The sample consisted of 113 Socratic method fragments from 18 cases, analyzed by observational methodology. The expert therapists had more than 6 years of experience, the inexperienced less than 2. Experts had fewer failure Socratic method fragments, but there were no differences in successful ones. The way of questioning had a different pattern: Inexperienced therapists suggested more the response, experts used more didactic verbalizations; also, experts used the aversive component more and contingently. The creation of guidelines based on functional description of verbal interaction and the need for novice psychologists training are some implications of these results.

Toward an experimental analysis of verbal shaping in psychotherapy.

AbstractObjective. Some authors have suggested that verbal shaping is an active component in cognitive restructuring. The goal of the current study was to provide experimental evidence in support of the shaping hypothesis. METHOD: Three consecutively admitted adults with symptoms of anxiety and depression participated in the study. Participants underwent baseline, treatment comparison, crossover, and follow-up phases as part of an experimental single-case study. We selected two target irrational beliefs and praised either the client's approximations to a terminal (more adaptive) class of verbalizations (differential reinforcement of approximations) or just the terminal class of verbalizations (terminal reinforcement). RESULTS: Irrational beliefs exposed to differential reinforcement of approximations was a more effective approach to reducing irrational beliefs. CONCLUSION: The study provides experimental evidence in support of the verbal shaping hypothesis. Our findings suggest that it may be possible to enhance clinical outcomes by actively engaging in verbal shaping during client-therapist verbal interaction.

Internet-based cognitive behavioural therapy programme with and without videoconference guidance sessions: A randomized controlled trial to treat work-related symptoms of anxiety and depression.

This study provides the results from the implementation of a highly structured therapist-guided iCBT programme for people with work-related anxiety and depression, in terms of programme efficacy, participants' adherence and satisfaction. Seventy-seven national police workers were randomly allocated to one of two groups: without additional videoconference sessions (web platform with guidance of therapist) and with additional videoconference sessions (same intervention as the previous group, plus two videoconference guidance sessions with a psychologist). The intervention was composed of 12 sessions and took place for 17-20 weeks. We found an adherence rate of 36.4%, with no differences between groups. All participants endorsed lower depression (BDI-II F(1) = 36.98, p < .001; ATQ F(1) = 24.22, p < .001), and anxiety (STAI-State F(1) = 76.62, p < .001) after the programme. As a variable related to anxiety and depression in workplace, participants also showed higher assertiveness levels (RAS F(1) = 8.96, p < .001). A significant reduction of the mean level of anxiety perceived by participants as the intervention programme progressed was observed in both groups (F(2) = 7.44; p = .003). Participants were satisfied with the therapists' intervention and with the programme. No significant group effects were found for any of the measures. Reduction in depression levels was maintained in the 12-month follow-up, but levels of anxiety increased. This study is innovative, as it is the first controlled trial to analyse the effect of two added videoconference sessions, and it includes short- and long-term measures, which is not usual. The results are discussed to clarify the role of the contact with the therapist to improve treatment adherence.

What works in the Socratic debate? An analysis of verbal behaviour interaction during cognitive restructuring.

BACKGROUND: Cognitive restructuring is one of the most complex application procedures in psychotherapy. It is widely used by psychologists from different orientations. However, the guidelines on how to apply it do not usually have empirical evidence and there is a lack of knowledge about the mechanisms of change that explain it. AIMS: The analysis of verbalizations that therapists emit during the Socratic method could help to better understand the functioning and strategies of effective debates. METHOD: In this study, specific verbal interaction sequences were analysed using observational methodology. The sample consisted of 113 Socratic questioning fragments belonging to 18 clinical cases, treated by behavioural therapists. RESULTS: Among other findings, it was found that using questioning together with certain previous verbalizations directed the client's response more effectively and those successful debates were characterized by using the aversive component in a frequent and contingent way. CONCLUSION: This study shows the most effective way to establish such an interaction in the Socratic method (following a style closer to Ellis's argumentative debate), which entails relevant practical applications in therapy.

Applying cognitive restructuring in therapy: The clinical reality in Spain.

Cognitive restructuring is one of the most widely used techniques among psychologists of different orientations. However, there is a lack of clarity in what concerns its precise definition, functioning, effectiveness, and components. OBJECTIVE: To obtain precise information on how psychotherapists use cognitive restructuring in their clinical practice in Spain. METHOD: A survey study was conducted following a descriptive quantitative methodology, with a cross-sectional design and a non-random sampling method. Three hundred and twenty psychotherapists responded to a questionnaire, created ad hoc, on cognitive restructuring. RESULTS: Cognitive restructuring is widely used by therapists with different levels of experience, training, and following different psychotherapeutic approaches. Furthermore, it is applied to address a wide variety of psychological problems. There exist relevant differences in the use of the technique depending on the therapists' level of experience. CONCLUSIONS: This study has shown, for the first time, how cognitive restructuring is applied in daily clinical practice. The main implications of these results are discussed, and new lines of inquiry are proposed. Clinical or methodological significance of this article: This study has contributed to bringing the clinical reality of cognitive restructuring closer to the scientific community, by identifying which of the elements and procedures that are taught or researched are actually applied in daily practice.

A theoretical and methodological proposal for the descriptive assessment of therapeutic interactions.

OBJECTIVE: The goal of this study is to show the development of a strategy for a descriptive assessment of the therapeutic interaction. METHOD: In this study, we develop an observational methodology to analyze the dialogues that took place during 92 sessions conducted in a psychological center in Madrid, Spain, in which 19 adults were treated for various psychological problems by 9 behavioral therapists. A system was developed to codify vocal behavior of both the therapists and the clients; the software The Observer XT was used for recording. Therapeutic interactions were analyzed using sequential analysis. RESULTS: There are three main sequences that synthesize the therapist-client interaction: first, an utterance by the client preceded by a therapist's verbalization, specifically a question (discriminative morphology) and followed by an expression of approval (reinforcement morphology); second, verbalizations of failure or discomfort uttered by the client, followed most often by verbalizations of disapproval (punishing morphology) uttered by the therapist; and third, verbalizations uttered by the client that are discriminated by the therapist after an in-depth explanation and followed by different therapist's utterances (expressions of approval, technical information, etc.). CONCLUSIONS: Depending on how the client responds the results in this study present a starting point for the study of the functional sequences that form the basis of therapeutic change.

Efectos de la detención del pensamiento y la defusión cognitiva sobre el malestar y el manejo de los pensamientos negativos / Effects of thought stopping and cognitive defusion on discomfort and the ability to deal with negative thoughts

Las nuevas terapias conductuales han criticado la eficacia de la detención del pensamiento. En este estudio se compara la eficacia de la detención del pensamiento y la defusion cognitiva sobre el malestar informado y el manejo de los pensamientos negativos. Los 60 participantes fueron asignados aleatoriamente a tres grupos: detención del pensamiento, defusion cognitiva o grupo control. Encontramos que ambas técnicas reducían significativamente el malestar informado en comparación con el grupo control y que existían diferencias significativas entre ambas técnicas en capacidad para manejar los pensamientos y en utilidad percibida, con mejores resultados para la detención del pensamiento. Se concluye que la detención del pensamiento es al menos tan eficaz como la defusion cognitiva, si es entrenada adecuadamente en sesión. Se discuten los mecanismos de funcionamiento y se resalta la importancia de considerar el análisis funcional para seleccionar las técnicas aplicadas para el manejo de pensamientos

Modern behavioral therapies have claimed that thought stopping is an ineffective technique. This study compares the effectiveness of thought stopping and cognitive defusion on self-reported discomfort and the ability to deal with negative thoughts. 60 participants were randomly assigned to three groups: thought stopping, cognitive defusion and control group. Results from our study indicate that both techniques significantly reduced self-reported discomfort compared to the control group and there were significant differences between techniques in self-perceived ability to deal with thoughts and in self-perceived usefulness, with better results for thought stopping. Our results support that thought stopping, if properly trained, is at least as efficient as cognitive defusion. The authors discuss the mechanisms underlying both techniques and highlight the relevance of functional analysis to select the techniques to be applied to deal with negative thoughts

Studying the Therapeutic Process by Observing Clinicians' In-Session Behaviour.

UNLABELLED: This paper presents a further step in the use and validation of a systematic, functional-analytic method of describing psychologists' verbal behaviour during therapy. We observed recordings from 92 clinical sessions of 19 adults (14 women and 5 men of Caucasian origin, with ages ranging from 19 to 51 years) treated by nine cognitive-behavioural therapists (eight women and one man, Caucasian as well, with ages ranging from 25 to 48 years). The therapists' verbal behaviour was codified and then classified according to its possible functionality. A cluster analysis of the data, followed by a discriminant analysis, showed that the therapists' verbal behaviour tended to aggregate around four types of session differentiated by their clinical objective (assessment, explanation, treatment and consolidation). These results confirm the validity of our method and enable us to further describe clinical phenomena by distinguishing psychologists' classes of clinically relevant activities. Specific learning mechanisms may be responsible for clinical change within each class. These issues should be analysed more closely when explaining therapeutic phenomena and when developing more effective forms of clinical intervention. KEY PRACTITIONER MESSAGE: We described therapists' verbal behaviour in a focused fashion so as to develop new research methods that evaluate psychological work moment by moment. We performed a cluster analysis in order to evaluate how the therapists' verbal behaviour was distributed throughout the intervention. A discriminant analysis gave us further information about the statistical significance and possible nature of the clusters we observed. The therapists' verbal behaviour depended on current clinical objectives and could be classified into four classes of clinically relevant activities: evaluation, explanation, treatment and consolidation. Some of the therapist's verbalizations were more important than others when carrying out these clinically relevant activities. The distribution of the therapists' verbal behaviour across classes may provide us with clues regarding the functionality of their in-session verbal behaviour.

Análisis de la conducta verbal del cliente durante el proceso terapéutico / Analysis of the client's verbal behavior during the therapeutic process

En el presente trabajo llevamos a cabo un análisis del cliente centrándonos en la actividad principal que se desempeña en sesión: hablar. Utilizando metodología observacional realizamos un estudio topográfico de la conducta verbal de los clientes a través del desarrollo de un instrumento de medida generado por el grupo de investigación: el Sistema de Categorización de la Conducta Verbal del Cliente (SISC- CVC). Se observaron y registraron 92 sesiones terapéuticas procedentes de 19 casos tratados por 9 terapeutas distintos. Los resultados muestran que, en líneas generales, el cliente principalmente ofrece información descriptiva relevante para la terapia, muestra su aceptación y entendimiento ante verbalizaciones del terapeuta cuya finalidad sea informar, motivar o instruir y expresa en mucha mayor medida contenidos relacionados con el cambio clínico frente a contenidos alejados de los objetivos perseguidos. Podemos concluir, además, que la conducta verbal de los clientes varía en función de la actividad terapéutica que se esté llevando a cabo y es independiente de la problemática tratada, las características personales del cliente o el estilo terapéutico del clínico (AU)

In this paper we conduct an analysis of the client behavior focusing on the main activity that is performed in session: talking. Using observational methodology we performed a topographical study of clients’ verbal behavior through the development of a measuring instrument by our research group: Categorization system of the interaction of client´s verbal behavior during the session (SISC- CVC). 92 clinical sessions from 19 cases treated by 9 therapists were observed and recorded. The results show that, in general, the client mainly provides descriptive information relevant to therapy, shows acceptance and understanding to the therapist’s verbalizations aiming to inform, motivate or instruct, and expresses more frequently contents related to clinical change compared to contents opposed to the objectives pursued. We can also conclude that the clients’ verbal behavior varies depending on the therapeutic activity that is taking place and is independent of the problems treated, the personal characteristics of the client or the clinician's therapeutic style (AU)

Descriptive study of the Socratic method: evidence for verbal shaping.

In this study we analyzed 65 fragments of session recordings in which a cognitive behavioral therapist employed the Socratic method with her patients. Specialized coding instruments were used to categorize the verbal behavior of the psychologist and the patients. First the fragments were classified as more or less successful depending on the overall degree of concordance between the patient's verbal behavior and the therapeutic objectives. Then the fragments were submitted to sequential analysis so as to discover regularities linking the patient's verbal behavior and the therapist's responses to it. Important differences between the more and the less successful fragments involved the therapist's approval or disapproval of verbalizations that approximated therapeutic goals. These approvals and disapprovals were associated with increases and decreases, respectively, in the patient's behavior. These results are consistent with the existence, in this particular case, of a process of shaping through which the therapist modifies the patient's verbal behavior in the overall direction of his or her chosen therapeutic objectives.

La importancia de las instrucciones del psicólogo para favorecer la adhesión terapéutica / The importance of psychologist's instructions for the improvement of therapeutic adherence

En el presente trabajo ofrecemos una aproximación descriptiva al estudio de las instrucciones en terapia como paso previo al estudio de la influencia de las instrucciones en la adhesión terapéutica. Se analizaron dos casos completos tratados por dos terapeutas de orientación conductual, uno experto y uno inexperto. Se observaron y registraron las sesiones clínicas por medio de un sistema de categorías utilizando el software The Observer XT. Los datos ponen de relieve ciertas diferencias en la frecuencia y el tipo de instrucciones dadas, según las tareas realizadas por el clínico dentro de sesión y la experiencia de éste. Los resultados permiten establecer unas hipótesis (a confirmar) sobre la existencia de patrones a la hora de instruir al cliente durante la terapia y establecer algunas bases para estudiar la influencia de las instrucciones sobre la adhesión terapéutica y poder mejorar la eficacia de las intervenciones psicológicas (AU)

This paper presents a first descriptive approach to the study of instructions in therapy as a previous step to a more comprehensive research about the influence of instructions on therapeutic adherence. Two cases treated by two behavioral therapists were analyzed throughout the treatment -one of them was an experienced therapist and the other was inexperienced one. The sessions were observed and registered with a specific coding system and The Observer XT software. Data highlight the differences in frequency and type of instructions depending on the tasks carried out by the therapists, as well as on their experience. Results provide some first hypotheses (to be proved) about the existence of different patterns of therapist instructions during the psychological treatment and allow us to establish some bases for the study of the influence of instructions on therapeutic adherence which may improve the effectiveness of psychological interventions (AU)

Functional analysis of the verbal interaction between psychologist and client during the therapeutic process.

The goal of this study is to analyze the verbal interaction that takes place between client and therapist over the course of a clinical intervention so as to analyze the potential learning processes that may be responsible for changes in the client's behavior. A total of 92 sessions were analyzed, corresponding to 19 clinical cases treated by 9 therapists specializing in behavioral therapy. The variables considered were therapist and client verbal behaviors, and these were categorized according to their possible functions and/or morphologies. The Observer XT software was used as a tool for the observational analysis. The results led to the conclusion that the therapist responds differentially to client verbalizations, modifying the verbal contingencies as his or her client content approaches or becomes more distant from therapeutic objectives. These results suggest the possible existence of verbal "shaping" processes through which the therapist guides the client's verbal behavior toward more adaptive forms. In addition, this study proposes an alternative to the traditional controversy regarding the relevance of the therapeutic relationship versus the treatment techniques used to explain clinical change. This article suggests that such differentiation is unnecessary because the therapeutic relationship and the treatment techniques should act in the same manner, this is, in providing the context for the occurrence of what is truly therapeutic, namely, the learning processes.

Investigación de resultados y de procesos sobre la técnica de reestructuración cognitiva / Research results and technical processes on cognitive restructuring

En este trabajo se presenta una revisión actualizada de la literatura científica que existe sobre la reestructuración cognictiva, tanto en cuanto a los estudios de los resultados como de proceso. Se ha escogido esta técnica de entre las muchas posibles por su relevancia clínica y por la cantidad de aspectos que quedan sin resolver en la literatura. Se comienza con una exposición de las principales carazterísticas de la investigación de resultados (estudio de los tratamientos de elección para distintos problemas psicológicos) y de la investigación de procesos (estudi de los mecanismos responsables del cambio) en la psicoterapia en general; más adelante se hace un resumen de ambos tipos de estudios en la reestructuración cognictiva. Se puede concluir que la reestructuración funciona, pero continuamos sin conocer cuáles son los mecanismos responsables de su éxito. Se apunta que es necesaria la investigación de lainteracción terapeuta-cliente para poder avanzar en el tema(AU)

This paper presents an updated review of scientific literature exists on the restructuring cognictiva, both in terms of outcome studies and process. This technique was chosen from among the many possible clinical relevance for and the number of issues still unresolved in the literature. It begins with an outline of the main carazterísticas of outcomes research (the study of different treatments of choice for psychological problems) and the research process (students of the mechanisms of change) in psychotherapy in general later a summary of both types of studies cognictiva restructuring. It can be concluded that the restructuring work, but we still do not know what are the mechanisms responsible for its success. It is noted that research is needed lainteracción therapist-client to make progress in the field(AU)

Guía para el uso de la reestructuración cognitiva como un procedimiento de moldeamiento / Guide to use cognitive restructuring as a shaping procedure

La modificación de conducta surgió como una alternativa de evaluación y tratamiento asentada en una fuerte base teórica y una sólida fundamentación experimental. La llamada revolución cognitiva supuso la introducción de una serie de variables mediacionales que contribuyeron al alejamiento progresivo de las técnicas de estos principios. El objetivo de nuestra línea de investigación es retomar el análisis de los procesos de aprendizaje que supuestamente subyacen a la intervención, eligiendo para el trabajo que presentamos la técnica de reestructuración cognitiva y, concretamente, el procedimiento de debate. Este estudio fue realizado analizando la conducta verbal de terapeuta y cliente durante la interacción clínica en 65 fragmentos de reestructuración correspondientes a siete casos clínicos. Los resultados del análisis secuencial confirman la hipótesis del moldeamiento según la cual el debate puede formularse como un proceso en el cual el psicólogo va reforzando las verbalizaciones del cliente según se aproximen a la verbalización (racional/adaptativa) final, al tiempo que castiga y/o extingue aquellas que se alejan. A partir de los resultados se sugieren algunas líneas de intervención que podría utilizar el terapeuta en su práctica clínica (AU)

Behavior modification emerged as an alternative for assessment and treatment founded on strong theoretical and experimental bases. The so-called cognitive revolution marked the introduction of a series of mediational variables that contributed to the progressive deviation of the techniques from these principles. The aim of our line of research is to return to the analysis of the learning processes that presumably underlie intervention, choosing for this work the cognitive restructuring technique and, specifically, the Socratic Method. For this study we analyzed the therapist’s and client’s verbal behavior during the clinical interaction in 65 fragments of cognitive restructuring from seven different clinical cases. Results of sequential analysis support the shaping hypothesis whereby the Socratic Method could be defined as a process in which the psychologist reinforces the client’s verbalizations as they come closer to the final verbalization (rational / adaptive); at the same time, the psychologist punishes and / or extinguishes those verbalizations that move away from such verbalization. Some intervention guidelines for the clinical practice of therapists are suggested based on these results

Estudio comparativo de la conducta verbal del terapeuta según su experiencia durante la evaluación clínica / Comparative study of therapist’s verbal behavior according its experience during clinical assessment

En el presente trabajo se ha realizado una primera aproximación al estudio de las diferencias entre terapeutas con diversos grados de experiencia. La lógica de este tipo de trabajos se centra en el supuesto de que el terapeuta experto es el que lo hace bien y analizar su comportamiento nos permitirá aprender cómo hacer terapia más eficientemente. La metodología de trabajo empleada es la observación y análisis de sesiones terapéuticas grabadas directamente y registradas mediante un sistema de categorías construido a tal efecto. Los resultados muestran que las categorías Función Discriminativa, Función de Refuerzo y Otras son las más utilizadas por los terapeutas inexpertos mientras que las categorías Función de Castigo, Función Evocadora, Función Motivadora, Función Instruccional y Función Informativa son las más usadas por expertos, observándose en la mayoría de los casos valores intermedios en los terapeutas de mediana experiencia. A pesar de las limitaciones encontradas, estos resultados indican que pueden existir diferencias tanto cuantitativas como cualitativas respecto a lo que hacen los terapeutas en sesión en función de su grado de experiencia (AU)

The present study is an initial approach to the study of differences between therapists with regard to their experience level. This type of study is based on the assumption that it is the expert therapist who does things well, and that the analysis of his/her behaviour will enable us to learn how to do therapy more efficiently. We used an observational methodology for the analysis of video-taped sessions. Verbal behaviour was coded with a coding system created for that purpose. Results show that the Discriminative, Reinforcement and “Others” functions were the most used by inexpert therapists, while Punishment, Elicitation, Motivating, Instructional, and Informative were the functions most used by expert therapists. Intermediate values were observed for most therapists with a middle degree of experience. Despite certain limitations, results indicate that there may be quantitative, as well as qualitative, differences with respect to what therapists do in session as a function of their experience level (AU)

Descriptive analysis of the verbal behavior of a therapist: a known-group validity analysis of the putative behavioral functions involved in clinical interaction.

This study analyzes the interobserver agreement and hypothesis-based known-group validity of the Therapist's Verbal Behavior Category System (SISC-INTER). The SISC-INTER is a behavioral observation protocol comprised of a set of verbal categories representing putative behavioral functions of the in-session verbal behavior of a therapist (e.g., discriminative, reinforcing, punishing, and motivational operations). The complete therapeutic process of a clinical case of an individual with marital problems was recorded (10 sessions, 8 hours), and data were arranged in a temporal sequence using 10-min periods. Hypotheses based on the expected performance of the putative behavioral functions portrayed by the SISC-INTER codes across prevalent clinical activities (i.e., assessing, explaining, Socratic method, providing clinical guidance) were tested using autoregressive integrated moving average (ARIMA) models. Known-group validity analyses provided support to all hypotheses. The SISC-INTER may be a useful tool to describe therapist-client interaction in operant terms. The utility of reliable and valid protocols for the descriptive analysis of clinical practice in terms of verbal behavior is discussed.