Functional Behavioral Assessment-based interventions on adults' delusions, hallucinations and disorganized speech: A single case meta-analysis.

The Functional Behavioral Assessment (FBA) approach involves the use of single-case designs (SCD) to study the problem behavior-environment contingencies and conduct interventions that consider this functional relationship. Although this approach has been considered an evidence-based practice (EBP) for the treatment of several psychological problems, no meta-analytic studies of FBA-based interventions on delusions, hallucinations and disorganized speech -commonly operationalized as "atypical vocalizations"- have been carried out. Therefore, the purpose of this study was to review and synthesize the results of FBA-based interventions on adults' atypical vocalizations. We conducted a systematic review and a multi-level meta-analysis of these interventions, using a recently developed effect size estimator for SCD studies (i.e., log response ratio). All the studies that met our eligibility criteria provided evidence supporting the effectiveness of FBA-based interventions on atypical vocalizations, with an overall average effect size of a 72% reduction. Both the publication year and the methodological quality were found to be significant moderators. Despite some methodological limitations, we can conclude that FBA-based interventions are effective to reduce atypical vocalizations. The implications of these results could be of interest for the mental health community.

Rule Emission: A Possible Variable for Improved Therapeutic Practice.

It has been suggested that achieving greater effectiveness in psychotherapeutic treatment requires analyzing what therapists actually do and say, how they do this and when it is done. Based on this approach, in this study we focused on the rules emitted by therapists, since providing rules is thought to be of fundamental importance in promoting effective and efficient clinical change. Specifically, we sought to determine whether the experience level of therapists and the brevity of therapy would be related to patterns of therapist rule emission as categorized by the Category System of Rules emitted by the Therapist (SISC-RULES-T) (Vargas-de la Cruz & Pardo-Cebrián, 2014). Greater therapist experience and shorter therapy duration were found to be reliably predictive of more rule emissions across most rule categories (Z values between: Z = -3.68 and Z = -2.05; p values: p < .05 and p < .001). These variables were also predictive of more emissions of rules that specified all three operant contingency elements (situation, behavior, and consequence) rather than fewer elements (Z = -2.59, p < .05; Z = -2.26, p < .05). In the expert therapists and therapist with shorter cases, there was a nonsignificant tendency for the emission of general and conceptual rules to increase over sessions whereas emissions of concrete and particular rules tended to decrease; the explicitness of the three contingency elements also tended to decrease as treatment progressed. These findings may help to identify verbal characteristics of therapists that could lead to improved therapeutic practice.

Una Extensión del Concepto de Regla y su Aplicación a la Terapia Psicológica / An extension of the concept of rule and its application to therapy

Proporcionar y seguir reglas se ha considerado un factor importante en la eficacia de los tratamientos psicológicos; sin embargo, hace falta una clarificación conceptual de lo que se entiende por emitir o seguir una regla y su aplicación en el ámbito clínico. Partiendo de una revisión sobre el concepto original de conducta gobernada por reglas, nuestro propósito fue extender la definición de esta conducta orientada al proceso terapéutico. Esta definición permite su identificación y estudio momento a momento a lo largo del proceso. La extensión de esta definición puede ayudarnos a identificar el papel funcional de las reglas en el cambio terapéutico y las variables involucradas que contribuyen al entendimiento de fenómenos clínicos como la generalización. Los hallazgos que se desprendan del estudio de las reglas desde esta perspectiva podrían contribuir a aumentar la información sobre el proceso de cambio terapéutico y la mejora del ejercicio clínico

Providing and following rules has been considered an important factor in the effectiveness of psychological treatments; however, a conceptual clarification is needed of what is meant by issuing or following a rule and its application in the clinical setting. Based on a review of the original concept of rule-governed behavior, our purpose was to extend the definition of this behavior oriented to the clinical process. This definition allows its identification and study moment by moment throughout the therapeutic process. The extension of this definition can help us to identify the al role of rules in clinical change and the variables involved that contribute to the understanding of clinical phenomena such as generalization. The findings that emerge from the study of rules from this perspective could increase the information on the therapeutic change process and, therefore, contribute to the improvement of clinical practice

Rule emission: a possible variable for improved therapeutic practice

It has been suggested that achieving greater effectiveness in psychotherapeutic treatment requires analyzing what therapists actually do and say, how they do this and when it is done. Based on this approach, in this study we focused on the rules emitted by therapists, since providing rules is thought to be of fundamental importance in promoting effective and efficient clinical change. Specifically, we sought to determine whether the experience level of therapists and the brevity of therapy would be related to patterns of therapist rule emission as categorized by the Category System of Rules emitted by the Therapist (SISC-RULES-T) (Vargas-de la Cruz & Pardo-Cebrián, 2014). Greater therapist experience and shorter therapy duration were found to be reliably predictive of more rule emissions across most rule categories (Z values between: Z = -3.68 and Z = -2.05; p values: p < .05 and p < .001). These variables were also predictive of more emissions of rules that specified all three operant contingency elements (situation, behavior, and consequence) rather than fewer elements (Z = -2.59, p < .05; Z = -2.26, p < .05). In the expert therapists and therapist with shorter cases, there was a nonsignificant tendency for the emission of general and conceptual rules to increase over sessions whereas emissions of concrete and particular rules tended to decrease; the explicitness of the three contingency elements also tended to decrease as treatment progressed. These findings may help to identify verbal characteristics of therapists that could lead to improved therapeutic practice

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Cognitive techniques and language: A return to behavioral origins / Técnicas cognitivas y lenguaje: un regreso a los orígenes conductuales

Background: the main purpose of this study is to offer an alternative explanatory account of the functioning of cognitive techniques that is based on the principles of associative learning and highlights their verbal nature. The traditional accounts are questioned and analyzed in the light of the situation of psychology in the 1970s. Method: conceptual analysis is employed to revise the concepts of language, cognition and behavior. Several operant- and Pavlovian-based approaches to these phenomena are presented, while particular emphasis is given to Mowrer’s (1954) approach and Ryle (1949) and Wittgenstein’s (1953) philosophical contributions to the field. Conclusions: several logical problems are found in regard to the theoretical foundations of cognitive techniques. A combination of both operant and Pavlovian paradigms based on the above-mentioned approaches is offered as an alternative explanatory account of cognitive techniques. This new approach could overcome the conceptual fragilities of the cognitive standpoint and its dependence upon constructs of dubious logical and scientific validity (AU)

Antecedentes: el objetivo de este trabajo es proponer una alternativa explicativa al funcionamiento de las técnicas cognitivas basándonos en los procesos de aprendizaje asociativo y destacando su carácter verbal; se cuestionan las explicaciones tradicionales, que se analizan a la luz de la situación de la psicología en los años 70 del siglo pasado. Método: se emplea el análisis conceptual para revisar los conceptos de lenguaje, cognición y conducta y se presentan las propuestas desarrolladas para su estudio desde planteamientos operantes y pavlovianos, haciendo especial hincapié en las aportaciones de Mowrer (1954) y en los planteamientos filosóficos de Ryle (1949) y Wittgenstein (1953). Conclusiones: se detectan una serie de problemas lógicos en los fundamentos de las terapias cognitivas. La combinación de los paradigmas operante y pavloviano y su soporte filosófico en las propuestas señaladas suponen una superación de dichas flaquezas y permiten una explicación del funcionamiento de las técnicas cognitivas sin necesidad de recurrir a constructos de dudosa validez lógica y científica (AU)

Las verbalizaciones tipo regla del terapeuta a lo largo del proceso clínico / The Therapist's rule-like Verbalizations throughout the Clinical Process

RESUMEN Se ha reconocido la importancia de las reglas del cliente para explicar un problema psicológico y para lograr superarlo. Sin embargo, no se ha incidido en el papel que podrían tener las reglas del terapeuta en el proceso clínico. Como un primer paso para poder dar una respuesta al respecto, en este estudio realizamos un análisis morfológico de las verbalizaciones en forma de regla emitidas por el terapeuta a lo largo del proceso clínico con el fin de identificar un patrón de emisión de este tipo de verbalizaciones que cambie de acuerdo con los distintos momentos de la terapia. Se analizaron las verbalizaciones en forma de regla emitidas por 9 terapeutas a lo largo de 19 casos clínicos (92 sesiones). Las verbalizaciones se codificaron de acuerdo con un Sistema de Categorización de las Reglas del Terapeuta (SISC-REGLAS-T). Los resultados mostraron diferencias entre el tipo de verbalizaciones en forma de regla y el objetivo que el terapeuta persigue alcanzar en los distintos momentos de la terapia. Estos resultados pueden ayudar a comprender cómo el terapeuta utiliza las verbalizaciones en forma de reglas, lo que contribuye al esclarecimiento del papel de las reglas que emite el terapeuta para conseguir el cambio clínico.

ABSTRACT It has been pointed out the importance of the rules to explain and to treat psychological problems. However it hasn't emphasize the role that the therapist's rules could have in clinical process. As a first step to give an answer, we realize a morphological analysis of verbalization- like-rule emitted by the therapist throughout the clinical process with the aim to identify a patron of emission of this kind of verbalization that changes according to different moments of therapy. This study analyzed the verbalization-like-rules emitted by 9 therapists over 19 clinical cases (92 sessions). The verbalizations were coded according to a system of categorization of the Rules Therapist (SISC-RULES-T). The results showed differences between the type of verbalizations-like-rules and target the therapist aims to achieve at different times of therapy. These results may help to understand how the therapist uses this kind of verbalizations, helping to clarify the functional role of rules issued by the therapist for clinical change.

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.

Verbal interaction patterns in the clinical context: a model of how people change in therapy.

BACKGROUND: The paper "Why do people change in therapy? A preliminary study" (2006), published in this journal, led to the beginning of a line of research based on observational methodology and aimed at the clarification of the therapeutic process. Throughout these years, significant progress has been made towards an explanation of clinical change. In this paper, a synthesis of this line of research is presented, along with a series of conclusions that can, to some extent, provide an answer to the questions we posed in the aforementioned first paper. METHOD: Verbal behavior both of therapist and client was coded for 92 clinical sessions using the Verbal Behavior Interaction Category System (SISC-INTER-CVT). Descriptive and sequential analyses of the observations were then performed. RESULTS: The data show the existence of certain patterns of verbal interaction that are related to the clinically relevant activities undertaken by the therapist, from which a model for verbal interaction in the clinical context was developed. CONCLUSIONS: The functional analysis of the therapist-client verbal interaction is essential for the comprehension of the processes that explain clinical change as well as for the improvement of the quality of psychological therapy.

Verbal interaction patterns in the clinical context: A model of how people change in therapy / Patrones de interacción verbal en el contexto clínico: un modelo de cómo la gente cambia en terapia

BACKGROUND: The paper 'Why do people change in therapy? A preliminary study' (2006), published in this journal, led to the beginning of a line of research based on observational methodology and aimed at the clarification of the therapeutic process. Throughout these years, significant progress has been made towards an explanation of clinical change. In this paper, a synthesis of this line of research is presented, along with a series of conclusions that can, to some extent, provide an answer to the questions we posed in the aforementioned first paper. METHOD: Verbal behavior both of therapist and client was coded for 92 clinical sessions using the Verbal Behavior Interaction Category System (SISC-INTER-CVT). Descriptive and sequential analyses of the observations were then performed. RESULTS: The data show the existence of certain patterns of verbal interaction that are related to the clinically relevant activities undertaken by the therapist, from which a model for verbal interaction in the clinical context was developed. CONCLUSIONS: The functional analysis of the therapist-client verbal interaction is essential for the comprehension of the processes that explain clinical change as well as for the improvement of the quality of psychological therapy

ANTECEDENTES: el artículo publicado en esta revista '¿Por qué la gente cambia en terapia? Un estudio preliminar' (2006) supuso el inicio de una línea de investigación basada en metodología observacional, dirigida a clarificar el proceso terapéutico. A lo largo de estos años han sido grandes los avances en la explicación del cambio clínico. En este artículo se presenta una síntesis de esta línea de investigación, aportando una serie de conclusiones que, en cierta medida, dan respuesta a muchos de los interrogantes que presentábamos en ese primer trabajo al que hacíamos referencia. MÉTODO: se registró la conducta verbal de terapeutas y clientes en 92 sesiones clínicas, mediante el sistema de categorización de la interacción de la conducta verbal en terapia (SISC- INTER- CVT). A continuación, se realizó un análisis descriptivo y secuencial de las observaciones. RESULTADOS: los datos mostraron la existencia de ciertos patrones de interacción verbal, relacionados con las actividades clínicamente relevantes desempeñadas por el terapeuta, a partir de los cuales se desarrolló un modelo de interacción verbal en el contexto clínico. CONCLUSIONES: el análisis funcional de la interacción verbal terapeuta-cliente resulta imprescindible para comprender los procesos que explican el cambio clínico y aumentar la calidad de la terapia psicológica

A translational approach to the functional analysis of language in psychotherapy / Un enfoque traslacional aplicado al análisis funcional del lenguaje en psicoterapia

The functional analysis of verbal behavior has been successful in establishing basic and advanced forms of language in individuals with developmental disabilities. The development of behavioral approaches to psychotherapy, such as the functional-analytic psychotherapy, have advanced the implementation of operant analyses of verbal behavior among typical adults. The field of behavior-analytic approaches to psychotherapy departs from the applied experimental research in behavior analysis in various ways: (a) minimal use of molecular analyses of behavioral processes using single-subject experimentation, (b) confined use of functional analysis and function-driven intervention, and (c) metaphoric use of mainstream behavioral concepts and methods. The breakthroughs brought about by behavioral approaches to psychotherapy may be supplemented by way of translating some of the findings of the applied experimental literature. The present analysis illustrates how behavioral processes demonstrated in the context of experimental research, often with individuals with developmental and intellectual disabilities, may be relevant to psychotherapy with typically-developed adults. This translational approach is discussed with reference to basic language processes: echoics, mands, tacts, and intraverbal dynamics. This approach could prompt programmatic translational research in the field of behavioral psychotherapies (AU)

El análisis funcional de la conducta verbal ha alcanzado un éxito notable en el establecimiento de operantes verbales básicas y avanzadas en personas con trastornos del desarrollo. El avance de aproximaciones conductuales a la psicoterapia, tales como la psicoterapia analítico-funcional, ha impulsado la aplicación de análisis operantes a la conducta verbal en adultos. Las psicoterapias analítico-conductuales se diferencian de la investigación experimental aplicada en análisis de conducta en varios aspectos: (a) ausencia de análisis moleculares de procesos conductuales usando metodología experimental de caso único, (b) uso limitado del análisis funcional y la intervención funcional, y (c) uso metafórico de conceptos y métodos clásicos. Los avances favorecidos por las psicoterapias conductuales podrían enriquecerse mediante la trasferencia de resultados de investigación procedentes de la investigación aplicada experimental. El presente análisis ilustra cómo procesos conductuales demostrados en el contexto de la investigación experimental con personas con trastornos del desarrollo y discapacidad intelectual pueden ser relevantes a población adulta con desarrollo típico y pueden conducir a la transferencia de resultados entre ambas áreas. Nuestro análisis se centra en procesos verbales básicos que incluyen la ecoica, el mando, el tacto y las dinámicas intraverbales. Este enfoque podría facilitar el desarrollo de investigación programática traslacional en el ámbito de las psicoterapias conductuales (AU)

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.

A translational approach to the functional analysis of language in psychotherapy.

The functional analysis of verbal behavior has been successful in establishing basic and advanced forms of language in individuals with developmental disabilities. The development of behavioral approaches to psychotherapy, such as the functional-analytic psychotherapy, have advanced the implementation of operant analyses of verbal behavior among typical adults. The field of behavior-analytic approaches to psychotherapy departs from the applied experimental research in behavior analysis in various ways: (a) minimal use of molecular analyses of behavioral processes using single-subject experimentation, (b) confined use of functional analysis and function-driven intervention, and (c) metaphoric use of mainstream behavioral concepts and methods. The breakthroughs brought about by behavioral approaches to psychotherapy may be supplemented by way of translating some of the findings of the applied experimental literature. The present analysis illustrates how behavioral processes demonstrated in the context of experimental research, often with individuals with developmental and intellectual disabilities, may be relevant to psychotherapy with typically-developed adults. This translational approach is discussed with reference to basic language processes: echoics, mands, tacts, and intraverbal dynamics. This approach could prompt programmatic translational research in the field of behavioral psychotherapies.

El análisis funcional de la conducta verbal ha alcanzado un éxito notable en el establecimiento de operantes verbales básicas y avanzadas en personas con trastornos del desarrollo. El avance de aproximaciones conductuales a la psicoterapia, tales como la psicoterapia analítico-funcional, ha impulsado la aplicación de análisis operantes a la conducta verbal en adultos. Las psicoterapias analítico-conductuales se diferencian de la investigación experimental aplicada en análisis de conducta en varios aspectos: (a) ausencia de análisis moleculares de procesos conductuales usando metodología experimental de caso único, (b) uso limitado del análisis funcional y la intervención funcional, y (c) uso metafórico de conceptos y métodos clásicos. Los avances favorecidos por las psicoterapias conductuales podrían enriquecerse mediante la trasferencia de resultados de investigación procedentes de la investigación aplicada experimental. El presente análisis ilustra cómo procesos conductuales demostrados en el contexto de la investigación experimental con personas con trastornos del desarrollo y discapacidad intelectual pueden ser relevantes a población adulta con desarrollo típico y pueden conducir a la transferencia de resultados entre ambas áreas. Nuestro análisis se centra en procesos verbales básicos que incluyen la ecoica, el mando, el tacto y las dinámicas intraverbales. Este enfoque podría facilitar el desarrollo de investigación programática traslacional en el ámbito de las psicoterapias conductuales.

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.

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.

El Proceso Terapéutico "Momento a Momento" desde una Perspectiva Analítico-Funcional / A "Moment-to-Moment" Analysis of the Therapeutic Process Using a Functional-Analytic Approach

Este trabajo describe cómo se desarrolla el proceso terapéutico en un caso concreto mediante el estudio de las posibles funciones de la conducta verbal del terapeuta durante la interacción con su cliente. Para ello, se procedió a la observación de las grabaciones de las 10 sesiones que constituyeron la totalidad de la intervención terapéutica del caso estudiado. La categorización del comportamiento verbal del psicólogo en sesión fue realizada mediante el software The Observer® XT y la aplicación del Sistema de Categorización de la Conducta Verbal del Terapeuta (SISC-CVT) desarrollado por las autoras y asociado a altos niveles de concordancia inter e intra observadores. El análisis de los registros permitió una primera aproximación a la formulación de una "radiografía funcional" del proceso terapéutico que puede tener importantes implicaciones para el estudio y comprensión del fenómeno clínico así como para el diseño, entrenamiento y aplicación de formas más efectivas de intervención psicológica (AU)

This study analyzes the potential functions of the therapist's verbal behavior during actual in-session therapist-client interactions. The complete therapeutic process of a clinical case was recorded (10 sessions). The therapist's verbal behavior was coded by means of The Observer® XT software and the Therapists' Verbal Behavior Category System (SISC-CVT), which has shown high levels of inter and intra-rater agreement. Results showed a descriptive analysis of the therapeutic process. Our results help to understand the functional relations and learning mechanisms that may be involved during in-session verbal interaction. The approach illustrated in the present study could serve a first step to designing, training and putting into practice more effective psychological interventions (AU)

Aproximación al Estudio Funcional de la Interacción Verbal entre Terapeuta y Cliente Durante el Proceso Terapéutico / An Approach to the Functional Study of the Verbal Interaction Between Therapist and Client During the Therapeutic Process

En este trabajo se presenta el desarrollo de un sistema de categorías de la conducta verbal del terapeuta (SISC-CVT) y su aplicación para el análisis de sesiones de terapia; el objetivo fue identificar topografías del comportamiento verbal de los clínicos que podrían corresponderse con las posibles funcionalidades de tal comportamiento. Se trabajó con 101 sesiones procedentes de 21 casos de adultos tratados por 8 terapeutas. La hipótesis de partida era que las categorías de la conducta verbal de los terapeutas se distribuirían en la intervención clínica de manera que se podría establecer un modelo de actuación verbal relacionado con el objetivo clínico durante el proceso terapéutico. Los resultados de los análisis realizados confirman esta hipótesis y permiten afirmar que lo que se relaciona con el tipo de comportamiento verbal emitido por los terapeutas es la actividad clínicamente relevante que se está llevando a cabo en sesión. Según estos resultados los terapeutas realizan cuatro tipos de actividades clínicamente relevantes (evaluación, explicación, tratamiento y consolidación del cambio) que están relacionadas con el tipo de categorías de la conducta verbal que predomina en cada una de ellas más que con el momento temporal de la terapia en el que tienen lugar (AU)

This paper presents the development process of a coding system of the verbal behavior of therapists (SISC-CVT) and its application in the analysis of a series of clinical sessions. The aim was to identify topographies of the clinicians' verbal behavior that could be related to the hypothesized functions of this behavior. We analyze the recordings of 101 sessions, corresponding to 21 adult clinical cases. The initial hypothesis was that the categories of therapists' verbal behavior are distributed throughout the clinical intervention in such a way that a model of verbal performance could be established related to the clinical objective pursued by the psychologist during the therapeutic process. The results have confirmed this hypothesis and support the conclusion that what is related to the type of verbal behavior emitted by cognitive-behavioral therapists is the clinically relevant activity that is being carried out in session. According to these results, therapists perform four types of clinically relevant activity (assessment, explanation, treatment and consolidation of change). These are related to the type of categories of verbal behavior that are most frequent during each activity, rather than to the temporal moment of therapy in which they occur (AU)