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The tripartite model of the therapy relationship, which includes the working alliance, real relationship, and transference-countertransference configuration, has been a useful way to conceptualize the complexity of the connection between a therapist and a client. However, little research has focused on the interrelationships between these three components over time. This study sought to replicate the findings of Bhatia and Gelso (2018) by examining the between-person relationships among each of the three elements averaged across all sessions. Additionally, we extended earlier work by examining the within-person relationship between the working alliance, the real relationship, and transference-countertransference with themselves as well as with each of the other elements across sessions. Using 5,931 sessions across 142 clients and 36 therapists, we examined time-ordered associations among the cocreated working alliance, cocreated real relationship, and the therapist-rated transference-countertransference configuration using latent variable dynamic structural equation modeling. Results replicated the findings of Bhatia and Gelso (2018), demonstrating that in one session, the working alliance and the real relationship were positively related, and both the working alliance and the real relationship were negatively related to the transference-countertransference configuration. Regarding the interrelations over time, the findings revealed that the working alliance in the previous session had a significant and positive relationship with real relationship in the current session, and the real relationship in the previous session was related to reduced transference-countertransference in the current session. These findings provide support for complex interrelations among the components over time. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Much of the multicultural counseling literature focuses on how White or U.S.-born therapists can work effectively with clients of color. However, with the increasing number of racial minority and international therapists and trainees, there is a need to expand the multicultural counseling literature to acknowledge and center the experiences of therapists and trainees of color, particularly the experiences of Asian international therapists. Specifically, a greater understanding and guidelines are needed regarding how Asian international therapists handle clients' xenophobia, racism, and microaggressions in therapy. This qualitative study interviewed 11 licensed practicing Asian international psychotherapists within the United States about their experiences of client-initiated microaggressions in therapy. Consensual qualitative research was used to analyze interview data. Results indicated four domains pertaining to Asian international psychotherapists' experiences in therapy: xenophobia, microaggression, impact, and strategy. Participants reported complex negative impacts of xenophobia and microaggressions on their well-being as well as the therapeutic relationship and treatment outcomes. Additionally, participants identified the difficulty and complexity of addressing client-initiated microaggressions in session. Implications for training and practice as well as suggestions for future research are provided. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The dominant narrative in much of the world, but especially the West, is that public safety and security are provided by policing. Psychotherapy invests in this dominant narrative via its reliance on emergency services provided by the state, such as 911 and police, to pursue the safety of clients and the larger society. However, the long-documented history of oppressive systems of policing suggest that these dominant narratives operate to protect powerful groups while surveilling and policing marginalized people, but particularly Black and Brown communities. As such, critical and abolitionist movements have rejected the idea that policing provides safety and have sought out alternative methods for ensuring community wellness and safety. Although the field of psychology has broadly expressed interest in growing its critical lens and interrupting systems of power, very little has directly addressed how carceral logics influence psychotherapy practice, and how this influences the client's sense of safety in therapy. This manuscript argues for an abolitionist approach to informed consent and safety planning in psychotherapy to address the disparate ways that clients, and especially marginalized clients such as Black and Brown people, experience psychotherapy's traditional use of systems of policing and state authority. Clinical illustrations are provided and future directions are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Clients' expectations of treatment have long been posited as an important therapeutic factor in treatment success. Decades of research and meta-analytic findings have supported the notion that client expectations about what will happen over the course of therapy and how beneficial therapy will be are directly related to treatment factors, such as the working alliance and treatment outcome. Client expectations can be categorized into two broad categories, outcome expectations (i.e., how beneficial treatment will be) and treatment expectations (i.e., what will happen in treatment). This study sought to examine clients' treatment expectations, specifically, their role expectations, which represent their beliefs of how their therapists will act in session. Data for this study included 1,233 clients participating in individual counseling with 49 therapists at a university counseling center. Multilevel polynomial regression and response surface analysis were used to test congruent and discrepant effects of clients' pretreatment support and challenge expectancy on reductions in their psychological distress over the course of treatment. Results indicated that reductions in clients' psychological distress were the greatest when their support and challenge expectancy scores were congruent and high. In other words, clients who expected both high challenge and high support from their therapist, prior to the start of counseling, reported the greatest improvement in counseling. Clients similarly reported reductions in their psychological distress when their support and challenge expectations were congruent and low, although this effect was smaller than when they expected high levels of both support and challenge. Together, these findings suggest that when clients' expectations of support and challenge are similar, they fare better in treatment, as opposed to when they expect a greater amount of support than challenge or vice versa. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

In this exploratory study, 54 adult clients seen by 11 therapists in open-ended individual psychodynamic psychotherapy reported about disclosure and nondisclosure of physical health issues (PHI) within psychotherapy. Although clients reported at intake that they had moderately severe PHI, they discussed these issues in therapy only in 12% of sessions, and clients initiated the discussion about these issues nearly 75% of the time. The most frequently disclosed PHI were sleep, weight, illness, and pain. Clients were more likely to disclose if PHI were distressing, related to their mental health, relevant to the psychotherapy process, a priority, and if there was enough time in therapy for discussion. At the client level for disclosed PHI, depth of discussion was associated with client-rated alliance; clients who generally rated the alliance high were those who disclosed about the PHI, initiated the PHI discussion, and were not distressed by the PHI. At the session level, clients rated the alliance higher when they were distressed by the PHI but did not discuss it in depth. For nondisclosed PHI, clients reported a higher alliance if they generally and in particular sessions were not distressed about the PHI. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

In this case study of an adult female client working with a doctoral student female therapist in 85 sessions of individual psychodynamic psychotherapy, we analyzed the antecedents, challenges, and consequences for 53 challenges in the intake and first five sessions, the middle three sessions, and the final three sessions. Within the context of a strong therapeutic relationship and when the client was balanced in being defended as well as open/reflective, the therapist's challenges that were of high quality (deep, clear, empathic, and moderately forceful) were associated with the client becoming more open/reflective. In contrast, when the client was defended (but not open/reflective), the therapist's challenges were of lower quality and were associated with the client becoming more defended and closed off. Thus, both the antecedent client state and the quality of the therapist challenges were associated with the consequences of challenges in terms of the client's response. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

In the present study, we examined whether clients' perceptions of similarity to their therapists in terms of the Big Five personality traits were associated with the real relationship and, indirectly through the real relationship, to treatment progress. Data collected through an online crowdsource platform from 212 adult clients in individual psychotherapy were analyzed using polynomial regression and response surface analysis. Results indicated that clients who perceived greater similarity to their therapists at higher (vs. lower) levels of Conscientiousness and Openness to Experience reported stronger real relationships, as did clients who perceived greater similarity at lower (vs. higher) levels of Neuroticism. Similarly, clients reported a stronger real relationship when they perceived their therapists as similarly high in Extraversion, but the real relationship decreased slightly when the similarity was perceived at higher (vs. moderate) levels of this trait. Perceived similarity at high and low levels of Agreeableness was also associated with stronger real relationships. There was no evidence of an indirect association between client-perceived similarity and treatment progress via the real relationship. However, clients who perceived greater similarity to their therapists at higher (vs. lower) levels of Openness to Experiences and Conscientiousness reported more progress in treatment. Implications for theory, research, and practice are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

We examined the effects of deliberate practice training focused on immediacy (Im) for 7 doctoral student trainees. Training included an 8-hr workshop, 4 individual 50-min sessions, and 4 individual 30-min homework sessions. Qualitative results indicated that trainees found the deliberate practice training to be effective, especially in helping them become aware of and manage emotions and countertransference, which had inhibited them from using Im. In addition, there was a moderate and significant effect of training on the trainee's self-efficacy for using Im, a small and significant effect on therapist-rated working alliance, and no significant effect for client-rated working alliance. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Interpersonal feedback is an important process in group therapy. Feedback can be both positive and negative, and group researchers have noted the importance of both positive and negative feedback in fostering cohesive groups and evoking behavioral change (Yalom & Leszcz, 2005). However, there is a paucity of research examining the amount and valence (i.e., positive and negative) of interpersonal feedback on group therapy process and outcomes. Therefore, this study tested the proposition that congruent and high levels of members' perceptions of positive and negative feedback was optimal for member's perceptions of cohesion and improvement in group therapy. Data for this study consisted of 168 members across 43 interpersonal process therapy groups. Polynomial regression and response surface analysis revealed that members' perceptions of congruent and high levels of positive and negative interpersonal feedback were positively associated with members' perceptions of group cohesion and improvement. In addition, members' perceptions of discrepant high positive feedback and low negative feedback were positively associated with members' perceptions of group cohesion and improvement. These findings suggest that members' perceptions of balanced and high amounts of positive and negative feedback, as well as discrepant high positive feedback and low negative feedback, are optimal in group therapy. Group leaders should attend to the amount and proportion of positive and negative member-member feedback in therapy groups to enhance the clinical benefit of these services. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

We investigated the antecedents, occurrences, and consequences of 183 silence events in the first 5 and last 5 sessions of a 73-session case of successful psychodynamic psychotherapy. Silences generally occurred within client speaking turns, such that the client often paused to reflect while speaking. In the last 5 sessions, as compared with the first 5 sessions, the client was more collaborative before and after silences, silences were shorter, the therapist was more connectional during silences (e.g., shared emotion and meaning with client), and the client was more emotional after silences. Antecedent client collaboration, duration of the silence, therapist behavior during silence events, client behavior during silence events, and who broke the silence all related to change in collaboration from before to after the silence events. We concluded that silence was helpful in this case because of client factors (the client naturally paused a lot during discussion, the client was quite reflective and insightful), therapist factors (the therapist was comfortable with and believed in silence), and relationship factors (there was a strong therapeutic relationship). (PsycINFO Database Record (c) 2019 APA, all rights reserved).

We investigated the process and outcome of the first silence event for each of 86 clients and 26 doctoral student therapists in individual psychodynamic psychotherapy. Antecedent client collaboration and client attachments styles did not predict type of client or therapist behavior during silence events. Client collaboration increased from before to after silence events if therapists were productive (mostly invitational) and if clients were productive (mostly emotional and expressive) during silence events. Furthermore, subsequent client collaboration was higher when productive therapist silence occurred with clients who were lower rather than higher in attachment anxiety. In contrast, subsequent client collaboration was higher when productive client silence occurred with clients who were higher rather than lower in attachment anxiety. These results suggest that type of silence and client attachment styles are important factors in the immediate outcomes of silence events. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Accurate estimations of progress in psychotherapy are necessary for therapists to identify clients at risk of deterioration and potentially reduce premature terminations. This need has resulted in a large body of literature examining the rate and trajectory of change in psychotherapy; however, few studies have tested these dose-response relationships outside of global measures of mental health. Moreover, there is a paucity of research examining the relationship between progress in treatment, treatment length, and premature termination. In this study, we conducted multivariate multilevel analyses to test the good-enough level model across the three domains of the phase model of psychotherapy: psychological symptoms, life functioning, and well-being. In addition, we tested changes in well-being, psychological symptoms, and life functioning, treatment length, and an interaction between treatment progress and treatment length as predictors of premature termination. Data for this study consisted of 438 clients who were treated by 57 therapists within a brief therapy model. Results failed to support the good-enough level model for changes in well-being, psychological symptoms, and life functioning, such that the rate of change across all three scales did not significantly vary as a function of treatment length. However, exploratory analyses revealed a significant interaction effect between changes in well-being, treatment length, and premature termination, indicating that clients who experienced high rates of change in well-being early in treatment were more likely to prematurely terminate treatment. Clinical implications and future research are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

In this article, we review the history and definition of countertransference, as well as empirical research on countertransference, its management, and the relation of both with psychotherapy outcome. Three meta-analyses are presented, as well as studies that illustrate findings from the meta-analyses. The first meta-analysis indicated that countertransference reactions are related inversely and modestly to psychotherapy outcomes (r = -.16, p = .02, 95% CI [-.30, -.03], d = -0.33, k = 14 studies, N = 973). A second meta-analysis supported the notion that countertransference management factors attenuate countertransference reactions (r = -.27, p = .001, 95% CI [-.43, -.10], d = -0.55, k = 13 studies, N = 1,065). The final meta-analysis revealed that successful countertransference management is related to better therapy outcomes (r = .39, p < .001, 95% CI [.17, .60], d = 0.84, k = 9 studies, N = 392 participants). In all meta-analyses, there was significant heterogeneity across studies. We conclude by summarizing the limitations of the research base and highlighting the therapeutic practices predicated on research. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Although writing about the real relationship has existed from the beginnings of the "talking cure," it is only in recent years that empirical research has focused on this phenomenon. The real relationship is the personal relationship between patient and therapist marked by the extent to which each is genuine with the other and perceives/experiences the other in ways that are realistic. The strength of the real relationship is determined by both the extent to which it exists and the degree to which it is positive or favorable. In this article, a meta-analysis is presented on the association between the strength of the real relationship and the outcome of psychotherapy. Summed across 16 studies, this meta-analysis revealed a moderate association with outcome (r = .38, 95% confidence interval [.30, .44], p < .001, d = 0.80, N = 1.502). This real relationship-outcome association was independent of the type of outcome studied (treatment outcome, treatment progress, and session outcome) and of the source of the measure (whether the client or the therapist rated the real relationship and/or treatment outcome). We also present commonly used measures of the real relationship, limitations of the research, and patient contributions. The article concludes with diversity considerations and practice recommendations for developing and strengthening the real relationship. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Experienced leaders of psychotherapy groups are surprisingly inaccurate in their judgments about their members' perceptions of positive bonding relationships with the leader and other group members. The practical implication is worrisome: the lower the leader's degree of accuracy, the worse the member therapeutic outcomes tend to be. A promising approach to improving leaders' appraisals of their members' perceptions of positive bonding relationships is to provide them, after each session, feedback about their own and their members' bonding relationship perceptions. Profiling trajectories of leaders' and members' perceptions over time yields rich "stories" of relationship development, that if strategically packaged into brief, concise, and vivid reports, and delivered as a formal "group member feedback" intervention, would direct leaders' attention to those emerging, but easily overlooked, countertherapeutic relationships, requiring immediate, well-informed targeted interventions. To increase the utility of such reports, training leaders use intuitively appealing, but structured heuristics ("interpersonal-fit-with-the-group" and "intrapersonal-split-relationships"), accelerate leaders' recognition of patterns in perceptions as they change over time, and free up their cognitive resources for determining whether to intervene into the group process at the appropriate level: intraindividual, interpersonal, or group-as-a-whole. To illustrate the use of these heuristics, we present two hypothetical cases, with visual displays of congruent and discrepant perceptions of bonding relationship perceptions between members over time, and make tentative recommendations about where and when leaders might intervene to achieve optimal impact. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

Multicultural group work has received growing attention over the past two decades; however, there is a lack of conceptual frameworks to guide therapists' cultural processes within group therapy at present. As such, we extend the multicultural orientation (MCO) to group therapy in an effort to provide a conceptual framework for group therapists to effectively engage multicultural group work. The MCO framework was developed in an effort to operationalize therapists' cultural processes of cultural humility, cultural comfort, and cultural opportunity. Although the MCO framework has been empirically tested within an individual psychotherapy context, application to alternative therapeutic modalities is needed. Given the inherent multicultural nature of group therapy and calls for group therapist to be culturally competent in the delivery of group-based services, we extend the MCO framework to the practice of group therapy. In this article, we provide a rationale for the application of the MCO framework to the practice of group therapy, and illustrate how group therapists' cultural humility, comfort, and opportunities can assist in establishing a multicultural group orientation throughout the development of the group. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

Using data from 3,263 sessions nested within 144 clients, nested within 19 therapists, we examined client- and therapist-rated working alliance (WA) and real relationship (RR) at Session 3 and growth in WA and RR across the course of open-ended psychodynamic psychotherapy for clients who identified as racial/ethnic minority (REM) or as White. To be included in the analyses, therapists had to work with at least 2 REM and 2 White clients. There were no significant therapist effects for the interaction between client- or therapist-rated WA and client REM status at Session 3, or for client- or therapist-rated RR and client REM status at Session 3. There were, however, significant therapist effects due to client REM status on the interaction between client-rated linear growth in WA and RR, showing that some therapists had stronger WA and RR growth with REM than that with White clients, whereas other therapists had stronger alliance growth with White than that with REM clients. There were significant therapist effects on therapist-rated linear growth in both WA and RR, which indicated that some therapists reported stronger WA and RR growth with all of their clients, whereas other therapists reported weaker WA and RR growth for all of their clients, although this differential WA and RR growth was not related to clients' REM status. Implications for practice and research are discussed in this paper. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

The development and factor analysis of the Adventure Therapy Experience Scale (ATES) is the first attempt found in the literature to empirically and quantitatively identify therapeutic factors theorized to affect change in the adventure therapy experience (Russell & Gillis, 2017). This study utilizes the ATES to explore how its inherent factors may impact treatment outcome utilizing a routine outcome monitoring process to empirically test how these factors may contribute to treatment outcome over time. The sample of 168 males 21.5 years of age completed an average of 79.6 days in the 90-day adventure-based substance use disorder residential treatment program. In the model, adventure-based experiences are a primary treatment tool. For outcome monitoring, all clients were administered the Outcome Questionnaire (OQ-45.2) at intake, every 2 weeks, and at discharge. In addition, clients were administered the 18-item ATES every 2 weeks. The ATES contains 2 items measuring how helpful the adventure experience was as well as how mindful they were of their treatment process during the experience. Clients also answer 16 Likert items measuring responses on 4 subscales: group adventure, nature, challenge, and reflection. Results reveal that clients, on average, improved in their psycho-social functioning as measured by the OQ 45.2. Weeks with higher helpfulness, mindfulness, and group adventure scores than the client's average helpfulness, mindfulness, and group adventure score, had greater decreases in OQ scores than weeks with lower helpfulness, mindfulness, and group adventure scores. Clients with higher aggregate helpfulness and group adventure scores, across all treatment weeks, had greater decreases in OQ scores than clients with lower aggregate helpfulness and group adventure scores. Implications for practice and future research are also discussed. (PsycINFO Database Record, ((c) 2017 APA, all rights reserved).)

We examine aspects of engagement (MacKenzie, 1983) as predictors of longitudinal change in Outcome Questionnaire-45.2 scores (Lambert, Kahler, Harmon, Burlingame, & Shimokawa, 2011) for 68, 18-24-year-old male residents in a 10-bed, open enrollment 90-day residential, substance use treatment program. Engagement was partitioned into within-member, between-member, within-other members, and between-other members' effects. Within-member engagement represented how a group member's score for a week deviated from that member's average engagement score (across all weeks), whereas between-member engagement was the member's average engagement score. Similarly, within-other member engagement represented how the other group members' scores for a week deviated from the other group members' average engagement score (across all weeks), whereas between-other member engagement was the other group members' average engagement score. A 2-level hierarchical linear model showed the interaction of between-member engagement and between-other member engagement was related to decreasing OQ-45 scores. When other group members generally saw the group as more engaged, higher group member average engagement ratings were related to improvement. There was a significant interaction between within-member engagement and between-member engagement in predicting OQ-45 scores. When clients generally saw the group as more engaged, weeks with relatively more member engagement, compared with other weeks, were associated with improvement in OQ-45 scores. However, when clients generally saw the group as less engaged, weeks with relatively more group member engagement, compared with other weeks, were associated with greater deterioration in OQ scores. We recommend tracking week-to-week changes in member and other member engagement to identify group members who are not getting optimal program benefits. (PsycINFO Database Record, ((c) 2016 APA, all rights reserved).)

We used West and Kenny's (2011) Truth-and-Bias (T&B) model to examine how accurately group therapists' judge their group members' alliances, and the effects of therapist-patient congruence in alliance ratings on patient outcomes. Were considered: (a) directional bias - therapists' tendency to over- or underrate their clients' alliances, (b) truth strength - clients' alliance ratings, and (c) bias strength - therapists' tendency to conflate their alliance ratings for a specific group member with the average alliance ratings for the other members of the group. There were 118 obese adult patients with binge-eating disorder that were treated by 8 therapists with Emotionally Focused Group Therapy. Outcomes were operationalized as pre- to postchanges in: health-related quality of life, binge eating, and psychological distress. Patients' and therapists' working alliance were assessed after the 2nd, 10th, and last (20th) group therapy sessions. (a) There was no significant congruence between group therapists' and members' ratings of alliance; (b) therapists' ratings of an individual group member's alliance were significantly related to therapists' ratings of the other group members' alliance in early sessions but unrelated in later sessions; and (c) the relationship between therapists' alliance ratings and bias strength was weaker when patient binge eating outcomes improved. Group therapists adopted a "better safe than sorry" strategy by underestimating the strength of their group members' alliances. Therapists had a tendency to judge each group member's individual alliance based on the aggregated alliance of the other group members. Improvement in patient binge eating outcomes was related to therapists overcoming this tendency. (PsycINFO Database Record, ((c) 2016 APA, all rights reserved).)

This study used the Actor Partner Interdependence Model (APIM; Kenny & Cook, 1999) to examine the associations of client- and therapist-rated real relationship (RR) and session quality over time. Eighty-seven clients and their therapists (n = 25) completed RR and session quality measures after every session of brief therapy. Therapists' current session quality ratings were significantly related to all of the following: session number (b = .04), their session quality rating of the previous session (b = .24), their RR in the previous session (b = 1.091), their client's RR in the previous session (b = .17), and interactions between their own and their clients' RR and session number (b = -.16 and β = -.04, respectively). Clients' ratings of current session quality were significantly related to only their own RR in the previous session (b = .47). Implications for future research and practice are discussed., (PsycINFO Database Record (c) 2014 APA, all rights reserved.)

The purpose of this study was to test the notion that complementary attachments are best for achieving a secure base in psychotherapy. Specifically, we predicted third to fifth session alliance from client- and therapist-rated attachment style interactions. Using a combined sample of 46 therapy dyads from a community mental health clinic and university counseling center, the client- and therapist-perceived therapy alliance, attachment anxiety, and attachment avoidance were examined at the beginning of therapy. The results of an Actor-Partner Interdependence Model (APIM; Kenny & Cook, 1999, Partner effects in relationship research: Conceptual issues, analytic difficulties, and illustrations. Personal Relationships, 6, 433-448.) indicated that there was no direct effect of either client or therapist attachment style on therapist or client early ratings of the alliance. One significant interaction emerged and indicated that client-perceived alliance was influenced by therapist and client attachment anxiety. The client-perceived early alliance was higher when more anxious therapists worked with clients with decreasing anxiety. The client early alliance was higher when less anxious therapists worked with clients with increasing anxiety. The findings partially support the notion that different attachment configurations between the therapist and client facilitate greater alliance, but this was the case only when assessing client-perceived early alliance and only with regards to the dimension of attachment anxiety. There were no significant main effects or interactions when exploring therapist-perceived alliance. Implications of the findings are discussed along with recommendations for future study and clinical training., (PsycINFO Database Record (c) 2014 APA, all rights reserved.)

I describe three clinical processes: (a) bringing the discussion into the here-and-now; (b) making impact disclosures; and (c) creating a corrective emotional experience, derived from interpersonal theory, that occurs in most of my individual and group therapy sessions. For each of these clinical processes, I provide: (a) the theoretical principals that support the clinical process, (b) clinical descriptions and dialogue that demonstrate the process, and (c) a review of some of the research examining the clinical process. Finally, I propose a task model of interpersonal therapy, which illustrates how the three clinical processes come together in interpersonal therapy., ((c) 2014 APA, all rights reserved.)

Volunteer clients (N = 96) evaluated sessions conducted by prepracticum trainees prior to and after the trainees received instruction in interpersonal-psychodynamic therapy. The relationship between changes in therapeutic style, measured by intension use, and changes in volunteer clients' session evaluations were examined with growth curve analyses. After training, trainees increased their focus on client emotions and on the therapeutic relationship and decreased their verbal activity. Increased session smoothness was related to decreases in trainee verbal activity and to increases in trainee flexibility. Increases in volunteer clients' perceptions of trainee expertness, attractiveness, and trustworthiness were related to trainees' increased focus on client emotions and increased focus on the therapeutic relationship and to decreases in confrontation., (PsycINFO Database Record (c) 2010 APA, all rights reserved.)

The authors examined immediacy (i.e., discussions about the here-and-now therapeutic relationship) in a 12-session case of individual interpersonal psychotherapy. Therapist immediacy during immediacy events most often focused on parallels between external relationships and the therapy relationship, encouraging expression of immediate feelings, processing termination, therapist expressing disappointment/sadness/hurt and inquiring about the client's reactions. Client involvement was slightly higher before and after than during immediacy events. On the positive side, therapist immediacy seemed to help the client express her immediate feelings about the therapist more openly, feel closer to the therapist, and become less defended. On the negative side, the client felt somewhat awkward and pressured when the therapist used immediacy. Limitations and implications for practice and research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

The psychology literature at large considers rater bias to be a substantial source of error in observer ratings. Yet, it is typically ignored by psychotherapy researchers using participant (psychotherapist/client) ratings. In particular, interrater variability, or differences between raters' overall tendency to rate others favorably or unfavorably, has been a largely ignored source of error in studies that use psychotherapists and/or clients as raters. Ignoring rater bias can have serious consequences for statistical power and for interpretation of research findings. Rater bias may be a particular problem in psychotherapy research, as psychotherapists are often asked to rate subjective variables that require much rater inference. Consequently, we examined the extent to which rater bias is a factor in psychotherapist ratings of client transference and insight, by comparing psychotherapist variance from these ratings to psychotherapist variance in ratings of client-perceived emotional intelligence, using Hierarchical Linear Modeling. Results suggest that bias may be a substantial source of error in psychotherapist process and relationship ratings, accounting for, on average, 38% of the total variance in scores, and 30% after accounting for perceived emotional intelligence. (PsycINFO Database Record (c) 2010 APA, all rights reserved).