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The working alliance has been shown to be a robust predictor of couple therapy outcomes. However, there are still questions regarding the best way to conceptualize and analyze the association between the alliance and outcomes in the couple therapy context. This study presents results from a relatively novel analytic approach for evaluating the alliance and therapy outcomes via the shared influence model (i.e., common fate statistical methodology) with 93 couples who had at least three sessions. Examining the alliance in couple therapy this way allows for nuance in conceptualizing the process of the alliance among partners and the therapist in couple therapy. Empirically, the question that remains is whether the shared experience of the alliance between partners is a stronger predictor of therapy outcome as compared to the unique individual experiences of the alliance. This approach has not yet been utilized to model the couple alliance-outcome association. Results revealed that the shared influence model demonstrated a significant association between the alliance and therapy outcome. Specifically, the couple-level alliance construct was adequately represented from the partners' alliance ratings with the therapist, and couples that report higher shared alliance experiences were also likely to have better therapy outcomes. These findings suggest that conceptualizing and analyzing the alliance at the couple level may be strongly advantageous. Implications for research and practice are provided.Se ha demostrado que la alianza terapéutica es un predictor fiable de los resultados de la terapia de pareja. Sin embargo, aún quedan preguntas con respecto a la mejor manera de conceptualizar y analizar la asociación entre la alianza y los resultados en el contexto de la terapia de pareja. Este estudio presenta resultados de un enfoque analítico relativamente innovador para evaluar la alianza y los resultados de la terapia mediante el modelo de influencia compartida (p. ej.: metodología estadística del destino común) con 93 parejas que tuvieron al menos tres sesiones. Analizar la alianza en la terapia de pareja de esta manera permite matices a la hora de conceptualizar el proceso de la alianza entre los integrantes de la pareja y el terapeuta en la terapia de pareja. Empíricamente, la pregunta que queda pendiente es si la experiencia compartida de la alianza entre los integrantes de la pareja es un predictor más fiable de los resultados de la terapia en comparación con las experiencias individuales únicas de la alianza. Este enfoque aún no se ha utilizado para interpretar la asociación entre la alianza de la pareja y los resultados. Los resultados revelaron que el modelo de influencia compartida demostró una asociación significativa entre la alianza y los resultados de la terapia. Específicamente, el constructo de la alianza a nivel de la pareja se representó adecuadamente a partir de las valoraciones de la alianza de los integrantes de la pareja con el terapeuta, y las parejas que informan más experiencias de alianza compartida también fueron propensas a tener mejores resultados en la terapia. Estos datos sugieren que puede ser enormemente ventajoso conceptualizar y analizar la alianza a nivel de la pareja. Se explican las consecuencias para la investigación y la práctica.关系联盟可以比较准确地预测伴侣治疗的结果，这都是已经被证实过了的。然而，在伴侣治疗的背景下，如何理解和分析这种联盟与治疗结果之间的关系，依然还存在问题。本研究采用了一种相对新颖的分析方法，通过共享影响模型 (即共同命运统计方法)来评估联盟和治疗结果。研究对象为93对至少参加过三次治疗会谈的伴侣。通过这种方式来考察伴侣治疗中的联盟，可以认识更多伴侣和伴侣治疗师之间的联盟过程中出现的细微差别。在实证经验上，仍然存在的问题是伴侣共同经历的联盟关系是否会比独特的个人单方面体验的联盟关系更能预测治疗结果。这种方法还没有被使用在建立伴侣联盟-结果的关系模型中去。研究结果显示，共同影响模型能展现联盟与治疗结果之间的显著关联。具体而言，从伴侣与治疗师的联盟评级中，可以充分地反映出伴侣层面的联盟关系构建。如果报告的共同经历的联盟体验越高，伴侣治疗的结果也可能更好。这些发现表明，对伴侣层面的联盟进行概念化的理解和分析可能非常有利。本论文对研究和实践提都供了启示。.

In 2014, Macnamara, Hambrick, and Oswald published a meta-analysis of studies questioning the strength of the association between deliberate practice and performance. In this brief report, the corr...

OBJECTIVE Although the working alliance-outcome association is well-established for adults, the working alliance has accounted for 1% of the variance in adolescent therapy outcomes. How the working alliance unfolds in therapy and is modeled in therapy studies may substantially affect how much variance is attributed to the working alliance. METHOD The sample included 2,990 military youth who were treated by 98 therapists and attended at least 8 therapy sessions. The average age was 14.91 years (SD = 1.79). Each session, clients completed the Outcome Rating Scale as a measure of psychological well-being/distress and the Session Rating Scale as a measure of working alliance. We utilized 3 models to examine the working alliance-outcome association in therapy: (a) mono-method model (i.e., 1 rating of working alliance correlated with outcomes), (b) aggregate-assessment model (i.e., multiple sessions aggregated and correlated with outcomes), and (c) change-based model (i.e., changes in working alliance scores correlated with outcomes). RESULTS Findings supported the change-based model. The amount of variance explained in youth outcomes via growth in working alliance scores in the change-based model was approximately 9.8%, which suggests that a key mechanism of client-perceived change for adolescents in therapy may be the continual development of the working alliance over the course of treatment. CONCLUSIONS The monitoring of and continual promotion of the working alliance among military youth in the early phases of therapy may help therapists improve treatment outcomes.

Little empirical research exists about highly effective psychotherapists, and none about the factors that mediate the acquisition and maintenance of superior performance skills (e.g., Ericsson, 1996, 2006; Ericsson, Krampe, & Tesch-Romer, 1993). In the full sample, a 3-level multilevel modeling (Level 1: clients; Level 2: therapists; Level 3: organization types) of practitioner outcomes was used to examine the contribution of the therapist to treatment effectiveness. Consistent with prior research, in the full sample (n = 69 therapists; n = 4,580 clients) it was found that therapist effects explained 5.1% of the variance in outcome, after adjusting for initial severity. Therapist gender, caseload, and age were not found to be significant predictors. In a subsample of therapists, the relationship between outcome and therapist demographic variables, professional development activities, and work practices was analyzed (n = 17 therapists, n = 1,632 clients). Therapist characteristics (e.g., years of experience, gender, age, profession, highest qualification, caseload, degree of theoretical integration) did not significantly predict client-reported outcomes. Consistent with the literature on expertise and expert performance, the amount of time spent targeted at improving therapeutic skills was a significant predictor of client outcomes. Further, highly effective therapists indicated requiring more effort in reviewing therapy recordings alone than did the rest of the cohort. Caveats and implications for clinical practice, continuing professional development, and training are discussed.

In recent years, McNamara, and associates Hambrick and Oswald, conducted and published studies which purportedly showed deliberate practice exerts less powerful main effects than presented and popu...

Objective: The measurement of clinical change via single-group pre-post effect size has become increasingly common in psychotherapy settings that collect practice-based evidence and engage in feedback-informed treatment. Different methods of calculating effect size for the same sample of clients and the same measure can lead to wide-ranging results, reducing interpretability. Method: Effect sizes from therapists—including those drawn from a large web-based database of practicing clinicians—were calculated using nine different methods. Results: The resulting effect sizes varied significantly depending on the method employed. Differences between measurement methods routinely exceeded 0.40 for individual therapists. Conclusions: Three methods for calculating effect sizes are recommended for moderating these differences, including two equations that show promise as valid and practical methods for use by clinicians in professional practice.

Purpose – To replicate the Luton pilot study (Andrews et al., 2011), both by investigating treatment changes using the Human Givens (HG) approach via a practice research network (PRN) and by assessing the viability of replacing the 34-item Clinical Outcome in Routine Evaluation Outcome Measure (CORE-OM) with the ten-item version (CORE-10). Design/methodology/approach – Clients were included if they were offered the HG approach to manage psychological distress and attended at least one measured treatment session following their initial assessment. Pre-post treatment effect size (Cohen's d) was benchmarked against data from Clark et al. (2009). Potential differences in treatment effects based on type of termination (planned vs unplanned) and medication use were examined. Findings – High correlation between the CORE-10 and CORE-OM and near-identical calculated effect sizes support the utilisation of CORE-10 as a routine outcome measure. Pre-post treatment effect size suggests that clients treated using the H...

In 1963, the first issue of the journal Psychotherapy appeared. Responding to findings reported in a previous publication by Eysenck (1952), Strupp wrote of the "staggering research problems" (p. 2) confronting the field and the necessity of conducting "properly planned an executed experimental studies" to resolve questions about the process and outcome of psychotherapy. Today, both the efficacy and effectiveness of psychotherapy has been well established. Despite the consistent findings substantiating the field's worth, a significant question remains the subject of debate: how does psychotherapy work? On this subject, debate continues to divide the profession. In this paper, a "way out" is proposed informed by research on the therapist's contribution to treatment outcome and findings from studies on the acquisition of expertise.

Building upon the foundation of variationist sociolinguistics and politeness theory, this paper examines the norms and patterns of compliment responses in Mandarin Chinese, and explores the constraints of sociolinguistic variables on the pragmatic variation of this speech act. This study is built on a corpus of 1,190 naturally occurring compliment exchanges collected in the speech community of Shanghai, in conjunction with the interlocutors' ethnographic information. Variable rule analysis is used to identify the factors that contribute to compliment response patterns. The most striking diachronic change revealed by this study lies in the fact that Chinese speakers considerably tend towards the acceptance of compliments while strategies of non-acceptance are on the decline, as exhibited by the Shanghai speech community. The study also suggests that Chinese speakers appear to be situated in a transitional period from the modesty maxim to the agreement maxim. In addition, the results demonstrated that the pragmatic variable of compliment response varies systematically with social variables such as gender, age, social status, education, social class, social distance, and the use of English. 本篇文章基于社会语言学的变异观和和礼貌理论，探讨汉语恭维回应语的模式和准则，并分析了多个社会语言学变量对其语用变异的制约作用。本研究共收集上海言语社区1,190个自然语言状态下的恭维语及恭维回应语用例，同时还收集了有关语言使用者的相关社会背景信息。研究采用变项规则分析法来分析不同语境因素对汉语恭维回应语的影响。研究结果揭示，恭维回应语模式的历时性显著变化是接受型模式越来越普遍，而不接受型模式则使用得越来越少，这是上海言语社区的一个真实写照。研究表明，中国人的礼貌准则正在经历一个由谦虚准则到一致准则过渡的阶段。研究结果还发现，恭维语回应语受到各种社会因素，如年龄、性别、社会地位、教育程度、社会阶层、社会关系、英语熟练程度等因素的制约，而且呈现出一定的系统性。

This study investigates the voicing contrast in word-final obstruents in Singapore English. Previous auditory accounts have suggested that word-final obstruents undergo complete devoicing in Singapore English and become identical to their voiceless counterparts, including neutralization of differences in adjacent vowel duration (among others, Bao 1998, Wee 2008). On the basis of acoustic data from the NIESCEA corpus (Low 2015), we examine the extent to which voicing-related differences are neutralized when reading wordlists, sentences and passages as well as in unscripted conversations. Results suggest that neutralization is phonetically incomplete in Singapore English, with underlying voicing being recoverable from such parameters as closure voicing ratio and durations of consonants and adjacent vowels. These findings are in line with the results for other devoicing languages, such as German and Russian, that also show incomplete neutralization of the voicing contrast in final obstruents (e.g., Roettger et al. 2014, Kharlamov 2014).

The purpose of this study was to establish the reliability and validity of the scores on a brief strengths-based assessment, the 22-item Personal Strengths Inventory (PSI). In Study 1, findings from exploratory factor analysis of 410 adolescents provided evidence for a five-factor solution—social competence (four items), emotional awareness (five items), goal setting (six items), emotional regulation (four items), and empathy (three items). Preliminary evidence of convergent validity was also reported. In Study 2, results from confirmatory factor analysis of 598 adolescents provided additional support for the results obtained from Study 1. Moderate to high reliability coefficients were obtained for the PSI scores. The results are discussed in comparison with other research on social—emotional competence, and further research is suggested.

In the field of psychotherapy a “great debate” is raging about how to improve quality and outcome (Wampold, 2001). On one side are those who hold that behavioral health interventions are similar to medical treatments (Barlow, 2004). Therapies work, they believe, because like penicillin they contain specific ingredients remedial to the disorder being treated. Consistent with this perspective, emphasis is placed on diagnosis, treatment plans, and adherence to so-called validated treatments (Chambless & Ollendick, 2001; Huppert, Fabbro, & Barlow, 2006; Siev, Huppert, & Chambless, 2009). The “medical model,” as it is termed, is the dominate view of how psychotherapy works. It is arguably the view held by most people who seek behavioral health treatment.

More than a dozen randomized controlled trials and several meta-analyses have provided strong empirical support for routine outcome monitoring (ROM) in clinical practice. Despite current enthusiasm, advances in implementation, and the growing belief among some proponents and policymakers that ROM represents a major revolution in the practice of psychotherapy, other research has suggested that the focus on measurement and monitoring is in danger of missing the point. Any clinical tool or technology is only as good as the therapist who uses it. Failing to attend to the therapist's contribution, the long neglected variable in psychotherapy outcome, ensures that efforts to create, research, and refine new outcome measurement systems will inevitably fall short. Research from the field of expertise and expert performance provides guidance for realizing the full potential of ROM.