College of Education
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The collections in this community comprise faculty research works, as well as graduate theses and dissertations..
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Item Getting on the Same Page: Associations of Immediacy and Client-Therapist Alliance Congruence(2022) Hillman, Justin William; Kivlighan, Jr., Dennis M; Counseling and Personnel Services; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)This study examined the within-dyad association of immediacy (i.e., a skill that therapists use to work with the therapeutic relationship in the here-and-now) with the strength and congruence of the working alliance across 1352 sessions of 58 adult community clients seeing 11 doctoral student therapists in individual psychodynamic-interpersonal psychotherapy. As a preliminary step, the factor structure and validity were tested for the Metacommunication in Session Questionnaire–Client Form (MSQ-C), a client-rated measure of immediacy adapted from the supervisory MSQ (Calvert, Deane, & Grenyer, 2020). After every session, clients and therapists completed the Working Alliance Inventory–Short Revised (WAI-SR; Hatcher & Gillaspy, 2006) and clients completed the MSQ-C. Factor analysis supported a two-factor structure for MSQ-C (Open Communication and Managing Disagreement/Discomfort factors). Validity of the MSQ-C was supported by predicted correlations with measures of helping skills, sessions quality, alliance, and therapist reported immediacy use, although some associations varied depending on the client or therapist rater perspective. Results of multilevel, latent variable models found that when clients reported more immediacy in a session compared to their average session, they tended to report a stronger alliance; and this effect was strongest in earlier sessions, weaker in magnitude in middle sessions, and non-significant in later sessions. Results of multilevel truth-and-bias models showed that therapist alliance ratings were temporally congruent with client alliance ratings, but client-perceived immediacy did not predict alliance congruence. Limitations and future directions are discussed.Item Differential Codevelopment of Working Alliance and Session Evaluation in Counseling Dyads(2022) Lin, Shihong; Kivlighan, Dennis; Counseling and Personnel Services; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)We examined session quality measured by the session evaluation scale (SES) and the working alliance measured by WAI-SR using the DSEM model, and reported similarities and differences in the codevelopment of the working alliance and session evaluation. In addition, we examined how the dynamic patterns of codevelopment for working alliance and session evaluation are associated with counseling outcomes. Major findings include: 1) there are significant actor effects for both working alliance and session evaluation; 2) In our study, there is no difference between therapist partner effects and client partner effects, for both working alliance and session evaluation; 3) The paths for session-to-session carryover effects (actor and partner effects) were stronger for working alliance than they are for session evaluation; 4) the therapist partner effects for session quality was statistically significantly associated with therapy outcome measure by the Outcome Questionnaire 45.2. Clinical implications of those findings were discussed.Item Relation of Efficacy Beliefs and Working Alliance to Psychotherapy Outcomes: A Multilevel Analysis(2007-07-16) Sheu, Hung-Bin; Lent, Robert W.; Counseling and Personnel Services; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The purpose of the study is to investigate the contributions of several common factor variables to individual psychotherapy outcomes at both individual and dyad levels. Two dyad-level variables (i.e., the working alliance and collective counseling efficacy) were hypothesized to mediate the relation of client individual-level predictors (i.e., coping efficacy, adult attachment, positive and negative affect) to outcomes (i.e., client-rated progress and session quality). The study involved a naturalistic research design in which no variables were manipulated and psychotherapy occurred without alteration. A novel instrument - the Collective Counseling Efficacy Scale (CCES) - was developed to measure the concept of collective counseling efficacy. Data collected from 73 dyads of clients and therapists were analyzed using multilevel structural equation modeling (SEM) techniques. Results of principal axis factoring procedures revealed a 1-factor structure for the CCES, and internal consistency estimates of the total scores were .96 and .93 for clients and therapists, respectively. Based on data from both clients and therapists, intraclass correlations showed that 59% and 34% of the variances of the alliance and collective counseling efficacy, respectively, occurred at the dyad level as opposed to the individual level. To model them as dyad-level factors, 2nd-order intercepts and slopes were created to represent the midpoint and the discrepancy of clients' and therapists' ratings of the two constructs. The alliance and collective counseling efficacy were further integrated by a set of 3rd-order intercept and slope, denoted relational factors. Multilevel SEM analyses provided evidence for the mediating effect of relational factors on the relation of pre-therapy client predictors to post-therapy client-rated outcomes. Specifically, client coping efficacy indirectly predicted client-perceived progress and session quality through the 3rd-order intercept. Also, client coping efficacy (positively) and avoidance attachment (negatively) were indirectly predictive of session quality through the 3rd-order slope. Post-hoc analyses indicated that clients' ratings of the alliance and collective counseling efficacy were significantly higher than those of therapists, and this pattern was positively associated with session quality. In conclusion, the importance of modeling common factor variables at different levels and the inclusion of collective counseling efficacy in psychotherapy research were initially supported by the findings of the study.