Browsing by Subject "Marriage counselors"
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Item A qualitative study of how marriage and family therapists make clinical judgements(Texas Tech University, 1998-12) Jankowski, Peter JWithin the field of marital and family therapy (MFT), there is growing recognition among research-practitioners that the advancement of MFT as a viable treatment option rests upon research-practitioners' ability to provide consumers with descriptions of the clinical processes of MFT. However, a research focus on clinical processes is being neglected. Thus, understanding the process of clinical judgment is an essential component of advancing the practice of MFT as a viable treatment option. The traditional approach is based upon the information-processing model and focuses on the internal, subjective judgment processes of the clinician to the neglect of the influence of context and therapist-client interaction on the judgment process. The purpose of this dissertation was to describe the judgment process of clinicians from a contextual assumptive framework. This dissertation moves the research area of clinical judgment into the realm of MFT and attempts to initiate a paradigmatic shift within the broader research community's already existent interest in clinical judgment. A grounded theory approach was used to answer the research question, "how do marriage and family therapists diagnose or arrive at a problem definition during the first session of therapy?" In answering the question, the process which emerged involved, in varying combinations: (1) comparing and contrasting knowledge that existed in the mind of the clinician prior to meeting the client with information obtained from the client during the session; (2) using an understanding of how larger contextual factors affected client and therapist experience during the session; and (3) having an awareness of what is happening between clinician and client, and determining how information from, and the experience of, the client fit with clinicians' previous experiences. Clinicians engaged in two meta-level judgment processes. The distinction between internal and conversational judgment processes was that the clinicians engaged in conversational judgment processes: (I) made overt their judgments and incorporated them into the therapeutic conversation; and (2) relied upon client input about what would or would not be helpful when constructing their judgments.Item Effects of couple exposure to direct and indirect therapy styles in marital therapy on therapist-couple struggle, cooperation, and responsibility(Texas Tech University, 1996-05) Butler, Mark H.The occurrence of therapist-couple struggle versus cooperation has been empirically linked to specific negative outcomes in therapy. No study, however, has yet investigated therapist-offered treatment process as it related to struggle versus cooperation. This study operationalized Murray Bowen's construct of promotion of responsibility in an indirect therapist style and contrasted it with a direct therapist style in an experimental design. In counterbalanced order, 25 couples in therapy were exposed to 12 minutes of a direct therapist style and 12 minutes of an indirect therapist style during one regular therapy session. After reviewing a videotape of the first therapist style episode, couples reported on their perceptions of struggle, cooperation, and responsibility within that therapist style. The same procedure was then followed for the second episode. Results indicated moderate support of hypothesized effects. Responsibility was higher and struggle was lower within an indirect therapist style. No difference in cooperation was found between therapist styles. A consistent inverse association was found between responsibility and struggle within both direct and indirect therapist styles, and a positive association was found between responsibility and cooperation within an indirect therapist style. Yet results indicated that significant proportions of the variance in struggle and cooperation are not explained by therapist style. Additional analyses were conducted to eliminate alternative explanations of the differences observed between the direct an indirect therapist style conditions. Some potential confounds to interpretation of therapist style effects were found. The findings suggest that an indirect therapist style, as represented by use of enactments (behavioral rehearsal), accommodation (couples' language and interaction patterns), and inductive process (eliciting dialogue and absence of direct teaching), relate to couples' experience of less therapist-couple struggle and a higher sense of personal responsibility for the outcome of therapy.