Passing patients’ tests and following patients’ coaching communications in psychotherapy: an empirical study

Francesco Gazzillo, Camilla Mannocchi, John Curtis, Giuseppe Stefano Biuso, Emma De Luca, Ramona Fimiani, Eleonora Fiorenza, Federica Genova, Michela La Stella, Jessica Leonardi, Martina Rodomonti & George Silberschatz

To cite this article: Francesco Gazzillo, Camilla Mannocchi, John Curtis, Giuseppe Stefano Biuso, Emma De Luca, Ramona Fimiani, Eleonora Fiorenza, Federica Genova, Michela La Stella, Jessica Leonardi, Martina Rodomonti & George Silberschatz (15 May 2024): Passing patients’ tests and following patients’ coaching communications in psychotherapy: an empirical study,

Counselling Psychology Quarterly, DOI: 10.1080/09515070.2024.2354283

To link to this article: https://doi.org/10.1080/09515070.2024.2354283

 

ABSTRACT

According to Control-Mastery Theory, patients attend therapy with an unconscious plan to achieve adaptive goals and disprove their pathogenic beliefs. One important way patients work to disconfirm these beliefs is by testing them. Moreover, patients coach their therapists on what they need at different times during their treatment.

The aim of this study is to expand the results of previous studies suggesting that therapists’ responses that support patients’plan predict progress. We investigated whether therapists’ ability to pass patients’ tests correlated with patients’ improvement in the following session and whether their ability to follow patients’ coaches correlated with immediate improvement. Transcriptions of 98 sessions from six brief psychodynamic psychotherapies wer assessed by 12 independent raters. The patients’ plans were formulated, and tests and coaching communications were identified. The accuracy of the therapist’s responses to these tests and coaches was rated, and the impact of the therapist’s interventions on the patient’s following communication was measured. The results showed that when a therapist’s intervention passes a patient’s tests, patients show signs of improvement both immediately and in the following session, and when therapists follow patients’ coaches, patients show signs of immediate improvement. The clinical implications and limitations of the findings are discussed.

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