Ernotion and elllotional expressions arc crucial factors in human psy―
chological wcl卜bcing and devclopmcnt(Frijda,1988:Penncbakcr,1990):indecd,an m● 。r thCOries of psychothcrapy acknowledge thc close relation‐ship bet、 vccn client emotional expressions and the proccsses of thcrapeuti9
change.In psychoanalysis,thc root of hysterical symptoms、 vas considercd
to bc strong emotion that has bcen strangulatcd(Breuer&Freud,1895)
and abreaction、 /as thc process by、vhich the patient was thoughtto achicve
a dircct cxprcssion of thcsc affects,resulting in a curc,or catharsis.Reich
(1949)cmphasized the role of abrcaction and the sustained cxpression ofcinotion throughout therapy as an important curative factor:he suggested
that the analysis of clients'defenses、 vas inost cffcctive、 vhen clients、vere
enlotionaHy aroused.
This cathartic nlodel of emotion is not lirnited to psychoanalysis,but
appears also in other approaches,such as prirnal screanl and bioenergctics
(Kos11liCki&Glickauf― Hugllcs,1997).Clients'cnlotional arousal is also
givcn central inlportance in experiential therapy,、 vhcrc cvoki1lg a clicnt's
cnlotional exprcssion is thought to bc csscntial to therapeutic、 vork and
also is seen to bc the nrst step in resol宙 ng clicnts'problems(Gcndlin,1996:Greenbcrg,Ricc,&Elllott,1993:Mahrcr,1986,1989)Affcctivcexploration― ―a ccntral thcrapeutic task in、 vhich clients attempt to discover
thc pcrsonai nlcaning of cvcnts and problematic cxpcricnccs― ―rcquircs
clicnts to havc inlmediate feclings in the session, rathcr than to silllply
recount Fcelings experienccd in the past ln the constructivist cognitive
thcrapies as、veH,change in cognitivc schcmata is conccptualizcd as rcquir―
ing a clicnt's affcctivc involvement in thcrapeutic tasks:、 vithout such en―
gagcnlent,any rcsulting changes lllay fail to produce long― term effects on
thc clicnt(Guidano,1991,1995:Mahoncy,1991).Some rcscarch has indicatcd that ilighcr lcvcis of client cmotional
eXPrCSS10n in therapy are rclated to better posttherapy outcomes
(Grccnbcrg&Safran,1987;Rosner,1996:Wiser&GoldfHcd,1993).Fur―thernlore,psychothcrapists of varying oricntations have nonlinatcd clicnts'
enlotional cxprcssion as one of the change mechanisms active across aH
schools of therapy,a colllmon factor crucial to psychothcrapcutic change
(Frank&Frank,1 991l Garflcld,1989).Foa and Kozak(1986),for CXamplc,havc cited emotional involvemcnt as a conlmon factor across different
thcrapics Noncthclcss,although clinicians frolll various theorctical schools
agree on the innportance or client emotional expression,itis not yet undcr―
stood undcr、 vhat conditions clients'affective cxpressions have the most
thcrapeutic potency. In othcr、 vords, it renlains unclear、 vhcther grcatcr
cnlotional involvcmcnt or cxprcssion isィ !′ It,rrys bcncFlcial,or、 vhcthcr there
Client Einotions,Therapisl lntervelltions,alld the Alliance
cxist Optiinal conditions in、 vhich clicnt emotiOnality lnay have diffcrcntial
valuc in therapy.
The Working Alllance,Therapist lnterventiOns,and Client
EmOtiOnaI PrOcesses
1、'akabe,Rogan,and Sta:ikas
thc sallle as thcir exprcssion of affect in a、 varm,safc,and appropriatetherapcutic environment、 vill bc; furthermore, it M/in not have the same
Watson and Greenberg(1994)report Cases in which failure to establish
a good 、vorking aniance interfered 、vith clients' performance on certain
thcrapcutic tasks in process― expcrientialthcrapy.Springing from an intcgra―
tion of clicnt―centercd and gcstalt therapics,thcsc tasks include focusing
ort、 vo― chair cxcrciscsthat cvoke and facHitatc the exploration ofimmediate
cinotional experienccs. In the cascs studied by Vヽatson and Grccnberg,clicnts、vere unablc lo conccntrate on thc task at handisome、 verc distracted
by aspccts Of the relationship,and some felt anxious about being``a good
clicnt.・ 'Onc client,reporting hcr expericnce to the authors in thc intcrvicw
aftcr thc scssiOn,stated,“ l anl fecling a littic bit confused and a littlc lost
becausc l am not sure ho、 v to do it propcrly l'rn trying to flgurc out、 vhat
she wants me to do Or what shc wants mc to say...''(p.161).ThC aim
of the exercises is tO help clients to intensify,to more fu‖ y expericncc,andto synlbolize more adequatcly the n。 、v oftheir cmotionsithat goal、 vill not
be achievcd if a client's attention is divcrted to extcrnal cucs、 irrclcvant t()
thc task in、vhich they are engaged Conscquently,the authors point out,
clicnts、vho are covcrtly or ovcrtly prcoccupied、 vith the quality of their
thcrapeutic relationship may experiencc frustration and illlpatience, and
inay not bcnerit optimaHy from a val・ icty of therapcutic intcrventions.
Thcrapists、 vith a psychodynantic orientation hold that the curative
po、ver of affectivc intervcntions such as transfercncc interpretations is
contingent upon thc quality of the tllerapcutic relationship(ButiCr&
Strupp,1991:Horvath&Luborsky,1993).WithOut the cstablishment of a
sufnciently positivc、 vOrking aHiance bct、 vcen therapist and clicnt,therapeu―
tic progrcss nlay bc dclaycd duc to unnecessary ncgativc rcsistancc.Franz
AIcxander describcs thc priinary mcchanism of psychoanalytic curc as a`・ corrcctive cmOtional cxperience,''in、 vhich favorable cmotional cOnditions
in thc therapy setting a‖ o、v thc patient tO cOpc、 vith and work throughsituations that he or shc could not handlc in thc past.Thus,hc lnaintains,・̀ Thc principal curativc po、 vers of this trcatmcnt . . lic in the fact that
lthe paticnti can eXpress his aggress市 cness tOward thc thcrapist without
being punished,and can asscrt hilllself without bcing ccnsured"(Alexan―
dcr&French,1946,p.22).“ Other thcrapeutic factors― such as intcllcctual
insight,abrcaction,rccoHcction of thc past,ctc.一 一are a‖ subordinatcd tothis ccntral thcrapcutic principle. . . .In the paticnt― physician rclationship,
the therapist has an unique opportunity tO providc the patient、 vith precisely
that typc of corrcctive expcriencc、 vhich he nccds for recovery''(p.338)It
、vould thereforc appear that a‖ psychoanalytic、vork,not silllply affectively
Clienl Emol:ons,Therapist interventions,and the Alliance 379
focused intervention,is rnost effective in the cOntcxt ofa sPccial relationship
or、vorking aHiance
Sirnilarly, in cognitivc therapy, thc clicnt's affcctivc invOlvcmcnt in
tasks such as cognitivc restructuring is hampcred、 vhen thc thcrapist― clientrelationship is nOt well establishcd(Raue&Goldfried,1994).Thcir atten―
tion shifts fronl thc task tO the therapisti as a result,clients fecl frustrated
and angry at the therapist, not knowing、vhcre the scssiOn is going,■ Or、vhetherthe thcrapist understands thcir nceds or even、 vhcther thcir currentactivity is in any way rclevant tO thc ends they、 vish tO achieve in thcrapy
(Safran&scgal,199()).In such cascs、 a sessiOn Of cOgnitivc thcrapy mayturn intO a dcbatc rather than a trcatment.Aaron Bcck(1970)has Called
the therapeutic a‖ iance in cognitivc thcrapy`'a cOHaborativc cmpiricisnl、 ''
and he emphasizcd its grcatimpOrtancc tO thcrapeutic cFfectivcncss.Bchav_
loral rescarchers、 toO,have discOvcred that rclationship variablcs cOntribute
signincantly tO outcOmc in thcir therapeutic wOrk(c.g.、 Agras,Lcitcn―berg,&Bar10w,1968).
Therc arc variOus cOnceptualizatiOns Ofthe rolc Of emOtiOnsin pcrson―
ality fllnctiOning as、 vcH as in psychOpatho10gy, but most sccnl to agrcethat productivc、vOrk、vith emOtiOns inv01vcs thc establishmcnt Of a safe
and supportive thcrapcutic rclationship.The relcvance of thcse factors tO
psychOtherapy intcgratiOn is also supported by the fact that bOth chcnt
cmotions and thc thcrapcutic rclationship have bccn identincd as critical
factOrs across psychOthcrapy systems(Orlinsky&Howard,1986:ヽValbOrn,1996).Indeed,therapeutic wOrk with cmOtiOnal cxpressiOns is discusscd
alrnost cxclusively under certain optimal relatiOnship conditiOns.In spitc Of
thc thcOretical and clinical emphasis placcd On the importance of relatiOnal
conditiOns tO client emotiOnal proccsses across thcOretica1 0rientatiOns,no
prcviOus research has cxa1llincd the interaction bet、veen thcse t、vO variables.If clicnts exprcss their emotiOns and a gOod rclationship is prcscnt in
the prOcess of psychOtherapy,differcnt therapies may foHo、v a silllilar path
in、vhich thcrapist― clicnt intcractions shO、 v a particular pattern indicativeof prOductive prOccss,regardlcss Of theOrctica1 0rientatiOn ()n the Othcr
hand,if thc thcrapeutic relationship is p00r,a client may not be ablc tO
exprcss his Or hcr fceling around problcmatic situatiOnsi this situatiOn,
臨‖:さi∴:1よ梶1濯in麗:胤髄‖ぷ富:ギ L[::忍著岬rtti盟 :and thcrapcutic relationship may prOvide a point Of convcrgencc sinlilar
to、vhat(3oldfried has ca‖ cd the clinical stratcgic lcvc1 0fintcgration,、 vherc
出認:Lξttλ∬響嘲亀1:簡ム「首rttit選驚富甚棚1躍p 994).
380 1wakabe,Rogan,and Stailkas
PURPOSE OF THE PRESENT STUDY
Thc purposc of thc present study 、vas to cxanlinc thc rclationshipbct、vecn clicnts'cmotional exprcssions,therapists'interventions,and the
、vorking aHiancc in a specinc sample T、 vO scts of research questions、 vereexplorcd in this study The nrst sct of questiOns focuscs on the clicnt and
their emotional cxpressions:(a)Do clicnts exprcss feclings morc intcnsely
whcn thc levc1 0f working allianccお high?(b)What typcs of cmotions arecxpressed whcn thc lcvel of the working alliancc is high(or 10W)?The
focus in this nrst set of research questions is on thc nature and intensity
of emOtiOnal expressiOns in t、 vO、vOrking aniance conditions.
The secOnd sct Of qucstions investigatcs therapist responses to,and
clicnt bchaviors around,cmotional expression:(a)IS the target(or direc_
tiOn)Of Clicnts' emotional cxprcssion different in thc high vs. thc lo、 v
working alliancc group?(b)Do the thcrapist intcrventions that fo1low
clicnts'cmotional exprcssions differ bctween thc two aHiancc groups?(c)
Is thc therapist_clicnt interaction fo‖ o、ving a client｀ s cmotional cxpresslondifferent,depending upOn the relationship contextin、 vhich thc cxpressionoccurred?This set Of rcscarch qucstions、 vill invcstigatc、 vhethcr clicnt―
therapist interactions,as、 vcH as thcrapist intervcntions in the twO cOndi―
tions、 are distinguishable from cach other.ヽ Vhat、ve、vant to achieve is an
abstraction Of charactcristic patterns of intcractions bct、 vcen thcrapist andclient across high and low、 vOrking aHiance conditions,in ordcr to obtain
not only differences in thc score of one dimension(i.e.,mean differencc
in intensity and type of emOtions),but also a more global picture of the
therapcutic proccss(i.e、 diffcrences in thc unfolding pattcrn of thcrapyunder various alliance cOnditions).The CCntral question is whether the
therapcutic process unfolds differcntly in high vs. low v/orking aHiancc
conditions.ヽ Ve aimed tO cOnstruct a nlicrOproccss lnOdel of cffective inter―
ventions by delineating distinct patterns Of thcrapist一 client intcractiOn cen―
tered around client emotional expressions associatcd with each lcvel of the
、vorking aHiancc.Thc in― session events、 ve investigatc in this papcr are of
clinical signincance,and are often evaluated and navigated intuitively by
clinicians.Thc development of a process model ofthese events,by transiat―
ing intuitive maps intO mOre explicit stcps、 、vi1l offer the possibHity ofmore cmpirical study,and thus a rnOre solid understanding of these events
(EI:iott,1989).
METHOD
In orderto ans、 verthc t、vo sets of qucstions above,thc prcscnt invcsti―
gation employcd two distillct rcscarch strategics.For thc nrst set ofresearch
C:ient EItlotions,TheraPist lntervcntions,and the AIliance 381
SAMPLE
Iwakabe,Rogan,and Stalikas
found to have thc lowcst WAI wcrc asfoHowsiallliddle scssion of Abraham
Le宙tsky with Ms L.,a woman in hcr thirtics(American Academy ofPsychotherapists Tapc Library,52 statcmcnts):a scCOnd session of Sidncy
Jourard with a middlc― agcd man(Amcrican Academy of PsychotherapistsTapc Library,60 statcnlents):PCris and Gloria,an initial session with a
woman in her tllirtics(ShOStrom,123 statements)i and Ellis and Sally,
an initial scssion with a woman in hcr thirtics(Albcrt Ellis lnstitutc,53
statements).Vcrbatim transcripts of these sessions werc obtained and
chcckcd against the audio tapes. Sincc our goal 、vas to make intensive
descriptions of rarc、 in― session evcnts that have not previously been studied,
our sample sizc、vas smaH.ヽ Vc also、vanted to test group differences using
statistical tests in ordcr to makc comparisons.The usc of a sman samplC
had scveral important ranlincatiOns that、 vill bc discussed later in relation
to our nndings.
Instruments
WO″た′′7g/4〃′α′7εビル7υθrl′ィク′7(NN′リ
Thc WAI(HorVath&Greenbcrg,1986)is a panthcorcticalinstrumcnt,
comp● scd of 36 Likert― type itcms(7 points),renecting three dinlcnslons
of the therapcutic relationship.Thcsc arc(a)“ Task,｀ 'renccting agrcemcnt
or coHaboration as to therapeutic activitiesi(b) “Goal,'' renecting
agrcclllcnt as to the aims of tllerapyl and(c).`BOnd,''rcllecting the positive
affcctive attachmcnt bct、 vccn C:ient and thcrapist.TllcヽVAl yiclds both a
total lcvcl of trtHiancc scorc,and individualleveis of each ofthe abovc threc
subscales.´「
herc arc paraHci client,therapisti and observer forms of this
inventory.While the present invcstigation uscd the obscrvcr― rated vcrsion
()fthcヽVAl,moststudiesexanliningthepsychomctricproperticsoftheWAlhavc focused on the clicnt｀ s and thcrapist's self― rcport vcrsions(HorVath&
Greenberg,1986,1989)In a Study by Tichcnor and Hill(1989),an ObSCrver
version ofthcヽ VAIsho、ved adequatc rcliability,、vith a Cronbach α ranging
bct、veen 84 and .98, as、 veH as convcrgent validity 、vith othcr obscrvcr
incasures of thc thcrapeutic aHiancc,such as the California Psychothcrapy
Alliancc Scalc
7カ g Sr′で′lgr/79′ ″ピιノル7g Sc′ ノぞrSFS'
Thc SFS,prcviously kno、 vn as thc Strcngth of Clicnt Fccling Scalc―
Re宙 scd(IwakabC,Stalikas,&Rogan,1995),was an adaptation of an carlicr
ibllぶ::記Fオ撫lll:i乱:譲よ:∬漁翼Tttti:糧 f:翼f鮮feeling At Lcvc1 4,clients cxprcss a mOderatc intcnsity of fceling whOse
type is alsO disccrniblc At Levc1 5 fecling is consPicuous 、vith variOus
織 T笥 ls‖:[胤gttRF鵠
よ ;::Lβ lよ躍 [よ :L『常 島:鷲::讐fccling、vords that M/cre sclcctcd from a p00!Of fccling、vords on the basisthat thcy、vcrc nlost frcqucntly cxpressed Feclings The typc of emotiOn is
rcgistered when intcnsity reachcs Lcvc1 4(1.e.When client cmotion is
unambigu?uSIy present).The list includes 20 fecling words:acceptancc,
器I∬Yふ、冒ほ1:lpttξ ttt螺;:冦l邸iよ、投竜I善im:1shame,and sLlrprisc.The scalc rcports acceptable lcvels Of intcrrater relia―
(2ι`ピ
ドrノィ,′ ]′ 2`′ ′′‐`ル
,7・ だ′,7イツ/ノィ,′ :″′′i1/7′θ∫∫′`,′
:だυ`′
7′、ゞ
`0だ
だεリ
Thc QEEE was dcvc10pcd spccifically forthis study,in Ordcrto invcsti
朧τ驚思吼:,311Ttttヽ 11:∬:lll『需じ冨どTと l壕I?i訛計judges tO describc aspccts of thcrapist rcsponscs tO thc clicnt's cmotional
Raters frorn thc McGill Psychothcrapy Proccss Rescarch Tearn had
previously rated an scssiOns fronl an original data pool of 25 psychothcrapy
憲 Tr:S臨 盤 ‖ 鷺 ∫為 瑞 :為蹴 :ぜ稲 も簡)II蹴
:織 [ξ嘗
each others'ratings or ofthe hypothcseS ofthe prescnt study.Thc intcrrater
Client EmOtiOns,Therapist interventions,and the Alliance
reliability measurcd by the Ebers intraclass corrclation、 vas bct、vecn .88
and.92 Thc mean Total WAI score oftlle 25 sessions was 172.05(SD=
36.82)For the prcscnt study,the four sessions included in the 10w_WAI
group have Total― VヽAI scorcs one standard deviation lo、ver than the nlean
(WAI Total<135.23).ThrCC Ofthe 4 sessions in the high― WAI group hada Total― WAI scorc one standard dc宙 ation above thc mcan(WAI Total>208.87)i thc fOurth highest session had a Total― WAI scorc of 195.This is
not a fu‖ standard deviation abOve thc mean,but 、ve included this as afourth sessiOn since it had the next highest WAI score,and its score、 vas
nonctheless inore than half a standard deviation above the mcan.
Sご暉ι`′
′7cc θ′1〃 R′′′″わノノ′r10F Cο`′
ル7ルゞ
′ヽerbatim transcripts、 vere obtaincd ofthc 4 scssions、 /ith thc highest,
and the 4 sessions、 vith the lo、vcst 、vorking aHiance scorest an thcrapiSt
and clicnt statements、 vere nunlbercd consccutivcly.A counsclor or clicnt
statemcnt 、vas dcfined as an the 、vords spoken by one party, precedcdand fo1lowcd by words spokcn by thc othcr party Eacll ludgc listcned
indcpcndcntly to thc cight audio― tapc scssions using thc vcrbatim transcript、
and ratcd every statcment using the SFS.Ratcrs、 oncc lnore,、 vere unawareofthc hypothcscs and focus ofthc prcscnt study.Thc raters lllet to concur
on thcir ratingsi a critcrion of 8()%agrccment amongst the iudges(fOur
out of nve)was requircd to accept a rating for thc SFS Ifthrcc or fcwer
For thc intcnsity scalc of SFS,Ebers intraclass corrclation coefflcients
(1950)for thCSC nve raters bcfore the consensus wcre betwccn.62 and.89for the 8 sclected tapcs,、 vith a mcan coefncicnt Of.74.For the type scalc
of the SFS,Cohcn's κ coefncients(1960)for all possiblc combinations ofany two judges rangcd bctwccn.69 and.92.
Results of Stlldy I
Thc mcan intensity of fccling、 vas obtaincd for each of 8 scsslons by
avcraging across al statcmcnts in cach scssioni thcrcfOre,a total of 8 6nal
scores(four in cach group)wcrC Obtaincd.Thc mcan intensity of feeling
across the 4 higll― WAI groups was 2.79(mean SD=.98)and aCrOss thclow‐ WAI groups 2.68(mean SD=.99).A onc― way analysis of variance、vas conductcd in ordcr to exanlinc thc differcnce in intcnsity of fceling
across the t、 vo WAIconditions.The tcst failed to nnd a signincant differencc
“C(I「 :chent‐ centercd therapy sessiOni ETl existcntial thcraPy session:GT:Gcstalt therapy scssioni RET:rational emotive thcrapy sessiOn The Strengthof Clicnt Fccung scalc― ―Re宙sed is a 6-point scale ranging frOm″ ′:ι ′″′′ルどj′,g(1)tO Sr″ο′:gメ′ノ′″g(6)ヽ4ean intcnsity was calculated by averagingυ■ヽ llし
=ll■ CC11113 0し diC~~｀ C Vibじ ulS a O― polnl scale ranging trom″ ′:ι ′″′′″ ピ′ι″g(1)tO Sr″ ο′:gノど′″″g(6)～ lean intcnsity was calculated by averagingthe totai number of statemcnts Frcquency of types of fceling are recordcd only、 vhen thc intcnsity level reaches lcvc1 4 The ll indicates the numbcrof statcments in each scssion The number in parcnthescs fo1lo、 ving frequcncy scores includes ro、 v pcrcentagc for the frequency of type of feeling
Illakabe,Rogan,ancl Stalikas
scssions. Whcn nlore than t、 vo cvents、 verc identiflcd in a singic scssiOn,
thc scgnlent、vith the highcstintensity offecling、 vas selected for study.After
events of cmOtiOnal expression were identined,the researchers retapcd iust
those scgments involved, and retyped the segments in a ne、 v vcrbatilll
transcript.ヽVc includcd thcrapists'statcments prior to clicnts'emotional
cxprcssions, in order to make the contcxt of events clearer. The nnal
stimulus matcrial that was prcscnted to thc iudgCS,Was madc by randomiz―
ing the ordcr oF segments in terms ofthe working aHiance group to、/hich
thesc scgments belong.Finally,ten iudgeS WhO did not participate in SFS
orヽVAI― ()ratings、 verc askcd to listen indepcndently to each segment、 vith
thc vcrbatinl transcripts, and then to use the QEEE to provide a brief
dcscription regarding(a)therapist intention and intervention in responsc
to thc clicnt emotional cxpression,and(b)SubSeqLlent Clicnt bchaviour in
rcsponse to thc thcrapist intervcntions.
S′ 91`ピ′]cι`′
′7r/′マι′′′わノノfry 9′ Cイ )ζノr77gs
Thc firstitcm on the QEEE一 ―thc dircction of tlle clicnt's cmotional
eXPl‐ ession― had an average kappa coeFncicnt or.95.Thc OEEE itcm f()r
rating thc type of prirllary fcchng had an average kappa cocfficicnt of.83,
and of 73 for thc sccOndary fccling.Ebcl's intraclass corrclations bctwcen
thc tcn iudgeS On thc 8 QEEE Likert scalc itcms rangcd betwecn 62 and
.92、vitll an avcragc of.82.Thc loM/cst rCliability cocfflcicnt、 vas obtaincd
for the QEEE itelll rcgarding therapist intervention in linking cxprcssed
feeling to other lllaterials.Overan,thesc indiccs of rcliability attcst to the
satisfactory accuracy of the measurements in thc present study. For thc
last two qualitativc qucstiOns,、 vc sorted and summarizcd the rcsponscs by
fo‖ o、ving a content analytic proccdurc.First,dcscriptions of the events of
cinotional cxpressions,writtcn by tllc tcn iudges,were typcd,duplicated,
and given tO thc t、 vo principa!rcscarchcrs.Thesc t、 vo rcscarchers read thc
rcsponses Of thc ten cliniccnljЧ dgeS fOr cach cvcnt、 and then cach draftcd
a final version of cvcnt dcscription.Third、 11l order lo enable confirmation
and cross― validation、 tlle t、vo pl・incipal rescarchers compared their versions
and generated a flna!version of the cvent dcscription Vヽhen rcsults ofthe
two rescarchers・ contcnt analyses did not agrcc,thc third rcscarcherioincd
the t、vo to resolve discrcpallcicsin ordcrto rnakc thc nnal vcrsion acccPtable
to aH three rcscarchers
Next,colllll10n Charactcristics across cvcnts as、 /eH as uniquc aspccts
of each cvent 、vcre cxalllilled ′へfter dcscriptions of the 8 evcnts 、vere
generated,the threc rcscarchersindepcndently isolated common character―
istics of thc 4 events bclongi:lg to thc sameヽ VAI group、 、vhile also noting
any idiosyncratic tcndencies of each evcnt.Oncc again,the thil・ d rescarchcr
iOined the nrsttwo whcn therc was disagreement bctween the two principalresearchcrs.FinaHy,modcls、 verc constructed out of the conllnon factors.
Duc to thc open_endcd nature of the data,inteliudgc reliability could be
dctcrmincd in a formal manner.Howcver,thc m● oHty Of diffcrences that
cmcrged bctwccn the clinicaljudgcs as wcll as thc thrcc researchers wcre
minor,mainly associatcd with、vording or phrasing.
Results of Study II
E′ 77イガ′`'′
1″ノExI)′・6、 ′ゞ`,′
,s
ln 3 out of 4 scssions in thc high― WAI group,iudges using thc QEEEagrced that the emotions 、vith thc highcst SFS― rated illtensity 、verc cx―presscd to、 vard a past cvcnt,or to、vard somconc in thc client's lifc.Thc
predonlinanttypc oF client cinotions manifestcd varicd fronl one high― VヽAIscssion to anotllcr(ic,Sadncss ocCurrCd in 2 sessions、 angerin l、 and fearin l).On thc othcr hand,in al1 4 of thc low_WA I scssions,thc strongcst
exprcssed in the low― VヽAI condition wcre ratcd by thc oEEE judges asbcing rathcr uniforill(ie..frustration occurrcd in 2 scssions,and anger also
in 2).
Cノ7`′″`rcrピ
′,`rたドィぇ′7カ′″′′ガ、ゞ了―C′た′7r′′7r`7・″(｀ r′ィ)′ 1
Thc S Likcrt scalc itcms conccrning charactcristics of thc thcrapist―
clicnt intcractions 、vcre analyzcd in a lllultivariatc analysis of variancc
dcsign,with one bctwcen― subicct ractor and two within― suЦ cct Factors Themeasurc of the working aniance was a bctwcen― subiectS factor with twolevcls(high― and 10w_WAl).Each thcrapist clicnt cvcnt was trcated as a
random factOr ncsted、 vithin thcヽ VA I groups.Thc individual scssions、 vcrcincluded as a randonl factor so that thc findings fronl our samplc、 vouldbc generalizable to other scssions of a siin‖ ar、vorking aHiancc lcvcl.Raters
wcrc sccn as a random,within― subieCt factor(10 1CVC!s)Although we wcrcnot intcrestcd in thc diffcrcnce Of mcan ratings ofthc QEEE ludgcS,they
vヽcre includcd hcrc as a randonl factor sO that our lilldings 、vould bcgcneralizable to othcr clinical iudgCS With similar levcls of clinical expcn―
ence ln this dcsign, 、ve included in the statistical ll10del only the main
effects Of these thrce variables,since intcractions bct、 veen factors arc notofintcrest,and in some cases not mcanillgful,tilus a‖ owing a rllorc parsinlo―
Iwakabc,Rogan,and Stalikas
nious tcst.Thc analysis was conducted using thc Gcncral Linear Ⅳlodel
procedure(prOc GLM)in thC SAS progranLMeans and standard de宙 ations Of each QEEE item arc presented in
Table II The multivariate test sho、 ved that thc overan effcct for VヽAIgroup was signincant,ス 8,56)=18.32,ρ <.001.UnivaHate follow― upanalyscs showcd that aH but l oftlle 8 dinlensions measured by thc QEEE
had signincant cffccts(sce Table II).The 10 Clinical judges who wcre
unaware of which sessiOns orヽ VAI group thc scgmellts camc fl‐ om―deternlined that levels of therapist empathy, Icvcls of thcrapist rcspon‐
sivcness, and icvels Of effectivcness Of therapists' interventions 、vere aHsignilicantly higher in the high― VヽAI group than in thc lo、 v― VヽAI group.Therapists in the high― VヽAI group alsO matchcd their vocal quality to that
of thcir clicnts lnOre than therapists in thc lo、 v―Ⅵ/AI group did.Ho、 vever,
high― VヽAI thcrapists、 vere less expressive of their o、vn feelings than、 verethose in thc 10wハvAI group(i.e.,lCSs tllerapist self― disclosure).High― WAItherapists、verc also less likely to intcrrupt clicnts'emotional cxpressions.
In turn,clients in the high― WAI group wcre iudged by Our ratcrs to JVCmore elaborated vcrbal descriptions of their emotions than those in thc
lo、 v― VヽAI group.FillaHy,Only one characteristic of therapists'behavior v/as
notsignincantly diffcrcnt bctwecn thc high and low workingalliancc grouls,
namely the extent to 、vhich therapists sought to link clicnts' emotional
cxprcssions tO a clicnt's thcmc or issue
Although a general group trcnd、 vas found bet、 vccn high― and low―
VヽAI groups, it appcars that therc is alsO large 、vithin group variability.
Particularly notable is the fact that,ofthe 4 1o、 v― /ヽAI therapists,2 received
effectivcness ratings that were as high as those received by thc high― VヽAI
Tal)ic II.Mcans and Standard Dc宙 ations ofthc 8 oEEE Itcms for High and Low WorkingAlliancc(〕 rouPs _High‐ VヽAI Group
(″ =4)LowヽVAI Group
(″ =4)
MCan (Sの) MCan (SD)
EmpatllyRcsPonSiVCncssVoicc matchingEffcctivcncss
Thcrapist
Sclf― disclosurc
Linking issucs
群It露器r面 _̈ ょ郡 お脇″ρ < ()5ハρ <()01
415()カ
4475カ
4()25.
46()().
115(ソ
3525
(1737)(1212)(1 775)
(()757)
(0580)(0499)
175029()()
20752_650
19()()
335021503775
“
1889)
(0829)(1 355)
(1320)
(1390)(()493)
(1916)(()9()())
CIient EmOtiOns,Therapist lnterventiOns,and the A‖ianc0 391
7/7`″ζr′おr― Cノた′7r′′7r′ ″`rc″
θ′7S Sθ9`ィ
`′
76`
Expressiontoward therapist
Encourage furtherexpresslon in ahere‐ and‐■ow manner(COnfrOntation,direct guidance)
Inaccurateassessment oF client
emotions
Resistance
Uninvolved
Frustration
ExPIoratiOn oftherapist‐ client
relationship
LowヽVAI
TheraDlSt
lntervention
Client
Bchavlour
GoodGT2(3.3)GT3(4.1)
Effcctivencss
m
Fig.1.市Iodcis of cvcnts of client cmotional exprcssions
High WAI
Good to Excellent
濃篭滉手ら,鴨Tl,>D
りＯＮ
И″g′″
Fr″ s′″α`Jο
″
LowRET2(1.1)ET(2.2)
】彙́“″”一ｏ・嘱″●””〓・”ョ』
∽〔“〓″”ゆ
ExPressiontoward client's
problems
high empathy,resPonsiveness,voice matching,encouraging furtherexpresslon
data used.The nlost rclcvallt Ofthcsc is that archiva!data OfFers us ncither
informatiOn about thc uitiinatc OutcOmc Ofthe sessions studied、nOr abOut
thc tralectOry of changcs Over thc cOurse Of thcrapy(eg.,shifts over tinle
in tlle wOrking alliancc).our invcstigatiOn,hOwcver,cOul(l fOrc80 thiS
::翼‖:l:IIP:署 ::滋 1臨 :R慧配 l導 凛 i:TItλ 鳳 l誓II:wil:ania1lcc and lo c01lstruct a nlicrOprOccss lllodcl in、
vhich future theorizatiOnas、vc‖ as cmpirical 、vOrk can bc built. It 、vOuld bc invaluable, in futtlrcrcsearch,to tcst ho、 v thc pr()ccssCsヽ ve studicd:‐ clate tO thc fi1la1 011tcomc.a1ld alsO tO cxanline thc difFcring cOnscclucnCCS Of cmotional cxpressi01l at
various phascs Ofthcrapy,as M/cH as thc inlportancc()fthc、vOrkil]g aniancc
at differcnt stagcs lt is possibic t1lat cmOtiOnal cxpressiOns in the eariv
phasc Ofthcrapy arc rclatcd lo clicnts｀ distrcss lcvels duc tO the iml■ ediaclof their prOblenlatic situations. As thcraPy prOgrcsscs、
cnlotions illay becxpresscd lllorc to、 vard past evcnts and issLICS arisil18 frolll the cxploratiOn
of prOblcms,clcarly a diffcrcnt class Of cinotional wOrk.The nattirc of Ollr
data alsO neccssitatcd that 、ve trcat thc wOrkillg a‖ iance as a Fairly static
