If we look at the therapeutic relationship as a process of reciprocal attunement, and if we define the therapeutic alliance as a sequence of ruptures and repairs in that interpersonal attunement (Safran & Muran 2000), it follows that in order to evaluate the quality this relationship it necessary to observe the so-called “local level” of the interaction (BCPSG, 2010), adopting a single communicative exchange (i.e. turn of speech) as a unit of measurement. The Collaborative Interactions Scales Revised (Colli, Gentile, Condino, & Lingiardi, 2014, 2017) and the Analysis of Interpersonal Motivations in Transcripts (Liotti & Monticelli, 2008) are two tools to be applied in clinical session transcripts, that have been developed within different theoretical frameworks, but that share a common interest in the study of the therapeutic relationship at the micro-process level. Nowadays, few theories claiming that our cognitive processes are oriented by a finite number of psychobiological systems whose goal are innate and set by the evolution of the species, whereas their functioning is shaped by interpersonal experience. Apart from attachment and sexuality, almost all authors also agree on the existence of at least a caregiving system and a ranking-competitive system. According to the evolutionary anthropology, a more recent motivational system appeared in some primates, and it is also visible in infants from the age of nine months, together with a sense of fairness and equity which anticipates the appearing of the morality: that of the peer cooperation. Thank to this motivational system, we are able to share our intentions and goals with other people. It is Giovanni Liotti in particular who placed the peer cooperation system at the centre of his conceptualisation of the therapeutic interaction (Liotti & Monticelli, 2014). Our work is part of a series of studies (Gentile et al, 2009; Colli et al., 2010, 2011; Lingiardi et al., 2014) that have found: (i) a correspondence between the collaborative interventions and the activation of the peer cooperation interpersonal motivational system; and (ii) a correspondence between the rupture markers and the activation of the rank interpersonal motivational system. The present study proposedto deepen the knowledge of the motivational attunement processes underlying the phases of “collaboration” and of “rupture”. Specifically, our aims are to investigate if: (1) the coordinations of the interpersonal motivational systems are predictive ofcollaborative processes; (2) the caregiving/careseeking interpersonal motivational systems are predictive both of collaborative processes and the ruptures processes. Methods: Sample is composed of sixty (n=60) transcript sessions from 30 Caucasians patients (14 men, 16 women; mean age=33.23 years, SD=6.76) in cognitive psychotherapy. All patients received a DSM–5 diagnosis (APA, 2013). A total of 11 patients had at least one PD diagnosis (cluster A=2; cluster B=4; cluster C= 4; not otherwise specified=1). Twelve patients have a clinical syndrome without PD diagnosis (mood disorders=2; anxiety disorders=3; eating disorders=2; adjustment disorder=4; substance use disorder=1). Seven patients have a PD diagnosis and a clinical syndrome in comorbidity. Psychotherapies were administered by 11 psychologists and 4 psychiatrists (mean age=45 years, SD=9), with a mean clinical experience of twelve years (SD=7). Therapists practiced in a private setting and in a mental health institutions. The transcript sessions were analyzed in a double-blind design with the CIS-R and AIMIT. Two group of independent raters evaluated the sessions. The raters were trained psychologists with a good IRR (ICC=.80 for the CIS-R and ICC=.78 for the AIMIT). Measures: (1) the Collaborative Interactions Scale-Revised (CIS-R) to evaluate therapeutic alliance ruptures and collaborative/resolution processes from an observer’ s perspective. The scale is inspired to the Safran and Muran’s model. The CIS-R is divided into two scales, one for the patient (CIS-P) and one for the therapist (CIS-T). The CIS-P is further divided into four subscales: Direct Rupture Markers (DRMs; three items), Indirect Rupture Markers (IRMs; four items), Direct Collaborative Processes (DCPs; three items), and Indirect Collaborative Processes (ICPs; three items). The CIS-T is composed of four subscales: Direct Collaborative Interventions (DCIs; four items), Indirect Collaborative Interventions (ICIs; three items), Rupture Interventions (RIs; five items), and Therapist Interventions (four items): supportive, explicative, explorative, and expressive). (2) the Assessing Interpersonal Motivations in Transcripts (AIMIT) is a validated coding system to assess the activation of interpersonal motivational systems in the transcripts of psychotherapy sessions as well as in any kind of human verbal interaction. According to a multi-motivational approach developed on the basis of attachment theory, the AIMIT include five basic motivational systems: care seeking and care giving systems for attachment relationships, rank system for the definition of dominance or submission, sexual mating and the cooperative system. AIMIT method allows the evaluation of the interpersonalstyles of both the patient and the therapist as well as their interactions in sessions. It is considered a useful instrument for exploring the relational context, especially in the ruptures and repairs of the therapeutic alliance, where AIMIT are typically either improper or not synchronized. The results evidenced that the coordination of the interpersonal motivational systems is predictive ofa better quality of the therapeutic alliance. The collaborative interactions (DCP, ICP, DCI, ICI) are mainly predicted by the cooperative interpersonal motivational system (b=.829, p=.000), whereas ruptures (DRM, IRM, RI) are characterized by competitive exchanges (b=.746, p=.05). However, results suggest that the processes of interpersonal attunement may be more rich and variated than that; as an example, the social rank interpersonal motivational system may be involved in the direct negotiation of goals and tasks of thetherapy (b=.658, p=.000), and the caregiving/careseeking interpersonal motivational systems may appear in both the indirect collaborative processes (b=.547, p=.003) and the indirect ruptures markers (b=.732, p=.025). These results will be discussed in the light of the convergence aspects and of the main theoretical differences between the two instruments and their theoretical perspectives.
Collaboration and beyond: the micro-processual analysis of the therapeutic relationship / Brasini, Maurizio; Gentile, Daniela; Aleandri, Stefania; Montuori, Anna; Pucci, Silvia; Colli, Antonello; Lingiardi, Vittorio; Liotti, Giovanni. - In: RESEARCH IN PSYCHOTHERAPY. - ISSN 2239-8031. - 21:1(2018), pp. 21-22. ((Intervento presentato al convegno XII Congresso Nazionale SPR Italia. "Oltre le tecniche. Psicoterapia e ricerca". tenutosi a Palermo.
|Titolo:||Collaboration and beyond: the micro-processual analysis of the therapeutic relationship|
|Data di pubblicazione:||2018|
|Citazione:||Collaboration and beyond: the micro-processual analysis of the therapeutic relationship / Brasini, Maurizio; Gentile, Daniela; Aleandri, Stefania; Montuori, Anna; Pucci, Silvia; Colli, Antonello; Lingiardi, Vittorio; Liotti, Giovanni. - In: RESEARCH IN PSYCHOTHERAPY. - ISSN 2239-8031. - 21:1(2018), pp. 21-22. ((Intervento presentato al convegno XII Congresso Nazionale SPR Italia. "Oltre le tecniche. Psicoterapia e ricerca". tenutosi a Palermo.|
|Appartiene alla tipologia:||04c Atto di convegno in rivista|