The Attainment of Insight in the Insight Stage of the Hill Dream Model: The Influence of Client Reactance and Therapist Interventions

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Ten sessions with high client insight gains in the insight stage and high client reactance, 10 with low insight gains and low reactance, 10 with high insight gains and low reactance, and 10 with low insight gains and high reactance were selected from 157 single sessions of dream-work. Judges coded therapist response modes and rated client insight in each speaking turn in the insight stage. Therapists used more interpretive and “other” responses but fewer probes for insight with clients who gained more insight in the insight stage. In speaking turns immediately following therapist interventions, clients were judged as having the most insight after interpretive responses and probes for insight, less after paraphrases, and even less after “other” responses. Results are discussed in terms of limitations and implications for practice and research.

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