Therapeutic Technique of APA Master Therapists: Areas of Difference and Integration Across Theoretical Orientations

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Abstract

This study utilized the American Psychological Association (APA) PsycTHERAPY digital video database of therapy masters working with participants on problems related to either anxiety or depression. Thirty-four APA master sessions were included. Therapist primary orientation included Cognitive–Behavioral (CB), Psychodynamic–Relational (P/R), and Person Centered-Experiential (PC/E), the last of which served as a comparison group to contrast the former 2 samples. All sessions were evaluated using the Comparative Psychotherapy Process Scale (CPPS) by 4 independent clinical raters who demonstrated excellent (>.75; Fleiss, 1981) reliability in the rating of these sessions. Results demonstrated significant differences on the CPPS Psychodynamic-Interpersonal (CPPS-PI) and Cognitive-Behavioral (CPPS-CB) subscales in the expected directions between the APA master CB and P/R sessions. APA master PC/E sessions did not rate as highly on either CPPS-PI or CPPS-CB subscales than therapists from the respective modalities. A subsample Integrative (IN) group was created using APA master therapist secondary orientation to further analyze the relationship between technique use and integration. Findings demonstrated that IN master therapists utilized significantly more CPPS-CB techniques than P/R therapists, and significantly more CPPS-PI techniques than CB therapists, supporting the IN orientation. Further, CB-3rd wave (Schema, ACT, Mindfulness) APA master therapist sessions demonstrated a significantly greater integration (i.e., use) of CPPS-PI items, particularly those related to participant emotional expression and exploration, identifying patterns of experience, and facilitating insight, than the traditional CB APA master therapist sessions. Clinical implications with regard to training and practice will be discussed.

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