Therapeutic activities after assimilation setbacks in the case of Alicia

ABSTRACT

This case study addressed what therapists do after assimilation setbacks. Previous research has shown that most setbacks reflect the client switching between strands of the problem and that most setbacks can be classified as balance strategy setbacks (BS) or setbacks due to the therapist exceeding the client’s zone of proximal development (TZPD). Alicia was a 26-year-old woman diagnosed as depressed and treated with a directive kind of therapy for 26 sessions. Sessions were transcribed and rated with the Assimilation of Problematic Experiences Scale (APES). Almost all setbacks could be classified as BS or TZPD. The therapist's succeeding interventions were coded with the List of Therapist’s Activities after a Setback and qualitatively described and summarized. Alicia showed improvement on the outcome measures, and the APES. Therapist activities following setbacks showed that exploratory activities and supportive and clarifying intentions seemed relatively more common after BS setbacks, whereas directive activities and intentions were relatively more common after TZPD setbacks. Results tended to support the conceptualization of setbacks as a switch of strands and suggested elaborations. In this directive therapy, the therapist tended to pursue the intended line of work after setbacks, using systematically different activities depending on which type of setback occurred.

KEYWORDS:

• Setbacks
• therapeutic activities
• therapeutic intentions
• balance strategy
• therapeutic zone of proximal development

Acknowledgments

The authors wish to thank Sara Llorens, Sonia Sáez and Restituto Vañó their participation as raters. And to Candela Conforte, Marc Franch, Carmen Paredes, and Raisa Pérez their participation as coders and observers.

Disclosure statement

No potential conflict of interest was reported by the author(s).

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Notes on contributors

Isabel Caro Gabalda

ISABEL CARO GABALDA Full Professor, Department of Personality, Assessment, and Psychological Treatments, University of Valencia (Valencia, Spain). She has written about linguistic therapy of evaluation, cognitive and constructivist psychotherapies, and process research. She has served as Associate Editor of Psychotherapy Research and is a member of the Editorial Board of journals such as Counselling Psychology Quarterly, or Behavioural and Cognitive Psychotherapy.

William B. Stiles

WILLIAM B. STILES Professor Emeritus, Department of Psychology, Miami University, Oxford, Ohio, USA Senior Research Fellow, Metanoia Institute, London, UK. He has been President of the Society for Psychotherapy Research and of Division 29 of the American Psychological Association (the Society for Psychotherapy). He has served as Editor of Psychotherapy Research and of Person-Centered and Experiential Psychotherapies. He has written about psychotherapy, verbal interaction, and research methods. Website: http://www.users.miamioh.edu/stileswb/ Email: [email protected]