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Therapist Common Factors’ Influence On ABSTRACT Title of Thesis: THERAPIST COMMON FACTORS’ INFLUENCE ON CLIENT CONSTRUCTIVE COMMUNICATION AND CONFLICT RESOLUTION IN COUPLE THERAPY Liza Harbison, Master of Science, 2018 Thesis Directed By: Professor Norman B. Epstein, Department of Family Science This study investigated the relationship between therapist common factors behaviors and changes in client constructive communication during couple therapy. Research suggests that common factors are associated with client improvement, but research on these factors in couple therapy is lacking. This study was a secondary data analysis of 41 couples presenting with mild to moderate psychological and physical partner aggression who received ten sessions of couple therapy at a university family therapy clinic. The study examined the relationship between therapist collaborative behavior and use of systemically based techniques coded from the fourth couple therapy session, and changes in client constructive communication, measured by client cognitions during conflict, client and partner behavior during conflict, and video coding of couple communication. Minimal significant links were found, but unexpectedly, therapist use of systemic techniques was negatively associated with change in female constructive problem solving cognitions. Implications of these findings are discussed. THERAPIST COMMON FACTORS’ INFLUENCE ON CLIENT CONSTRUCTIVE COMMUNICATION AND CONFLICT RESOLUTION IN COUPLE THERAPY By Liza Suzanne Harbison Thesis submitted to the Faculty of the Graduate School of the University of Maryland, College Park, in partial fulfillment of the requirements for the degree of Master of Science 2018 Advisory Committee: Professor Norman B. Epstein, Ph.D., Chair Assistant Professor Mona Mittal, Ph.D. Assistant Teaching Professor Laura Evans, Ph.D., Penn State University, Brandywine Campus © Copyright by Liza Suzanne Harbison 2018 Acknowledgements This thesis would not have been possible without the support and guidance of many people I am lucky to call my friends, family, and mentors. Norm, I cannot thank you enough for the support and patience you provided me during this process. You helped me grow and learn at every step of my thesis, and at every step of my graduate education. I am honored to have worked with you and know that your replacement has really big shoes to fill. Mona, you are such a force for good in this program and have helped me grow so much. Thank you for your encouragement and thoughtfulness about my thesis, and for the respect and time you give to your students. Laura, thank you for your support and attentiveness throughout this process and for bringing the language of common factors into my life. Your scale was the inspiration for my thesis and continues to influence how I conduct therapy. Diamond, Pam, Natalie, Naomi, Wilson, Jordan, Jasmine, Liann, and Rolonda, how can I begin to thank this wonderful cohort? My classmates, my co-therapists, my friends. When things got tough, I had the nine best therapists a woman could ask for. Thank you for being my clinic family for the last two years. Mom and Dad, you are the reason I followed this dream and believed I could see it through. Your unconditional support, love, and guidance helped me find my path. Thank you for being my cheerleaders and role models in all things. Josh, I literally could not have done this without you. Your willingness to take on so much to help me pursue my dream is something I can only hope to someday do for you. Your love makes me stronger, and life with you is my favorite adventure. I am so lucky to call you my husband in six months. I promise to start washing dishes again soon. ii Table of Contents ACKNOWLEDGEMENTS .......................................................................................................................... ii LIST OF TABLES ....................................................................................................................................... iv LIST OF FIGURES ...................................................................................................................................... v CHAPTER 1: INTRODUCTION ................................................................................................................. 1 STATEMENT OF THE PROBLEM .................................................................................................................. 1 PURPOSE .................................................................................................................................................... 5 LITERATURE REVIEW ................................................................................................................................ 7 Brief Summary of Empirical Evidence for the Effectiveness of Couple Therapy ................................. 7 History of Empirical Research to Test Efficacy of Specific Therapy Models ....................................... 8 Common Factors Influencing Therapy Outcomes (versus Therapy Model-Specific Effects) ............. 10 THEORETICAL FOUNDATIONS FOR STUDY .............................................................................................. 18 Social Learning Theory as a Base for Understanding Effects of Therapist Behavior on Client Functioning ......................................................................................................................................... 18 VARIABLES IN THE PRESENT STUDY ....................................................................................................... 25 HYPOTHESES ........................................................................................................................................... 26 CHAPTER 2: METHOD ............................................................................................................................ 28 SAMPLE ................................................................................................................................................... 28 MEASURES ............................................................................................................................................... 33 Therapist Collaborative Behavior ...................................................................................................... 33 Therapist Use of Systemically Based Techniques ............................................................................... 33 Client Constructive Problem Solving Cognitions ............................................................................... 34 Observed Client Constructive Communication Behavior ................................................................... 35 Client Self-Reports of Couple Mutual Constructive Communication ................................................. 37 PROCEDURE ............................................................................................................................................. 38 CHAPTER 3: RESULTS ............................................................................................................................ 41 OVERVIEW OF DATA ANALYSIS .............................................................................................................. 41 TESTS FOR POTENTIAL CONTROL VARIABLES ........................................................................................ 41 TESTS OF THE HYPOTHESES .................................................................................................................... 42 TEST OF RESEARCH QUESTION ............................................................................................................... 44 POST-HOC ANALYSES ............................................................................................................................. 44 CHAPTER 4: DISCUSSION ...................................................................................................................... 50 LIMITATIONS OF THE CURRENT STUDY .................................................................................................. 53 DIRECTIONS FOR FUTURE RESEARCH ..................................................................................................... 56 APPENDIX A ............................................................................................................................................. 61 APPENDIX B ............................................................................................................................................. 63 APPENDIX C ............................................................................................................................................. 64 APPENDIX D ............................................................................................................................................. 65 REFERENCES ............................................................................................................................................ 67 iii List of Tables TABLE 1: Descriptive Statistics for Couple Relationship Status 30 TABLE 2: Descriptive Statistics for Race of Female Partners 30 TABLE 3: Descriptive Statistics for Race of Male Partners 30 TABLE 4: Descriptive Statistics for Highest Level of Education Achieved for Female Partners 31 TABLE 5: Descriptive Statistics for Highest Level of Education Achieved for Male Partners 31 TABLE 6: Mean Scores on Pre- and Post-Therapy Assessments for Female Partners 46 TABLE 7: Mean Scores on Pre- and Post-Therapy Assessments for Male Partners 46 iv List of
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