Hostname: page-component-76fb5796d-vfjqv Total loading time: 0 Render date: 2024-04-26T10:46:32.325Z Has data issue: false hasContentIssue false
  • English
  • Français

Juicy Conceptualizations: Increasing Alliance Through Attending to Client Metaphoric Language

Published online by Cambridge University Press:  17 May 2017

Fiona Mathieson Open the ORCID record for Fiona Mathieson [Opens in a new window] ,
Jennifer Jordan ,
Paul Merrick  and
Maria Stubbe
Fiona Mathieson*
Affiliation:
University of Otago, Wellington, New Zealand
Jennifer Jordan
Affiliation:
University of Otago, Christchurch, New Zealand
Paul Merrick
Affiliation:
Massey University, Albany, Auckland, New Zealand
Maria Stubbe
Affiliation:
University of Otago, Wellington, New Zealand
*
Correspondence and reprint requests to Fiona Mathieson, Department of Psychological Medicine, University of Otago, Wellington, PO Box 7343, Wellington 6242, New Zealand. E-mail: fiona.mathieson@otago.ac.nz
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: There is increasing interest in the use of metaphor in cognitive behaviour therapy. Experts advocate bringing client metaphors into case conceptualizations, but there is little empirical research to support this. Aims: This study evaluated the effect of training 12 therapists to attend to client metaphors and bring them into case conceptualizations. Method: Pre- and post-training role-played therapy sessions were conducted and video-recorded. Alliance was rated by role play ‘clients’ and an external expert rated the quality of the sessions and of the shared conceptualizations. Results: There were significant increases in some ratings of alliance, based on role play ‘client’ ratings and external ratings of role plays of therapy sessions before and after training. The greater the difference between therapist and ‘client’ on a measure of preference for producing metaphor, the lower the rating of the session by the ‘client’ on the Bond factor score of an alliance measure, the Working Alliance Inventory. This result suggests that working metaphorically may be most effective when the therapist and client have a similar degree of preference for speaking metaphorically. Conclusion: This study provides preliminary support for the idea that attending to client metaphors during conceptualization can be beneficial for alliance.

Keywords

Metaphorcognitive behaviour therapyconceptualizationalliance
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 45 , Issue 6 , November 2017 , pp. 577 - 589
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Blackburn, I., James, I. A., Milne, D. L., Baker, C., Standart, S., Garland, A. and Reichelt, F. K. (2001). The revised cognitive therapy scale (CTS-R): psychometric properties. Behavioural and Cognitive Psychotherapy, 29, 431–466.CrossRefGoogle Scholar
Blampied, N. M. (2007). Single-Case Research Designs: Adaptations for the Analysis of Group Data. Paper presented at the Association for Behavior Analysis International Conference, August 2007, Sydney, NSW, Australia.Google Scholar
Brinley, J. F. (1965). Cognitive sets, speed and accuracy of performance in the elderly. In Welford, A. T. and Birren, J. E. (eds), Behavior, Ageing, and the Nervous System: Biological Determinants of Speed of Behavior and its Changes with Age, pp. 114–119. Springfield, IL: Charles C. Thomas.Google Scholar
Butler, G., Fennell, M. and Hackmann, A. (2008). Cognitive Behaviour Therapy for Anxiety Disorders: Mastering Clinical Challenges. New York: Guilford Press.Google Scholar
Cohen, J. W. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd edn). Hillsdale, NJ: L. Erlbaum Associates.Google Scholar
Duncan, B., Miller, S., Sparks, J., Claud, D., Reynolds, L., Brown, J. and Johnson, L. (2003). The Session Rating Scale: Preliminary Psychometric Properties of a ‘Working’ Alliance Measure. Journal of Brief Therapy, 3.Google Scholar
Elliott, C., Adams, R. and Hodge, G. (1992). Cognitive therapy: possible strategies for optimising outcome. Psychiatric Annals, 22, 459–463.Google Scholar
Ferrara, K. W. (1994). Therapeutic Ways with Words. New York, NY: Oxford University Press.Google Scholar
Foody, M., Barnes-Holmes, Y., Barnes-Holmes, D., Törneke, N., Luciano, C., Stewart, I. and McEnteggart, C. (2014). RFT for clinical use: the example of metaphor. Journal of Contextual Behavioral Science, 3, 305–313. doi: https://doi.org/10.1016/j.jcbs.2014.08.001 CrossRefGoogle Scholar
Gibbs, R. and Colston, H. (2012). Interpreting Figurative Meaning. New York, NY: Cambridge University Press.Google Scholar
Goncalves, O. F. and Craine, M. H. (1990). The use of metaphors in cognitive therapy. Journal of Cognitive Psychotherapy, 4, 135–149.CrossRefGoogle Scholar
Hatcher, R. L. and Gillaspy, J. (2006). Development and validation of a revised short version of the Working Alliance Inventory. Psychotherapy Research, 16, 12–25. doi: https://doi.org/10.1080/10503300500352500 Google Scholar
Hayes, S. C., Strosahl, K. D. and Wilson, K. G. (1999). Acceptance and Commitment Therapy: An Experiential Approach to Behaviour Change. New York: Guilford Press.Google Scholar
Hoffart, A., Borge, F.-M., Sexton, H., Clark, D. M. and Wampold, B. E. (2012). Psychotherapy for social phobia: how do alliance and cognitive process interact to produce outcome? Psychotherapy Research, 22, 82–94.CrossRefGoogle ScholarPubMed
Horvath, A. O. and Greenberg, L. S. (1986). The development of the Working Alliance Inventory psychotherapeutic process: a research handbook (pp. 529–556). New York, NY: Guilford Press.Google Scholar
Horvath, A. O. and Greenberg, L. S. (1989). Development and validation of the Working Alliance Inventory. Journal of Counseling Psychology, 36, 223–233. doi: https://doi.org/10.1037/0022-0167.36.2.223 CrossRefGoogle Scholar
Horvath, A. O. and Symonds, B. D. (1991). Relation between working alliance and outcome in psychotherapy: a meta-analysis. Journal of Counseling Psychology, 38, 139–149.Google Scholar
Kopp, R. and Craw, M. (1998). Metaphoric language, metaphoric cognition, and cognitive therapy. Psychotherapy: Theory, Research, Practice, Training, 35, 306–311.Google Scholar
Kuyken, W., Beshai, S., Dudley, R., Abel, A., Görg, N., Gower, P. et al. (2016). Assessing competence in collaborative case conceptualization: development and preliminary psychometric properties of the Collaborative Case Conceptualization Rating Scale (CCC-RS). Behavioural and Cognitive Psychotherapy, 44, 179–192. doi: 10.1017/S1352465814000691 Google Scholar
Kuyken, W., Padesky, C. A. and Dudley, R. (2009). Collaborative Case Conceptualisation: Working Effectively with Clients in Cognitive-Behavioral Therapy. New York: Guilford Press.Google Scholar
Martin, J. D., Graske, J. P. and Davis, M. K. (2000). Relation of the therapeutic alliance with outcome and other variables: a meta-analytic review. Journal of Consulting and Clinical Psychology, 68, 438–450.Google Scholar
Mathieson, F., Jordan, J., Carter, J. and Stubbe, M. (2015). The metaphoric dance: co-construction of metaphor in cognitive behaviour therapy. the Cognitive Behaviour Therapist, 8, e24.CrossRefGoogle Scholar
Mathieson, F., Jordan, J., Carter, J. D. and Stubbe, M. (2016). Nailing down metaphors in CBT: definition, identification and frequency. Behavioural and Cognitive Psychotherapy, 44, 236–248. doi: 10.1017/S1352465815000156 Google Scholar
McMullen, L. M. (2008). Putting it in context: metaphor and psychotherapy. The Cambridge Handbook of Metaphor and Thought (pp. 397–411). New York, NY: Cambridge University Press.Google Scholar
Munder, T., Wilmers, F., Leonhart, R., Linster, H. W. and Barth, J. (2010). Working Alliance Inventory-Short Revised (WAI-SR): psychometric properties in outpatients and inpatients. Clinical Psychology and Psychotherapy, 17, 231–239.Google Scholar
Newman, C. F. (2015). Becoming a virtuoso in CBT: learning and interpreting the score with technique and artistry. Paper presented at the BABCP 2015 43rd annual conference, University of Warwick.Google Scholar
Padesky, C., Kuyken, W. and Dudley, W. (2011). Collaborative Case Conceptualization Rating Scale and Coding Manual, version 5, 19 July.Google Scholar
Pallant, J. (2010). SPSS Survival Manual: a step by step guide to data analysis using the SPSS program (4th edn).Google Scholar
Raue, P. J. and Goldfried, M. R. (1994). The therapeutic alliance in cognitive-behavior therapy. The Working Alliance: Theory, Research, and Practice (pp. 131–152). Oxford, UK: John Wiley and Sons.Google Scholar
Ronen, T. (2011). The positive power of imagery: harnessing client imagination in CBT and related therapies. West Sussex, UK: Wiley-Blackwell.Google Scholar
Semino, E., Heywood, J. and Short, M. (2004). Methodological problems in the analysis of metaphors in a corpus of conversations about cancer. Journal of Pragmatics, 36, 1271–1294. doi: https://doi.org/10.1016/j.pragma.2003.10.013 Google Scholar
Sims, P. and Whynot, C. (1997). Hearing metaphor: an approach to working with family-generated metaphor. Family Process, 36, 341–355. doi: 10.1111/j.1545-5300.1997.00341.x Google Scholar
Snippe, E., Fleer, J., Tovote, K., Sanderman, R., Emmelkamp, P. M. and Schroevers, M. J. (2015). The therapeutic alliance predicts outcomes of cognitive behavior therapy but not of mindfulness-based cognitive therapy for depressive symptoms. Psychotherapy and Psychosomatics, 84, 314–315. doi: https://doi.org/10.1159/000379755 Google Scholar
Stott, R., Mansell, W., Salkovskis, P., Lavender, A. and Cartwright-Hatton, S. (eds) (2010). Oxford Guide to Metaphors in CBT: Building Cognitive Bridges. Oxford, New York: Oxford University Press.Google Scholar
Tay, D. (2013). Metaphor in Psychotherapy: A Descriptive and Prescriptive Analysis. Amsterdam, Netherlands: John Benjamins.Google Scholar
Yarbrough, D. B. (1991). The reliability and validity of a measure of reported affinity for figurative language. Creativity Research Journal, 4, 317–335.Google Scholar
Submit a response

Comments

No Comments have been published for this article.