Therapist beliefs, emotional reactions, and response styles to distressed clients
Altabef, David L.
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Talking though distress helps ease distress (Caplan, Haslett, & Burleson, 2005; Jones, 2004). Therapists’ use of responses which help clients process their emotions more deeply, such as active listening, are associated with positive therapy outcomes (Greenberg, 2004). However, listening to those in distress has been shown to be a stressful experience for the listener (Joiner & Katz, 1999). Research (e.g., Joiner & Katz; Lewis & Manusov, 2009) continues to explore factors that account for variance in the degree of emotional reaction to hearing distress and how the listener responds (i.e., active listening, advice, etc.). These factors are particularly relevant to therapists, both because they spend large amounts of their time listening to distress, and because their reactions and responses can affect client outcomes. This study examined the relationship of therapists’ beliefs about their responsibility to solve their clients’ problems in therapy with (a) their emotional reactions and (b) use of active listening or non-active listening responses to a distressed client. More specifically, this study explored the following research questions: 1. Is there a relationship between therapist beliefs associated with a need to fix/solve client problems and therapist negative emotional reactions to distressed clients? 2. Is there a relationship between therapist beliefs associated with a need to fix/solve client problems and whether a therapist uses active listening or problem-solving oriented responses with a client? In addition to therapist beliefs, this study explored demographic variables and therapist experience levels as independent variables which may impact therapist negative emotional reactions and use or non-use of active listening, with the following research questions: 3. What is the relationship between experience level of therapists and (a) therapist negative emotional reactions to distressed clients, and (b) whether or not therapists use active listening with a client? 4. What is the relationship between demographic variables and (a) therapist negative emotional reactions to distressed clients, and (b) whether or not therapists use active listening with a client? An online response form containing a video clip of an individual expressing distress, measures of negative emotion pre- and post-video, a measure of beliefs, and demographic data was sent to therapists and therapists in training. Responses were collected from 91 respondents, with 71 complete responses included in the final analysis. After viewing the clip, participants provided a written response to the individual in the video as though they were treating this person as a client. Responses were coded as either active listening or non-active listening, based on the operational definition of AL utilized by Rautalinko and Lisper (2004). Participants’ negative emotional reactions were measured by the Negative Affect Score component of the Positive and Negative Affect Schedule (PANAS; Watson, Clark, & Tellegen, 1988), at baseline and after viewing the clip. Therapist’s views regarding (a) their responsibility to ‘fix’ clients and (b) the role of emotion in psychotherapy will be measured using The Therapist Belief Scale – Revised (TBS-R; McLean, Wade & Encel, 2003). The purpose of this study was to provide additional information about variance in therapist emotional reactions to distressed clients and use of active listening or non-active listening based on their beliefs about responsibility. The results provided evidence that certain groups may be more likely to utilize active listening than others, including female therapists and counseling psychologists. Additional exploratory analyses highlighted a possible association between the use of active listening and another area of therapist beliefs: those related to a need for control and understanding. Results also supported the potential usefulness of Therapist Belief Scale – Revised, a relatively new scale, in assessing of therapist beliefs for training or professional development purposes. The findings may have implications for therapist training in general and inform the training of new therapists in the use of microskills – in particular, active listening.