https://doi.org/10.4081/ripppo.2021.590
Assessing children’s defense mechanisms with the Defense Mechanisms Rating Scales Q-sort for Children
Submitted: September 24, 2021
Accepted: December 17, 2021
Published: December 21, 2021
Accepted: December 17, 2021
Abstract Views: 2930
PDF: 1187
HTML: 627
HTML: 627
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Defense mechanisms are unconscious and automatic psychological processes that serve to protect the individual from painful emotions and thoughts. There is ample evidence from the adult psychotherapy and mental health literature suggesting the salience of defenses in the maintenance and amelioration of psychological distress. Although several tools for the assessment of children’s defenses exist, most rely on projective and self-report tools, and none are based on the empirically derived hierarchy of defenses. This paper outlines the development of the defense mechanisms rating scale Q-sort for children (DMRS-Q-C), a 60-item, observer-rated tool for coding the use of defenses in child psychotherapy sessions. Modifications to the Defense Mechanisms Rating Scale Q-Sort for adults to create a developmentally relevant measure and the process by which expert child psychotherapists collaborated to develop the DMRS-Q-C are discussed. A clinical vignette describing the child’s defensive functioning as assessed by the innovative DMRS-Q-C method is also reported. Finally, we provide an overview of forthcoming research evaluating the validity of the DMRS-Q-C.
Aafjes-Van Doorn, K., Békés, V., Xiaochen, L., & Prout, T. A. (2021). What do therapist defence mechanisms have to do with their experience of professional self-doubt and vicarious trauma during the COVID-19 pandemic?. Frontiers in Psychology, 12, 647503. doi:10.3389/fpsyg.2021.647503.
DOI: https://doi.org/10.3389/fpsyg.2021.647503
American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders. (4th ed., text rev.). Washington, DC: American Psychiatric Press.
Babl, A., grosse Holtforth, M., Perry, J. C., Schneider, N., Dommann, E., Heer, S., & Caspar, F. (2019). Comparison and change of defence mechanisms over the course of psychotherapy in patients with depression or anxiety disorder: evidence from a randomized controlled trial. Journal of Affective Disorders, 252, 212-220. doi:10.1016/j.jad.2019.04.021.
DOI: https://doi.org/10.1016/j.jad.2019.04.021
Békés, V., Aafjes-Van Doorn, K., Spina, D., Talia, A., Starrs, C. J., & Perry, J. C. (2021a). The relationship between defence mechanisms and attachment as measured by observer-rated methods in a sample of depressed patients: A pilot study. Frontiers in Psychology, 12, 648503. doi:10.3389/fpsyg.2021.648503.
DOI: https://doi.org/10.3389/fpsyg.2021.648503
Békés, V., Prout, T. A., Di Giuseppe, M., Wildes Ammar, L., Kui, T., Arsena, G., Conversano, C. (2021b). Initial validation of the defence mechanisms rating scales Q-sort: A comparison of trained and untrained raters. Mediterranean Journal of Clinical Psychology, 9(2). doi:10.13129/2282-1619/mjcp-3107.
Beresford, T. P. (2012). Psychological adaptive mechanisms: Ego defence recognition in practice and research. Oxford: Oxford University Press.
Berney, S., de Roten, Y., Beretta, V., Kramer, U., & Despland, J. N. (2014). Identifying psychotic defences in a clinical interview. Journal of Clinical Psychology: In Session, 70(5), 428-439. doi:10.1002/jclp.22087.
DOI: https://doi.org/10.1002/jclp.22087
Block, J. (1978). The Q-Sort method in personality assessment and psychiatric research. Mountain View, CA: Consulting Psychologists Press.
Boldrini, T., Lo Buglio, G., Giovanardi, G., Lingiardi, V., & Salcuni, S. (2020). Defence mechanisms in adolescents at high risk of developing psychosis: An empirical investigation. Research in Psychotherapy: Psychopathology, Process and Outcome, 23(1), 4-15. doi:10.4081/ripppo.2020.456.
DOI: https://doi.org/10.4081/ripppo.2020.456
Brown, S. R. (1993). A primer on Q methodology. Operant Subjectivity, 16, 91-138.
Brown, S. R. (1995). Q methodology as the foundation for a science of subjectivity. Operant Subjectivity, 18, 1-16.
Cramer P. (1991) The development of defence mechanisms. Berlin: Springer. Available from: https://doi.org/10.1007/978-1-4613-9025-1_12
DOI: https://doi.org/10.1007/978-1-4613-9025-1
Cramer, P. (2003). Personality change in later adulthood is predicted by defence mechanism use in early adulthood. Journal of Research in Personality, 37, 76-104. doi:10.1016/S0092-6566(02)00528-7.
DOI: https://doi.org/10.1016/S0092-6566(02)00528-7
Cramer, P. (2006). Protecting the self: Defence mechanisms in action. New York, NY: Guilford Press.
Cramer, P. (2008). Seven pillars of defence mechanism theory. Social & Personality Psychology Compass, 2, 1-19. doi:10.1111/j.1751-9004.2008.00135.x.
DOI: https://doi.org/10.1111/j.1751-9004.2008.00135.x
Cramer, P. (2015). Defence mechanisms: 40 years of empirical research. Journal of Personality Assessment, 97(2), 114-122. doi:10.1080/00223891.2014.947997.
DOI: https://doi.org/10.1080/00223891.2014.947997
Conversano, C. (2021) The psychodynamic approach during COVID-19 emotional crisis. Frontiers in Psychology, 12, 670196. doi:10.3389/fpsyg.2021.670196.
DOI: https://doi.org/10.3389/fpsyg.2021.670196
de Roten, Y., Djillali, S., von Rotten, F. C., Despland, J.-N., Ambresin, G. (2021). Defence mechanisms and treatment response in depressed patients. Frontiers in Psychology, 12, 633939. doi:10.3389/fpsyg.2021.633939.
DOI: https://doi.org/10.3389/fpsyg.2021.633939
Di Giuseppe, M., Ciacchini, R., Micheloni, T., Bertolucci, I., Marchi, L., & Conversano, C. (2018). Defence mechanisms in cancer patients: a systematic review. Journal of Psychosomatic Research, 115, 76-86. doi:10.1016/j.jpsychores.2018.10.016.
DOI: https://doi.org/10.1016/j.jpsychores.2018.10.016
Di Giuseppe, M., & Perry, J. C. (2021). The hierarchy of defence mechanisms: assessing defensive functioning with the defence mechanisms rating scales Q-sort (DMRS-Q). Frontiers in Psychology, 12, 718440. doi:10.3389/fpsyg.2021.718440.
DOI: https://doi.org/10.3389/fpsyg.2021.718440
Di Giuseppe, M., Prout, T. A., Rice, T., & Hoffman, L. (2020a). Regulation-focused psychotherapy for children (RFP-C): Advances in the treatment of ADHD and ODD in childhood and adolescence. Frontiers inPpsychology, 11, 572917. doi:10.3389/fpsyg.2020.572917.
DOI: https://doi.org/10.3389/fpsyg.2020.572917
Di Giuseppe, M., Perry, J. C., Conversano, C., Gelo, O. C. G., Gennaro, A. (2020b). Defence mechanisms, gender, and adaptiveness in emerging personality disorders in adolescent outpatients. The Journal of Nervous and Mental Disease, 208(12), 933-941. doi:10.1097/NMD.0000000000001230.
DOI: https://doi.org/10.1097/NMD.0000000000001230
Di Giuseppe, M., Perry, J. C., Lucchesi, M., Michelini, M., Vitiello, S., Piantanida, A., Fabiani, M., Maffei, S., Conversano, C. (2020c). Preliminary reliability and validity of the DMRS-SR-30, a novel self-report based on the defence mechanisms rating scales. Frontiers in Psychiatry, 11, 870. doi:10.3389/fpsyt.2020.00870.
DOI: https://doi.org/10.3389/fpsyt.2020.00870
Di Giuseppe, M., Perry, J.C., Petraglia, J., Janzen, J., & Lingiardi, V. (2014). Development of a Q-Sort version of the defence mechanism rating scales (DMRS-Q) for clinical use. Journal of Clinical Psychology, 70(5), 452-465. doi:10.1002/jclp.22089.
DOI: https://doi.org/10.1002/jclp.22089
Di Giuseppe, M., Perry, J. C., Prout, T. A., & Conversano, C. (2021a). Editorial: Recent empirical research and methodologies in defence mechanisms: Defenses as fundamental contributors to adaptation. Frontiers in Psychology, 12, 802602. doi:10.3389/fpsyg.2021.802602.
DOI: https://doi.org/10.3389/fpsyg.2021.802602
Di Giuseppe, M., Nepa, G., Prout., T. A., Albertini, F., Marcelli, S., Orrù, G., Conversano, C. (2021b). Stress, burnout, and resilience among healthcare workers during the COVID-19 emergency: the role of defence mechanisms. International Journal of Environmental Research and Public Health, 18, 5258. doi:10.3390/ijerph18105258.
DOI: https://doi.org/10.3390/ijerph18105258
Fortunato, A., Tanzilli, A., Lingiardi, V., & Speranza, A. M. (2021). Childhood personality assessment Q-sort (CPAP-Q): a clinically and empirically procedure for assessing traits and emerging patterns of personality in childhood. International Journal of Environmental Research and Public Health, 18, 6288. doi:10.3390/ijerph18126288.
DOI: https://doi.org/10.3390/ijerph18126288
Giovanardi, G., Mirabella, M., Di Giuseppe, M., Lombardo, F., Speranza, A. M., Lingiardi, V. (2021). Defensive functioning of individuals diagnosed with gender dysphoria at the beginning of their hormonal treatment. Frontiers in Psychology, 12, 665547. doi:10.3389/fpsyg.2021.665547.
DOI: https://doi.org/10.3389/fpsyg.2021.665547
Gross, J. J., Thompson, R. A. (2007). Emotion regulation: Conceptual foundations. In Gross, J. J. (Ed.), Handbook of emotion regulation (pp. 3-24). New York, NY: Guildford Press. doi:10.1080/00140130600971135.
DOI: https://doi.org/10.1080/00140130600971135
Hibbard, S., & Porcerelli, J. (1998). Further validation for the Cramer defence mechanism manual. Journal of Personality Assessment, 70(3), 460-483. doi:10.1207/s15327752jpa7003_6.
DOI: https://doi.org/10.1207/s15327752jpa7003_6
Hoffman, L., Rice, T. R., & Prout, T. A. (2016). Manual of regulation-focused psychotherapy for children (RFP-C) with externalizing behaviours: A psychodynamic approach. London: Routledge.
DOI: https://doi.org/10.4324/9781315736648
Hovanesian, S., Isakov, I., & Cervellione, K. L. (2009). Defence mechanisms and suicide risk in major depression. Archives of Suicide Research, 13(1), 74-86. doi:10.1080/13811110802572171.
DOI: https://doi.org/10.1080/13811110802572171
Kempe, L., Bohn, J., Remmers, C., Hörz-Sagstetter, S. (2021). It’s not that great anymore: The central role of defence mechanisms in grandiose and vulnerable narcissism. Frontiers in Psychology, 12, 661948. doi:10.3389/fpsyg.2021.661948.
DOI: https://doi.org/10.3389/fpsyt.2021.661948
Kramer, U., de Roten, Y., Perry, J. C., & Despland, J. N. (2013). Change in defence mechanisms and coping patterns during the course of 2-year-long psychotherapy and psychoanalysis for recurrent depression: a pilot study of a randomized controlled trial. The Journal of Nervous and Mental Disease, 201(7), 614-620. doi:10.1097/NMD.0b013e3182982982.
DOI: https://doi.org/10.1097/NMD.0b013e3182982982
Laor, N., Wolmer, L., & Cicchetti, D. V. (2001). The comprehensive assessment of defence style: measuring defence mechanisms in children and adolescents. The Journal of Nervous and Mental Disease, 189(6), 360-368. doi:10.1097/00005053-200106000-00003.
DOI: https://doi.org/10.1097/00005053-200106000-00003
Lingiardi, V., & Giovanardi, G. (2017). Challenges in assessing personality of individuals with gender dysphoria with the SWAP-200. Journal of Endocrinological Investigation, 40(7), 693-703. doi:10.1007/s40618-017-0629-7.
DOI: https://doi.org/10.1007/s40618-017-0629-7
Lingiardi, V., McWilliams, N., Bornstein, R. F., Gazzillo, F., & Gordon, R. M. (2015). The psychodynamic diagnostic manual version 2 (PDM-2): assessing patients for improved clinical practice and research. Psychoanalytic Psychology, 32(1), 94-115. doi:10.1037/a0038546.
DOI: https://doi.org/10.1037/a0038546
Lingiardi, V., & McWilliams, N. (Eds.). (2017). Psychodynamic diagnostic manual: PDM-2 (2nd ed.). London: The Guilford Press.
Lingiardi, V., Lonati, C., Delucchi, F., Fossati, A., Vanzulli, L., & Maffei, C. (1999). Defence mechanisms and personality disorders. The Journal of Nervous and Mental Disease, 187(4), 224-228. doi:10.1097/00005053-199904000-00005.
DOI: https://doi.org/10.1097/00005053-199904000-00005
Maffei, C., Fossati, A., Lingiardi, V., Madeddu, F., Borellini, C., & Petrachi, M. (1995). Personality maladjustment, defences, and psychopathological symptoms in nonclinical subjects. Journal of Personality Disorders, 9(4), 330-345. doi:10.1521/pedi.1995.9.4.330.
DOI: https://doi.org/10.1521/pedi.1995.9.4.330
Malone, J. C., Cohen, S., Liu, S. R., Vaillant, G. E., & Waldinger, R. J. (2013). Adaptive midlife defence mechanisms and late-life health. Personality and Individual Differences, 55(2), 85-89. doi:10.1016/j.paid.2013.01.025.
DOI: https://doi.org/10.1016/j.paid.2013.01.025
Metzger J. A. (2014). Adaptive defence mechanisms: function and transcendence. Journal of Clinical Psychology, 70(5), 478-488. doi:10.1002/jclp.22091.
DOI: https://doi.org/10.1002/jclp.22091
Nimroody, T., Hoffman, L., Christian, C., Rice, T., & Murphy, S. (2019). Development of a defence mechanisms manual for children’s doll play (DMCP). Journal of Infant, Child, and Adolescent Psychotherapy, 18, 58-70. doi:10.1080/15289168.2018.1565005.
DOI: https://doi.org/10.1080/15289168.2018.1565005
Perry J. C. (1990). Defence Mechanism Rating Scales (DMRS). 5th ed. Cambridge, MA: Author.
Perry, J. C. (2014). Anomalies and specific functions in the clinical identification of defence mechanisms, Journal of Clinical Psychology, 70, 406-418. doi:10.1002/jclp.22085.
DOI: https://doi.org/10.1002/jclp.22085
Perry, J. C., & Bond. M. (2012). Change in defence mechanisms during long-term dynamic psychotherapy and five-year outcome. American Journal of Psychiatry, 169, 916-925. doi:10.1176/appi.ajp.2012.11091403.
DOI: https://doi.org/10.1176/appi.ajp.2012.11091403
Perry, J. C., & Høglend, P. (1998). Convergent and discriminant validity of overall defensive functioning. Journal of Nervous and Mental Disease, 186(9), 529-535. doi:10.1097/00005053-199809000-00003.
DOI: https://doi.org/10.1097/00005053-199809000-00003
Porcerelli, J. H., Thomas, S., Hibbard, S., & Cogan, R. (1998). Defence mechanisms development in children, adolescents, and late adolescents. Journal of Personality Assessment, 71(3), 411-420. doi:10.1207/s15327752jpa7103_9.
DOI: https://doi.org/10.1207/s15327752jpa7103_9
Porcerelli, J. H., Cogan, R., Kamoo, R., & Miller, K. (2010). Convergent validity of the defence mechanisms manual and the defensive functioning scale. Journal of Personality Assessment, 92(5), 432-438. doi:10.1080/00223891.2010.497421.
DOI: https://doi.org/10.1080/00223891.2010.497421
Prout, T. A., Gerber, L. E., Gaines, E., Hoffman, L., & Rice, T. R. (2015). The development of an evidence-based treatment: regulation- focused psychotherapy for children with externalizing disorders. Journal of Child Psychotherapy, 41(3), 255-271.
DOI: https://doi.org/10.1080/0075417X.2015.1090695
Prout, T. A., Malone, A., Rice, T., & Hoffman, L. (2019). Resilience, defence mechanisms, and implicit emotion regulation in psychodynamic child psychotherapy. Journal of Contemporary Psychotherapy: On the Cutting Edge of Modern Developments in Psychotherapy, 49(4), 235-244. doi:10.1007/s10879-019-09423-w.
DOI: https://doi.org/10.1007/s10879-019-09423-w
Prout, T. A., Zilcha-Mano, S., Aafjes-van Doorn, K., Bekes, V., Christman-Cohen, I., Whisler, K., & Di Giuseppe, M. (2020) Identifying predictors of psychological distress during COVID-19: A machine learning approach. Frontiers in Psychology, 11, 586202. doi:10.3389/fpsyg.2020.586202.
DOI: https://doi.org/10.3389/fpsyg.2020.586202
Prout, T. A., Di Giuseppe, M., Zilcha-Mano, S., Perry, J. C., & Conversano, C. (2021a). Psychometric properties of the defence mechanisms rating scales-self-report-30 (DMRS-SR-30): internal consistency, validity and factor structure. Journal of Personality Assessment. [Epub ahead of print] doi:10.1080/00223891.2021.2019053.
Prout, T. A., Rice, T., Chung, H., Gorokhovsky, Y., Murphy, S., and Hoffman, L. (2021b). Randomized controlled trial of regulation focused psychotherapy for children: A manualized psychodynamic treatment for externalizing behaviours. Psychotherapy Research. [Epub ahead of print] doi:10.1080/10503307.2021.1980626.
DOI: https://doi.org/10.1080/10503307.2021.1980626
Rice, T. R., & Hoffman, L. (2014). Defence mechanisms and implicit emotion regulation: A comparison of a psychodynamic construct with one from contemporary neuroscience. Journal of the American Psychoanalytic Association, 62, 693-708. doi:10.1177/0003065114546746.
DOI: https://doi.org/10.1177/0003065114546746
Tallandini, M. A., & Caudek, C. (2010). Defence mechanisms development in typical children. Psychotherapy Research, 20(5), 535-545. doi:10.1080/10503307.2010.493536.
DOI: https://doi.org/10.1080/10503307.2010.493536
Tanzilli, A., Di Giuseppe, M., Giovanardi, G., Boldrini, T., Caviglia, G., Conversano, C., & Lingiardi, V. (2021). Mentalization, attachment, and defence mechanisms: a Psychodynamic Diagnostic Manual-2-oriented empirical investigation. Research in Psychotherapy: Psychopathology, Process and Outcome, 24(1), 31-41. doi:10.4081/ripppo.2021.531.
DOI: https://doi.org/10.4081/ripppo.2021.531
Tanzilli, A., Gualco, I., Baiocco, R., & Lingiardi, V. (2020). Clinician reactions when working with adolescent patients: the therapist response questionnaire for adolescents. Journal of Personality Assessment, 102(5), 616-627. doi:10.1080/00223891.2019.1674318.
DOI: https://doi.org/10.1080/00223891.2019.1674318
Tanzilli, A., Lingiardi, V., & Hilsenroth, M. (2018). Patient SWAP-200 personality dimensions and FFM traits: Do they predict therapist responses? Personality Disorders: Theory, Research, and Treatment, 9(3), 250-262. doi:10.1037/per0000260.
DOI: https://doi.org/10.1037/per0000260
Tanzilli, A., Muzi, L., Ronningstam, E., & Lingiardi, V. (2017). Countertransference when working with narcissistic personality disorder: An empirical investigation. Psychotherapy, 54(2), 184-194. doi:10.1037/pst0000111.
DOI: https://doi.org/10.1037/pst0000111
Tanzilli, A., & Gualco, I. (2020). Clinician emotional responses and therapeutic alliance when treating adolescent patients with narcissistic personality disorder subtypes: A clinically meaningful empirical investigation. Journal of Personality Disorders, 34, 42-62. doi:10.1521/pedi.2020.34.supp.42.
DOI: https://doi.org/10.1521/pedi.2020.34.supp.42
Steiner, H., Araujo, K. B., Koopman, C. (2001). The response evaluation measure (REM-71): A new instrument for the measurement of defences in adults and adolescents. American Journal of Psychiatry, 158, 467-473. doi:10.1176/appi.ajp.158.3.467.
DOI: https://doi.org/10.1176/appi.ajp.158.3.467
Vaillant, G. E. (1995). The wisdom of the ego. Cambridge, MA: Harvard University Press.
Vaillant, G. E. (1971). Theoretical hierarchy of adaptive ego mechanisms: A 30-year follow-up of 30 men selected for psychological health. Archives of General Psychiatry, 24(2), 107-118. doi:10.1001/archpsyc.1971.01750080011003.
DOI: https://doi.org/10.1001/archpsyc.1971.01750080011003
Wolmer, L., Laor, N., & Cicchetti, D. V. (2001). Validation of the comprehensive assessment of defence style (CADS): mothers’ and children’s responses to the stresses of missile attacks. The Journal of Nervous and Mental Disease, 189(6), 369-376. doi:10.1097/00005053-200106000-00004.
DOI: https://doi.org/10.1097/00005053-200106000-00004
How to Cite
Di Giuseppe, M., Prout, T. A., Ammar, L., Kui, T., & Conversano, C. (2021). Assessing children’s defense mechanisms with the Defense Mechanisms Rating Scales Q-sort for Children. Research in Psychotherapy: Psychopathology, Process and Outcome, 24(3). https://doi.org/10.4081/ripppo.2021.590
Copyright (c) 2021 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Adam Otto Horvath, Jeremy Safran: a hero's journey , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 22 No. 1 (2019)
- Johan Berg, Lars-Gunnar Lundh, Fredrik Falkenström, Countertransference in Swedish psychotherapists: testing the factor structure of the Therapist Response Questionnaire , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 22 No. 1 (2019)
- Juliana Beatriz Stover, Alejandro Castro Solano, Mercedes Fernández Liporace, Dysfunctional personality traits: relationship with Five Factor Model, adaptation and symptomatology in a community sample from Buenos Aires , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 22 No. 2 (2019)
- Gianluca Lo Coco, Giorgio A. Tasca, Paul L. Hewitt, Samuel F. Mikail, Dennis M. Kivlighan, Jr., Ruptures and repairs of group therapy alliance. An untold story in psychotherapy research , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 22 No. 1 (2019)
- Olga Fernández González, J. Carola Pérez, Mariane Krause, The relation between the therapeutic alliance and communicative intentions in therapeutic interaction during the initial phase of adolescent therapy , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 22 No. 2 (2019)
- Francesca Locati, Franco Del Corno, Laura Parolin, Jeremy Safran’s impact on Italian psychotherapy research and practice: a window into the processes involved in therapeutic alliance , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 22 No. 1 (2019)
- Júlia Halamová, Jana Koróniová, Martin Kanovský, Mária Kénesy Túniyová, Nuriye Kupeli, Psychological and physiological effects of emotion focused training for self-compassion and self-protection , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 22 No. 2 (2019)
- Leandro Martín Casari, Mirta Susana Ison, Beatriz Margarita María Gómez, Personal style of the therapist and personality dimensions in a sample of Argentinian therapists , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 22 No. 2 (2019)
- Attà Negri, Christopher Christian, Rachele Mariani, Luca Belotti, Giovanbattista Andreoli, Kerri Danskin, Linguistic features of the therapeutic alliance in the first session: a psychotherapy process study , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 22 No. 1 (2019)
- Marco Solmi, Mara Campeol, Federica Gentili, Angela Favaro, Carla Cremonese, Clinical presentation and need for treatment of a cohort of subjects accessing to a mental illness prevention service , Research in Psychotherapy: Psychopathology, Process and Outcome: Vol. 23 No. 1 (2020)
You may also start an advanced similarity search for this article.