https://doi.org/10.4081/ripppo.2024.751
The assessment of therapist responsiveness in psychotherapy research: a systematic review
Submitted: January 16, 2024
Accepted: May 13, 2024
Published: June 19, 2024
Accepted: May 13, 2024
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SUPPLEMENTARY MATERIAL: 143
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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.
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Therapist responsiveness is an emerging construct in psychotherapy research that still lacks a clear definition and, consequently, a unique operationalization. Indeed, there is a great overlap between therapist responsiveness and other variables, such as attunement, flexibility, and empathy. This overlap inevitably hinders the assessment of the therapist’s responsiveness, although it is crucial for the effectiveness of the treatments. Therefore, the current systematic review aims at exploring the different methodologies of measurement and analysis of therapist responsiveness, including both direct and indirect instruments. The results confirmed difficulties and divergences in the operationalization of the construct, as shown by the great heterogeneity found in the choice and use of the tools. Furthermore, this review provides guidance for future research, clinical practice, and training of therapists.
Barker, T. H., Stone, J. C., Sears, K., Klugar, M., Tufanaru, C., Leonardi-Bee, J., Aromataris, E., & Munn, Z. (2023). The revised JBI critical appraisal tool for the assessment of risk of bias for randomized controlled trials. JBI Evidence Synthesis, 21(3), 494-506. doi: 10.11124/JBIES-22-00430.
Cahill, J., Barkham, M., Hardy, G., Gilbody, S., Richards, D., Bower, P., & Connell, J. (2009). A review and critical appraisal of measures of therapist-patient interactions in mental health settings. Health Technology Assessment, 12(24), iii. doi: 10.1108/cgij.2009.24814aaf.003.
Culina, I., Fiscalini, E., Martin-Soelch, C., & Kramer, U. (2022). The first session matters: therapist responsiveness and the therapeutic alliance in the treatment of borderline personality disorder. Clinical Psychology & Psychotherapy, 30(1), 131-140. doi: 10.1002/cpp.2783.
Elkin, I., & Smith, Y. (2007). Therapist responsiveness study rating scale. School of Social Service Administration, University of Chicago, Chicago, Illinois.
Elkin, I., Falconnier, L., Smith, Y., Canada, K. E., Henderson, E., Brown, E. R., & Mckay, B. M. (2014). Therapist responsiveness and patient engagement in therapy. Psychotherapy Research, 24(1), 52-66. doi: 10.1080/10503307.2013.820855.
Erskine, R. G. (1998). Attunement and involvement: therapeutic responses to relational needs. International Journal of Psychotherapy, 3(3), 235-244.
Esposito, G., Di Maro, A., & Passeggia, R. (2024). The relationship between treatment integrity and outcome in group psychotherapy: A systematic review. Clinical Psychology & Psychotherapy, 31(1), 1-17. doi: 10.1002/cpp.2952
Esposito, G., Passeggia, R., Cutolo, A. S., Karterud, S., & Freda, M. F. (2020). Treatment integrity and members’ change in group counseling: A pilot study on counselor’s mentalizing interventions. Professional Psychology: Research and Practice, 51(6), 588-597. doi: 10.1037/pro0000304
Eubanks, C. F., Lubitz, J., Muran, J. C., & Safran, J. D. (2019). Rupture resolution rating system (3RS): development and validation. Psychotherapy Research, 29(3), 306-319. doi:10.1080/10503307.2018.1552034.
Eubanks, C. F., Sergi, J., & Muran, J. C. (2021). Responsiveness to ruptures and repairs in psychotherapy. In Watson, J. C., & Wiseman, H. (Eds.), The responsive psychotherapist: attuning to clients in the moment (pp.83-103). American Psychological Association.
Gelo, O. C. G., Pritz, A., & Rieken, B. (2015). Preface. In O. C. G. Gelo, A. Pritz, & B. Rieken (Eds.), Psychotherapy research: Foundations, process, and outcome (pp. v-vi). Springer.
Gelo, O. C. G., Salcuni, S., & Colli, A. (2012). Text analysis within quantitative and qualitative psychotherapy process research: Introduction to special issue. Research in Psychotherapy: Psychopathology, Process and Outcome, 15(2), 45–53. https://doi.org/10.7411/RP.2012.005
Gelso, C. J., Kelley, F. A., Fuertes, J. N., Marmarosh, C., Holmes, S. E., Costa, C., & Hancock, G. R. (2005). Measuring the real relationship in psychotherapy: initial validation of the therapist form. Journal of counseling psychology, 52(4), 640-649. doi: 10.1037/0022-0167.52.4.640.
Hatcher, R. L. (2015). Interpersonal competencies: responsiveness, technique, and training in psychotherapy. American Psychologist, 70(8), 747-757. doi: 10.1037/a0039803.
Hatcher, R. L. (2021). Responsiveness, the relationship, and the working alliance in psychotherapy. In Watson, J. C., & Wiseman, H. (Eds.), The responsive psychotherapist: attuning to clients in the moment (pp. 37-58). American Psychological Association.
Hatcher, R. L., & Gillaspy, J. A. (2006). Development and validation of a revised short version of the working alliance inventory. Psychotherapy research, 16(1), 12-25. doi: 10.1080/10503300500352500.
Kendall, P. C., & Frank, H. E. (2018). Implementing evidencebased treatment protocols: flexibility within fidelity. Clinical Psychology: Science and Practice, 25(4), e12271. doi: 10.1111/cpsp.12271.
Kivlighan, Jr, D. M., Kline, K., Gelso, C. J., & Hill, C. E. (2017). Congruence and discrepancy between working alliance and real relationship: Variance decomposition and response surface analyses. Journal of Counseling Psychology, 64(4), 394-409. doi: 10.1037/cou0000216.
Kramer, U., Flückiger, C., Kolly, S., Caspar, F., Marquet, P., Despland, J. N., & De Roten, Y. (2014). Unpacking the effects of therapist responsiveness in borderline personality disorder: motive-oriented therapeutic relationship, patient in-session experience, and the therapeutic alliance. Psychotherapy and Psychosomatics, 83(6), 386-387. doi: 10.1159/000365400.
Kramer, U., Pascual-Leone, A., Rohde, K. A., & Sachse, R. (2016). Emotional processing, interaction process, and outcome in clarification-oriented psychotherapy for personality disorders: a process-outcome analysis. Journal of Personality Disorders, 30(3), 373-394. doi: 10.1521/pedi_2015_29_204.
Lockwood, C., Munn, Z., & Porritt, K. (2015). Qualitative research synthesis: methodological guidance for systematic reviewers utilizing meta-aggregation. International Journal of Evidence-Based Healthcare, 13(3), 179-187. doi: 10.1097/XEB.0000000000000062.
Marques, L., Valentine, S. E., Kaysen, D., Mackintosh, M. A., Dixon De Silva, L. E., Ahles, E. M., Youn, S. J., Shtasel, D. L., Simon, N. M., & Wiltsey-Stirman, S. (2019). Provider fidelity and modifications to cognitive processing therapy in a diverse community health clinic: Associations with clinical change. Journal of Consulting and Clinical Psychology, 87(4), 357-369. doi: 10.1037/ccp0000384.
McAleavey, A. A., & Castonguay, L. G. (2015). The process of change in psychotherapy: common and unique factors. In O. C. G. Gelo, A. Pritz, & B. Rieken (Eds.), Psychotherapy research: foundations, process, and outcome (pp. 293-310). Springer Vienna.
Messina, I., Gelo, O. C. G., Sambin, M., Bianco, F., Mosconi, A., Fenelli, A., Curto, M., Gullo, S., & Orlinsky, D. (2018). Trainees’ self-evaluation of their development as psychotherapists: An Italian contribution to an international collaborative study on psychotherapy training. Clinical Psychology & Psychotherapy, 25(2), 338–347. https://doi.org/10.1002/cpp.2165
Meystre, C., Kramer, U., De Roten, Y., Despland, J. N., & Stiles, W. B. (2014). How psychotherapeutic exchanges become responsive: a theory-building case study in the framework of the assimilation model. Counselling and Psychotherapy Research, 14(1), 29-41. doi: 10.1080/14733145.2013.782056.
Moola S., Munn Z., Tufanaru C., Aromataris E., Sears K., Sfectu R., Currie M., Qureshi R., Mattis P., Lisy K., & Mu P-F. (2020). Chapter 7: Systematic reviews of etiology and risk. In: Aromataris E., & Munn Z (Eds.), JBI Manual for Evidence Synthesis. JBI.
Page, M. J., Moher, D., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo- Wilson, E., McDonald, S., McGuinness, L. A., Stewart, L. A., Thomas, J., Tricco, A. C., Welch, V. A., Whiting, P., & McKenzie, J. E. (2021). PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. British Medical Journal, 372, n160. doi: 10.1136/bmj.n160.
Reis, H. T. (2014). Responsiveness: affective interdependence in close relationships. In M. Mikulincer & P. R. Shaver (Eds.), Mechanisms of social connection: from brain to group (pp. 255-271). American Psychological Association. doi: 10.1037/14250-015.
Richards, D., Timulak, L., & Hevey, D. (2013). A comparison of two online cognitive-behavioural interventions for symptoms of depression in a student population: the role of therapist responsiveness. Counselling and Psychotherapy Research, 13(3), 184-193. doi: 10.1080/14733145.2012.733715.
Sachse, R., Schülken, T., Leisch, M., & Sachse, M. (2011). Effektivität Klärungsorientierter Psychotherapie: erste Ergebnisse. In R. Sachse, J. Fasbender, J. Breil, & M. Sachse (Eds.), Perspektiven Klärungsorientierter Psychotherapie II (pp. 239-276). Lengerich: Pabst Science Publishers. [Material in German].
Siddaway, A. P., Wood, A. M., & Hedges, L. V. (2019). How to do a systematic review: a best practice guide for conducting and reporting narrative reviews, meta-analyses, and meta-syntheses. Annual review of psychology, 70, 747-770. doi: 10.1146/annurev-psych-010418- 102803.
Silberschatz, G. (2009). The patient’s experience of attunement and responsiveness scale (Unpublished manuscript).
Snyder, J., & Aafjes-van Doorn, K. (2016). Utilizing measure-based feedback in control-mastery theory: a clinical error. Psychotherapy, 53(3), 291-296. doi: 10.1037/pst0000075.
Snyder, J., & Silberschatz, G. (2016). The patient’s experience of attunement and responsiveness scale. Psychotherapy Research, 27(5), 608-619. doi: 10.1080/10503307.2016.1147658.
Spagnuolo Lobb, M., Sciacca, F., Iacono Isidoro, S., & Di Nuovo, S. (2022). The therapist’s intuition and responsiveness: What makes the difference between expert and in training Gestalt psychotherapists. European Journal of Investigation in Health, Psychology and Education, 12(12), 1842-1851. doi: 10.3390/ejihpe12120129.
Stiles, W. B. (2002). Assimilation of problematic experiences. In J. C. Norcross (Eds.), Psychotherapy relationships that work: therapist contributions and responsiveness to patients (pp. 357-365). Oxford University Press.
Stiles, W. B. (2021). Responsiveness in psychotherapy research: problems and ways forward. In Watson, J. C., & Wiseman, H. (Eds.), The responsive psychotherapist: attuning to clients in the moment (pp. 15-35). American Psychological Association. doi: 10.1037/0000240-002.
Stiles, W. B., & Horvath, A. O. (2017). Appropriate responsiveness as a contribution to therapist effects. In L. G. Castonguay & C.E. Hill (Eds.), How and why are some therapists better than others? Understanding therapist effects (pp. 71-84). American Psychological Association. doi: 10.1037/0000034-005.
Stiles, W. B., & Wolfe, B. E. (2006). Relationship factors in treating anxiety disorders. In L. G. Castonguay & L. E. Beutler (Eds.), Principles of therapeutic change that work (pp. 155-165). Oxford University Press.
Stiles, W. B., Honos-Webb, L., & Surko, M. (1998). Responsiveness in psychotherapy. Clinical Psychology: Science and Practice, 5(4), 439-458. doi: 10.1111/j.1468-2850.1998.tb00166.x.
Trijsburg, R. W., Frederiks, G. C. F. J., Gorlee, M., Klouwer, E., Hollander, A. D., & Duivenvoorden, H. J. (2002). Development of the comprehensive psychotherapeutic interventions rating scale (CPIRS). Psychotherapy Research, 12(3), 287-317. doi: 10.1093/ptr/12.3287.
Watson, J. C., & Wiseman, H. (Eds.). (2021). The responsive psychotherapist: attuning to clients in the moment. American Psychological Association. doi: 10.1037/0000240-000.
Zalaznik, D., Strauss, A. Y., Halaj, A., Barzilay, S., Fradkin, I., Katz, B. A., & Huppert, J. D. (2021). Patient alliance with the program predicts treatment outcomes whereas alliance with the therapist predicts adherence in internet-based therapy for panic disorder. Psychotherapy Research, 31(8), 1022-1035. doi: 10.1080/10503307.2021.1882712.
Zuroff, D. C., Kelly, A. C., Leybman, M. J., Blatt, S. J., & Wampold, B. E. (2010). Between-therapist and within-therapist differences in the quality of the therapeutic relationship: effects on maladjustment and self-critical perfectionism. Journal of Clinical Psychology, 66(7), 681-697. doi: 10.1002/jclp.20683.
How to Cite
Esposito, G., Cuomo, F., Di Maro, A., & Passeggia, R. (2024). The assessment of therapist responsiveness in psychotherapy research: a systematic review. Research in Psychotherapy: Psychopathology, Process and Outcome, 27(2). https://doi.org/10.4081/ripppo.2024.751
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