A process study of psychotherapy with children and adolescents coping with parental divorce
Therapeutic process was assessed using the Vanderbilt Psychotherapy Process Scale (VPPS) for children who received psychological services from a university outpatient clinic. A pilot study was completed using videotapes of individual counseling with six girls whose parents had requested psychological services at the clinic. Child-based anchors were developed for VPPS items and then used by three trained raters to evaluate various aspects of the therapeutic process in girls' second, third, and fourth sessions of individual counseling. Based on the pilot study, the author determined to use four subscales of the VPPS for the present study: the two most internally consistent subscales for therapist behaviors and attitudes (i.e., Therapist Exploration and Therapist Warmth and Friendliness) and the two subscales with the highest internal consistency for client behaviors and attitudes (i.e., Patient Exploration and Patient Participation). Videotapes of individual counseling sessions with 20 children, ages 7 to 17, whose parents have divorced or separated with the expressed intent of divorcing were analyzed. Children were systematically assigned to one of two treatment approaches commonly used with children of divorce. Each of the two five-session treatment plans had a specific focus, either divorce-focused or non-divorce-focused. Segments from the videotapes of the five sessions were randomly assigned to three trained raters. These raters were asked to rate the segments utilizing the VPPS, the Therapeutic Influence subscale, and whether or not divorce was discussed within the five-minute segment viewed. Analysis was completed on the ratings across sessions (i.e., #1-#5) and within sessions. Significant differences were found between the treatment methods both across and within sessions. There was also an interaction effect for time in session and treatment.