Videotaping and Rating Your Own Sessions: Two Valuable Ways to Improve the Quality of Therapy



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The Coding Process

In our research program, selected sessions of therapy are coded from videotape. First, the session is divided into ten-minute segments (usually 5 or 6 per session). For each ten-minute segment, identify the adaptive affect (F pole, e.g. anger, grief, positive feelings toward the self, etc.) of the core conflict which that segment focuses on predominantly (there may be more than one, but generally a single core conflict predominates). Once this focus is identified, ratings are given for:

  1. Defense Recognition: How well does the patient see their defenses (and other parts of the D-A-I pattern on the triangle of conflict)?

  2. Defense Relinquishing: How motivated is the patient to give up their defenses?

  3. Affect Experiencing: How intensely does the patient experience the adaptive affect that raters identified as the focus during the segment?

  4. Affect Expression: How well is the patient able to express the adaptive affect to others (either to the therapist during the segment, or to someone outside the session as described by the patient during the segment).

  5. Anxiety Regulation: What degree of inhibitory affect is present in the ten-minute segment that diminishes or blocks the experience of adaptive affect. [ADD (Note that anxiety regulation is not a separate treatment objective but is a component of each of the six objectives).]

Finally, for the entire therapy session, ratings are given for:

  1. Self-Restructuring: How adaptive is the patient’s inner representation of self?

  2. Other-Restructuring: How adaptive are the patient’s inner representations of others?

The ratings for Self- and Other-Restructuring are given only once per session because they tend to fluctuate less from segment to segment than the five ratings for Defense and Affect Restructuring, and Anxiety Regulation.



References

Alpert, M. (1996). Videotaping psychotherapy. Journal of Psychotherapy Practice and Research, 5(2), 93-105.

McCullough, L., Kuhn, Andrews, Hatch, Valen & Osimo (2003). The Reliability of the Achievement of Therapeutic Objectives Scale: Five Studies. Journal of Brief Psychotherapy, in preparation.



McCullough, L., Larsen, Schanche, Andrews & Kuhn (2003), Achievement of Therapeutic Objectives Scale: ATOS Scale. www.affectphobia.org

2/03

Addenum to Treating Affect Phobia, © 2003 Leigh McCullough



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