Interactional structures of therapist and client participation in adult psychotherapy: P technique and chronography.

In previous studies, the utterances of 6 clients and their therapists in early, middle, and late sessions were rated on 34 and 39 speech categories, respectively. P-technique analyses revealed 4 client and 4 therapist factors. For the present study, therapist and client utterances were assigned factor scores. A 17 x 17 correlation matrix was constructed, consisting of correlations across 4 lagged utterances (therapist-client-therapist-client), with each utterance represented by 4 factor scores and a score for the third from which the utterance was sampled. Principal-components analysis of this matrix revealed 4 therapist-client interaction factors: Mutual Therapeutic Engagement, Therapeutic Negotiation, Undirected Client Reminiscence, and Sustained Therapist Work. Unsuccessful cases deviated most from successful cases on at least 1 factor. Comparisons of interaction chronographs of episodes drawn from a successful and unsuccessful case revealed meaningful differences. Discussion highlights the power of P technique to reveal structures of psychotherapeutic discourse.