Therapist Responsivity to Patients’ Early Treatment Beliefs and Psychotherapy Process
Alice E. Coyne, PhD & 2 others
March 5, 2019
Abstract
As the conceptualization of evidence-based practice expands beyond the phasic application of treatment manuals for specific mental health diagnoses, greater attention is being paid to treatment personalization, including at its very first steps. One approach to such early personalization involves therapist flexible responsivity to patients’ presenting nondiagnostic characteristics, such as their treatment-related beliefs, that are known to correlate with treatment outcomes. Such tailoring represents one element of the context-responsive psychotherapy integration framework that privileges the therapist’s use of evidence- informed strategies in response to specific patient characteristics and contextual process markers (Constantino, Boswell, Bernecker, & Castonguay, 2013). In this article, we map context-responsive psychotherapy integration principles onto a psychotherapy case illustration. Namely, we describe Alice E. Coyne’s attempt to navigate responsively a patient’s early outcome expectation and treatment credibility perception, both of which revealed the need to change course from an original treatment plan (despite that plan making good sense vis-a`-vis the patient’s diagnoses and initial positive reaction to the explanation of a specific treatment protocol). In addition, the case illustrates the influence that patient treatment beliefs can have on other early therapeutic processes, such as patient change ambivalence and resistance to the therapy, that also require therapist responsivity in the service of personalization.
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About the Authors
Alice E. Coyne, PhD
Dr. Alice Coyne is an Assistant Professor of Psychology at American University. Dr. Coyne completed her PhD at the University of Massachusetts Amherst and completed her postdoctoral training at Case Western Reserve University. Broadly speaking, Dr. Coyne’s research program aims to identify and develop ways to capitalize on patient, therapist, and dyadic characteristics and processes that can enhance the effectiveness of mental health care (MHC). More specifically, she studies personalized pathways to therapeutic change through answering the broad questions of how, for whom and in what contexts, and when delivered by whom does psychotherapy work? Across these interrelated foci, Dr. Coyne draws on diverse research designs and methods, including longitudinal process-outcome research, experimental comparative effectiveness trials, meta-analyses, community-based research (with diverse MHC stakeholders), and qualitative studies. She has conducted this work in the context of various treatments (e.g., cognitive behavioral therapy, interpersonal psychotherapy, and prolonged exposure), for a broad range of conditions (e.g., depression, generalized anxiety disorder, and posttraumatic stress disorder). Across these treatment-patient contexts, Dr. Coyne is keenly interested in bridging the science-practice gap by increasing the effectiveness and precision of therapeutic interventions, including when delivered in routine practice settings that can reach historically underserved and marginalized populations.
Michael J. Constantino, Ph.D.
Dr. Michael J. Constantino received his BA in Psychology from the State University of New York (SUNY) at Buffalo, and his MS and PhD from the Pennsylvania State University. He completed a predoctoral clinical internship at SUNY Upstate Medical University, and a postdoctoral fellowship at the Stanford University Medical Center. He then joined the Clinical Psychology faculty at the University of Massachusetts Amherst (UMass), where is a Professor of Psychological and Brain Sciences (PBS). At UMass, he directs the Psychotherapy Research Lab, teaches graduate and undergraduate courses on psychotherapy, supervises clinicians-in-training, and is the PBS Graduate Program Director. Among other professional positions, Dr. Constantino is Past- President of the North American Society for Psychotherapy Research and APA Division 29 (Society for the Advancement of Psychotherapy). Dr. Constantino’s professional and research interests center on patient, therapist, and dyadic characteristics/processes influencing psychosocial treatments; pantheoretical principles of clinical change (i.e., common factors); and measurement-based care.President of the North American Society for Psychotherapy Research, and current President of APA Division 29 (Society for the Advancement of Psychotherapy). Dr. Constantino’s professional and research interests center on patient, therapist, and dyadic characteristics/processes influencing psychosocial treatments; pantheoretical principles of clinical change (i.e., common factors); and measurement-based care.http://www.umass.edu/pbs/people/michael-constantino https://sites.google.com/site/constantinotherapyresearchlab/home
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