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The effects of confrontation and clarification on patient affective and defensive responding

Author(s): Salerno M, Farber BA, McCullough L, Winston A, Trujillo M

Abstract

This study examined the effects of therapist confrontations and clarifications on patient defensive and affective responding in short-term dynamic psychotherapy. Four videotaped therapy sessions from each of 16 patients were coded on a per-minute basis for the occurrence of selected patient and therapist variables. Contrary to prediction, no significant differences were found regarding the effects of confrontation and clarification of defense on immediate patient affective responding. In addition, therapist confrontation of patient defensive behavior elicited significantly more defensive responding than did clarification. Results also indicated that, within a 3-minute frame, patients' affective and defensive responding in minute 3 is most closely related to their own behavior in minute 1 regardless of the intervening therapist activity. Future research, it is suggested, needs to focus on a longer time frame as well as on the cumulative effects of persistent confrontations on patient affective responding.

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