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Verbal Interaction and Levels of Meaning in Psychotherapy
MORRIS A. SKLANSKY, MD;
KENNETH S. ISAACS, PhD;
EDITH S. LEVITOV, PhD;
ERNEST A. HAGGARD, PhD
Arch Gen Psychiatry. 1966;14(2):158-170.
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ONE OF THE CRUCIAL issues in psychotherapy is the nature of the verbal interaction between the therapist and the patient and its effect on the Psychotherapeutic process. If we accept the proposition that the intervention of the therapist plays an important role in this process, then it is of value to discover and identify the kinds of intervention that are most effective.
Although psychoanalytic theory and practice have provided us with an abundance of significant insights concerning the psychotherapeutic process, there has been relatively little verification of these ideas through the analysis of recorded therapy data.* This study is an attempt to provide such an analysis for some aspects of verbal interaction in psychotherapy.
We are presenting here some results from a study of ten psychotherapy hours. Our research was focused on the several levels of meaning in communications by patients, the therapist's reaction to them,
. . . [Full Text PDF of this Article]
Author Affiliations
CHICAGO
From the University of Illinois College of Medicine.
Footnotes
Submitted for publication May 29, 1965.
An early study by Eldred et al,11 shows the reliability of such units. Data from our first paper (Sklansky et al,12 p 136) indicate the reliability we obtained in unitizing. Two of us independently segmented a therapy hour; they showed 80% agreement on the exact place of separation of segments.
Reprint requests to PO Box 6998, 912 S Wood St, Chicago 60680 (Dr. Sklansky).
This is not to gainsay the increase of such attempts in recent years. For general reviews and symposia, see Rubinstein and Parloff,1 Strupp and Luborsky,2 Wirt and Wirt,3 Colby,4 Gottschalk and Auerbach,5 Marsden,6 and Matarazzo.7 Among many individual and group studies are those of Cohen and Cohen,8 and Gotschalk.9 Some of the continuing "dilemmas" in this area are discussed in Ward.10
In our method, we both infer and specify the patient content at nonmanifest levels. Our research differs in this way from other studies that are either confined to manifest material or do not deal with the specific content at inferential levels, such as Murray,13 Strupp,14 Dollard and Auld,15 and Speisman.16
As a way of testing reliability, a sample consisting of two sets of levels of meaning independently inferred by these judges was submitted to two "reliability judges." The latter were asked to determine whether the independent wordings of the two sets of levels of meaning had the same meaning. One of the reliability judges found that out of a total of 23 segments, there had been agreement on meanings at the various levels in 96% of the segments; the other reliability judge found there had been agreement in 55% of the segments.
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