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Hobson, R.F., & Shapiro, D.A. (1970). The Personal Questionnaire as a method of assessing change during psychotherapy. British Journal of Psychiatry, 117, 623-626. An account is given of a preliminary study of assessment of patient change in a psychotherapy community unit by means of a self-report measure, the Personal Questionnaire, constructed individually for each patient. It was found that: (i) the 'immediate improvement effect' that occurs with other types of treatment session was not detected following individual psychotherapeutic sessions; (ii) there was no evidence of a trend towards improvement over the twelve-week period which was intensively studied, although there was some suggestion that positive changes occurred in succeeding months; (iii) there was more widespread change in the patient's subjective state 'for better or for worse' during interviews than during comparison periods, although there were no overall divergent trends during a 12-week period which would have suggested that some patients were harmed and some helped. These findings are discussed with reference to further intensive research into the psychotherapeutic process.
Shapiro, M.B., & Shapiro, D.A. (1974). Experiments on the feeling of depression. British Journal of Social and Clinical Psychology, 13, 191-199. Individual-centred experiments were carried out on the state described by the word 'depression'. The subjects were six non-psychotic psychiatric inpatients. Three of them were in a therapeutic community and three in a general psychiatric ward. In the first three subjects changes in the feeling of depression, during interpretative psychotherapeutic sessions, were compared with changes during unsupervised sessions in the ward. In the second three patients the comparison was between sessions of non-directive psychotherapy and of behavioural modification. Interpretative interviews were associated with a relatively high frequency of within-session worsening compared with ward sessions. During modification sessions there was a higher frequency of within-session improvement than during non-directive interviews. Size of difference, in both groups, was highly inconsistent between patients. Similar differences were found for tension states and fear-anxiety states but were consistently large for the former and consistently small for the latter. Anomalous results were obtained for various kinds of somatic states.
Kent, G.G., Davis, J.D., & Shapiro, D.A. (1978). Resources required in the construction and reconstruction of conversation. Journal of Personality and Social Psychology, 36, 13-22. It is proposed that the achievement of orderly social interaction rests in part on the ability of actors to provide one another with continual instruction in how to proceed and in part on consensual knowledge of the social world and its interactional rules. The role of questions as an instructional resource was examined by depriving conversationalists of their use; the ability of third parties to reconstruct the resultant dialogues after they had been randomized was taken as an index of conversational structure. We found that under a ban on questions, the length of a speaker's conversational turn increased and dialogues were hard to reconstruct accurately. The importance of shared cultural knowledge for the reconstruction (and, by implication, the construction) task was apparent in the superiority of British over Canadian subjects in reconstructing unconstrained British dialogues, but this superiority vanished when conversational structure had been impaired by the ban on questions. The methodology employed is presented as a resource through which social psychologists can remedy their long-standing neglect of linguistic communication in social interaction.
Shapiro, D.A., & Shapiro, D. (1982). Meta-analysis of comparative therapy outcome studies: A replication and refinement. Psychological Bulletin, 92, 581-604. The results are reported of a meta-analysis of 143 outcome studies, published over a 5-year period, in which two or more treatments were compared with a control group. Consistent with previous reviews, the mean of the 1,828 effect size measures obtained from the 414 treated groups approached one standard deviation unit, and differences among treatment methods accounted for, at most, 10% of the variance in effect size. The impact of differences among treatment methods was outweighed by the combined effects of other variables, such as the nature of the target problem under treatment, aspects of the measurement methods used to assess outcome, and features of the experimental design. However, multiple regression analysis suggested that differences between treatments were largely independent of these other factors. Direct comparisons between pairs of treatments figuring together in the same subsets of the data suggested some consistent differences, with cognitive and certain multimodal behavioral methods yielding favorable results. The practical implications of the conclusions drawn were limited, however, by the predominantly analogue nature of the research reviewed and its unrepresentativeness of clinical practice.
Brewin, C.R., & Shapiro, D.A. (1984). Beyond locus of control: Attributions of responsibility for positive and negative outcomes. British Journal of Psychology, 75, 43-49. Many locus of control measures fail to distinguish attributions for positive and negative outcomes even though these appear to be separate dimensions. Scales measuring the attribution of responsibility for positive and for negative outcomes are reported, together with data on their reliability and validity. Rotter's I-E scale was found to correlate with responsibility for positive but not for negative outcomes. Responsibility for positive outcomes, together with the Rotter scale, predicted examination performance, while responsibility for negative outcomes correlated with self-esteem and revealed consistent sex differences. The implications for locus of control research are discussed.
Barkham, M., & Shapiro, D.A. (1986). Counselor verbal response modes and experienced empathy. Journal of Counseling Psychology, 33, 3-10. In the present study, client and counselor perceptions of empathy were examined at different stages in the counseling process, in relation to the verbal response modes used by counselors in 24 client-counselor dyads. Each of six counselors was studied in counseling with four clients, of whom two were in initial sessions and two were in sessions drawn from ongoing counseling relationships. Clients perceived counselors as showing significantly greater empathy during ongoing than during initial sessions, and counselors perceived themselves as showing significantly greater empathy during initial sessions than did clients rating the same sessions. Clients rated counselors using fewer general advisements as more empathic, whereas counselors who rated themselves more empathic used more explorations and fewer reassurances. At the moment-to-moment level tapped by Interpersonal Process Recall, exploration was the only category strongly associated with both client and counselor experiences of empathic communication in both initial and ongoing sessions.
Parry, G., & Shapiro, D.A. (1986). Social support and life events in working class women: Stress buffering or independent effects? Archives of General Psychiatry, 43, 315-323. Several authors have suggested that social support reduces the risk of psychiatric disorder by providing a 'buffer' against the adverse effects of stressful events. Others have proposed, in contrast, that social support is beneficial irrespective of life stress. We addressed this issue in a community survey of 193 working class mothers by measuring social support, threatening life events, psychiatric symptomatology, and psychological well-being, via a detailed assessment combining a standardized interview and case-identification procedure with self-report questionnaires yielding continuous measures of distress and well-being. Subject selection minimized confounding between support and events. The effects of life stress and social support were found to be largely independent of one another, although detailed analysis suggested that the conclusions drawn in such studies are affected by the measures and statistics used.
Stiles, W.B., Shapiro, D.A., & Elliott, R. (1986). "Are all psychotherapies equivalent?" American Psychologist, 41, 165-180. Despite clear demonstrations by process researchers of systematic differences in therapists' techniques, most reviews of psychotherapy outcome research show little or no differential effectiveness of different psychotherapies. This contradiction presents a dilemma to researchers and practitioners. Numerous possible solutions have been suggested. Some of these challenge the apparent equivalence of outcome, arguing that differential results could be revealed by more sensitive reviewing procedures or by more differentiated outcome measures. Others challenge the seeming differences among treatments, arguing that, despite superficial technical diversity, all or most therapies share a common core of therapeutic processes. Still others suggest that the question of equivalence is unanswerable as it is usually posed but that differential effectiveness of specific techniques might be found at the level of brief events within therapy sessions. In spite of their diversity, many of the proposed solutions converge in calling for greater precision and specificity of theory and method in psychotherapy research.
Shapiro, D.A., & Firth, J. (1987). Prescriptive vs. Exploratory psychotherapy: Outcomes of the Sheffield Psychotherapy Project. British Journal of Psychiatry, 151, 790-799. Prior research suggests that psychotherapeutic techniques which differ in their contents are quite similar in their outcomes. Outcome data are reported from a study designed to maximise sensitivity to technique effects on outcome in a clinically realistic setting, and to permit detailed analysis of the relations between content, immediate impact, and outcome of therapy. Forty professional and managerial workers with depression or anxiety received eight sessions of Prescriptive (cognitive-behavioural) and eight sessions of Exploratory (relationship-oriented) therapy in a crossover design, with each client seeing the same therapist throughout. Outcome was assessed by standard interview and questionnaire methods. The results favoured Prescriptive therapy, although this difference was of moderate extent. The outcome was largely unaffected by the order in which the two methods were offered.
Reynolds, S., Taylor, E., & Shapiro, D.A. (1993). Session impact and outcome in stress management training. Journal of Community and Applied Social Psychology, 3, 325-337. The evaluation of stress management training (SMT) programmes suggests that benefits to participants may be due to non-specific factors and not to the technical components of SMT. The current study employed a method of psychotherapy process research to assess the extent to which task, i.e. technique driven, impacts and non-specific impacts are related to outcome. Sixty-two female health service workers participated in six standardized sessions of SMT, each of which contained specific techniques. After training, participants reported significantly lower levels of psychological distress but now changes in job or non-job satisfaction. Specific task impacts, such as insight and problem definition, and non-specific impacts, support, relief and involvement were significantly related to non-job satisfaction one month after training. In addition, the slope of interpersonal impacts (support and relief) was associated with less psychological distress at one- and three-month follow-up. Process research methods appear to be a promising way of maximizing the benefits attributed to SMT and developing more effective interventions.
Startup, M.J., & Shapiro, D.A. (1993). Therapist treatment fidelity in prescriptive vs. exploratory psychotherapy. British Journal of Clinical Psychology, 32, 443-456. Therapist fidelity to the manuals for prescriptive and exploratory psychotherapies were assessed via the Sheffield Psychotherapy Rating Scale. Ratings on 220 sessions drawn from the Second Sheffield Psychotherapy Project showed adequate inter-rater reliabilities within and between treatments. Discriminant analysis showed that the treatments could be differentiated almost perfectly even though the same five therapists delivered both of them. Relationship enhancing skills, measured by a facilitative conditions scale, were held constant across treatments and contributed nothing to the discriminant function. There was no evidence that adherence varied with the severity of the clients' symptoms and only very limited evidence that it varied with the duration of treatment, despite there being adequate statistical power to detect small effects. Small variations in adherence with the stage of treatment were found but only for sessions of prescriptive therapy.
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