Measuring client modes of engagement in humanistic experiential psychotherapy

  • Micaela Jimenez Borja

Student thesis: Doctoral Thesis


The role of clients' emotional engagement has progressively played a central role in psychotherapy. This project inserts itself in this debate by seeking to validate the Client Modes of Engagement (CME) theoretical model (Elliott 2006; 2013a). While Elliott's CME framework-a process-diagnostic map based on clients' experiential content-was grounded on decades of research and clinical practice, it had yet to be made amenable to empirical investigation.;This project responds to this absence by offering the Client Modes of Engagement Observational Coding System (CME-OCS) and the Client Modes of Engagement Questionnaire (CMEQ-R2). These instruments measure the construct from both the perspective of external observers (CME-OCS) and therapists (CMEQ-R2).;This dissertation explores the application and validation process for both the CME-OCS and the CMEQ-R2. The results confirmed that the CME-OCS is a reliable coding system for identifying CMEs during EFT psychotherapy. Additionally, the findings suggest that there are interactions between CMEs, phases of therapy, and outcome groups. Moreover, I established that there are differences in the ways outcome groups' transition between CMEs at particular stages of therapy.;I applied both classical psychometric properties methods and Rasch modelling with the purpose of examining the CMEQ-R2's psychometrics, refining the instrument, and later applying it in a process outcome study. The results suggest that levels of CME early in therapy and changes in levels of CME over therapy-as measured by the CMEQ-R2-are significantly associated with client pre-post therapeutic improvement.;I also found firm ground for arguing that therapists can distinguish between levels of CMEs and that their perspective can be systematically analysed. Together, both instruments pose important implications for research and clinical practice. Overall, this study validates the contention that researchers and therapists should be particularly attentive to clients' manner of engagement and focus of attention on specific levels of their emotion scheme.
Date of Award6 Aug 2018
Original languageEnglish
Awarding Institution
  • University Of Strathclyde
SupervisorRobert Elliott (Supervisor) & Anna Robinson (Supervisor)

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