Academic journal article Journal of Cognitive Psychotherapy

The Vanderbilt Psychotherapy Process Scale (VPPS)

Academic journal article Journal of Cognitive Psychotherapy

The Vanderbilt Psychotherapy Process Scale (VPPS)

Article excerpt

This article describes the development and refinement of a measure designed to assess salient aspects of the psychotherapeutic process. The VPPS consists of seven scales which can be grouped under the headings of: Exploratory Processes, Patient Involvement, and Therapist-Offered Relationship. Its reliability and other psychometric properties are considered satisfactory so that the instrument can be recommended for operational use.

When psychotherapy research began to gather momentum in the 1940s and 1950s, investigators were faced with the necessity of forging tools for the objective study of the phenomena considered in need of scientific scrutiny. Essential were techniques for quantifying in a clinically relevant way the verbal and, to a lesser extent, the nonverbal messages exchanged between patients and therapists. Among the initial purposes of these techniques were objective comparisons between therapists adhering to the same or different theoretical orientations, patients' responses to different therapeutic techniques, and many others. Readers interested in the history of process measures will find comprehensive accounts in Kiesler (1973), Marsden (1971), and Auld and Murray (1955), while an overview of current process measures can be found in Greenberg and Pinsof (1986).

In this article we have set ourselves the task of describing the development of one of the major process measures that has occupied the attention of the Vanderbilt research team for the last 15 years. The Vanderbilt Psychotherapy Process Scale (VPPS) was dictated by the practical needs of the Vanderbilt Psychotherapy Project I, a long-range process and outcome study of time-limited psychotherapy. The overriding objective was to evolve a general purpose instrument to assess what we hypothesized to be salient aspects of the patient-therapist interaction. As will be seen, this instrument has undergone extensive field-testing, statistical analysis, and general refinement. At this time, its utility has been well documented, and it promises to be a useful methodological tool in future investigations.

Since Strupp (1957) developed a multidimensional system for quantifying therapists' communications, the reader may wonder why it was considered necessary to evolve new systems. The most compelling reason was the need for techniques with which to study therapist and patient variables (the 1957 system only measured therapist communications) and, to the greatest extent possible, to focus on qualitative aspects of the interaction between the patient and the therapist. These efforts were aided by progress that had resulted in a clearer understanding of the patient-therapist relationship as a dynamic system. Furthermore, forceful attention had been drawn, particularly by clinicians, to the importance of the therapeutic alliance.1 The VPPS, whose conception owes much to the pioneering research of Orlinsky and Howard (1967, 1975), was our first attempt to develop a practical and robust method for quantifying salient aspects of the therapeutic dyad. Another instrument, the Vanderbilt Negative Indicators Scale, was intended as a magnifying glass of adverse characteristics and events in the therapeutic interaction and is described elsewhere (Strupp, Moras, Sandell, Waterhouse, O'Malley, Keithly, & Gomes-Schwartz, 1981).

THE VANDERBILT PSYCHOTHERAPY PROCESS SCALE

The Vanderbilt Psychotherapy Process Scale (VPPS) is a general purpose instrument designed to assess both positive and negative aspects of patient and therapist behaviors and attitudes that are expected to facilitate or impede progress in therapy. While built on general assumptions of psychotherapy as an interpersonal process, the scale is intended to be largely "neutral" with respect to any particular theory of psychotherapy, and to be applicable to a wide range of therapeutic interventions. Specific subscales of the instrument tap patient characteristics such as level of exploration, active engagement in the therapeutic process, emotional stance, and negativism during the session. …

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