1. Monitoring Communicative Contact Contact and Connection Glasgow 2014 17/10/2015

2. Mathias Dekeyser Garry Prouty Robert Elliott Mia Leijssen University of Leuven Psychosociaal Centrum Leuven 17/10/2015

3. Monitoring Communicative Contact 1. What is contact and why monitor it? 2. What measures of contact are there? 3. What can we use those measures for? 3

4. Monitoring Communicative Contact 1. What is contact and why monitor it? Rogers Prouty Dinacci 2. What measures of contact are there? 3. What can we use those measures for? 4

5. Rogers (1957): core condition of change □ Psychological contact □ “a minimal relationship” □ “each makes some perceived difference in the experiential field of the other” □ Monitoring contact to check whether the core conditions are met. 5

6. Prouty (1994): psychological function □ 3 psychological contact functions ◊ Awareness ◊ External world: Reality Contact ◊ Internal world: Affective Contact ◊ Expression ◊ Communicative Contact □ Monitoring contact to check... □ when contact reflections are appropriate; □ if Pre-Therapy really works. 6

7. Dinacci (1997): communication □ Observing psychological contact through: □ client reactivity = “communicative sign” □ meaningfulness, verbality, (non)verbal coordination (= language pragmatics) □ touch □ Monitoring contact to check if Pre- Therapy really works. 7

8. Monitoring Communicative Contact 1. What is contact and why monitor it? 2. What measures of contact are there? PTRS (Hinterkopf & Prouty-v1; Prouty-v2) ECPI (Dinacci; Brenner-additions) CCS (Dekeyser, Elliott, Leijssen) 3. What can we use those measures for? 8

9. Pre-Therapy Rating Scale (PTRS) □ Counting markers in annotated transcripts to measure two dimensions: □ Reality/Communication (verbal) □ Affective contact (verbal+nonverbal) □ High inter-rater agreement is possible □ Increased scores reportedly associated with carer’s observed change 9

10. Evaluation Criterion for Pre-Therapy Interview (ECPI) ◊ Detecting and scoring client reactivity in video recording, to measure ◊ Reactivity (moderate reliability) ◊ Elements of [language pragmatics] (low to moderate) ◊ Touch, eye contact (low to high reliability) ◊ General Index ◊ Language related subscales associated with measures of pragmatic performance (ALICC) ◊ Increased scores reportedly associated with carer’s observed change 10

11. Communicative Contact Scale (CCS) ◊ Self-report perceived communicative contact in the other, with two subscales ◊ Meaningfulness ◊ Reactiveness □ Developed with help of expert group, tested on parents, students, (therapists, clients) □ Meaning of the (sub)scales may vary □ Positively associated with evaluation of interaction (self-report), but not with affective color or clinical symptoms (high level functioning clients GAF/BSI scores) 11

12. CCS Meaningfulness plotted by child age (N=267) 12

13. Communicative Contact Scale (CCS) □ All scores predicted by □ Acquaintance with the observed □ Mindfulness of observer (acting with awareness) □ Child ability to involve the parent (-4y) □ Child pragmatic performance (4y+) □ Empathic attitude (association varies with role of observer) □ Working alliance of reporting therapist and observed client □ Meaningfulness predicted by □ age of observed child – logarithmic curve □ mutual attunement of parent and child (-4y) 13

14. Monitoring Communicative Contact 1. What is contact and why monitor it? 2. What measures of contact are there? 3. What can we use those measures for? Research on the concept of contact Clinical research: outcome, process Practice and training 14

15. Research on the concept of contact -Do people develop (implicit) mental models of communicative contact? -Do we assess contact differently according to the situation? -How is the development of contact skills related to the development of language, mentalisation, social skills? -How do we naturally assess reality contact and affective contact in another person?

16. Clinical research: outcome □ Effect sizes are promising, but larger studies are needed. □ After treatment, the PTRS-Re ality/ ECPI test score was likely to increase in 86% of the cases, and likely to be higher than 74% of similar patients. □ Development of PTRS/ECPI norm scores would be helpful. □ Can we think of less labor-intensive approaches? Other, indirect measures? □ Nurses in contact work training have reported symptom decrease in patients (Ondracek, 2004) □ Where are clients’ qualitative reports? (Traynor, in preparation)

17. Clinical research: process □ PTRS and ECPI offer great detail of within- session process □ Much more is possible than we do now. □ Can we build a collection of coded transcripts? □ CCS can be used to analyse the evolution of perceived contact across interactions/sessions □ Can CCS be used to discriminate between phases in a session?

18. PTRS: 1 session (schizoaffective, mental disability) (Prouty, 1994) 18

19. PTRS: 1 session (female, schizophrenia) (Van Werde, 1993; Van den Mooter, 2006) 19

20. CCS: 1 session (12 clients) 20

21. Practice and training □ Can studying PTRS/ECPI coded transcripts be part of training? □ PTRS more closely related to theory (Prouty) □ CCS scale can be used to: □ give a quick feel of the topic □ discuss cases and concepts □ support intervision/supervision? 21

22. 22 mathias.dekeyser@gmail.com