본 연구에서는 상담과정 변인인 상담자 즉시성이 상담성과 변인인 회기평가와 작업동맹에 영향을 미치는지를 검증하였다. 이 때, 즉시성의 고유효과를 확인하기 위해 해석 등 다른 상담기법의 영향력을 통계적으로 통제하였고, 내담자 변인(심리적 디스트레스, 대인관계문제)과 상담자 변인(상담경력)이 즉시성의 효과에 영향을 미치는지를 확인하였다. 본 연구를 위해 서울, 경기, 경북 지역에 소재한 대학상담센터에서 근무하고 있는 상담경력 1년 이상인 상담자들(N = 10)이 참여하였고, 실제 내담자 또는 상담심리 수업에서 상담을 자원한 학부생 등 총 28명으로부터 자료를 수집하였다. 회기-내담자-상담자 3수준 성장모형을 설정하고, HLM 6.08을 사용하여 자료를 분석하였다. 자료 분석 결과, 상담이 진행됨에 따라 내담자의 회기평가는 선형으로 증가하였고, 상담자 즉시성은 내담자의 회기평가에 정적인 영향을 미치는 것으로 나타났다. 내담자의 상담 전 대인관계문제가 심각할수록 즉시성의 영향력이 증가한 반면, 상담자의 상담경력은 즉시성 효과에 영향을 미치지 않는 것으로 나타났다. 내담자가 지각한 작업동맹은 시간의 흐름에 따라 역-U자 형태로 변하는 것으로 나타났는데, 상담자 즉시성은 작업동맹 변화에 영향을 미치지 않는 것으로 나타났다. 본 연구결과를 토대로 후속연구에 대한 제언과 즉시성 관련 교육 및 훈련에 대한 시사점을 논하였다.
This study investigated the effects of counselor immediacy on client-perceived session evaluation and working alliance, controlling for other counselor techniques (e. g., interpretation). Additionally, psychological distress and interpersonal problems as client variables and counseling experience as a counselor variable were included to examine if they influenced the relations between immediacy and outcome variables. Ten professional counselors at regional university counseling centers collected data from 28 clients including undergraduate students who volunteered for counseling at a counseling psychology class. HLM analyses revealed that immediacy was positively related to the linear change of session evaluation, which varied by the level of client's interpersonal problems. Counselor's counseling experience showed no effects on the relation between immediacy and session evaluation. Results also indicated that working alliance changed in a quadratic fashion, with immediacy having no effects on the change pattern. Limitations of the study and the implications for counselor training and supervision are discussed.
김계원, 정종진, 권희영, 이윤주, 김춘경 (2011).상담심리학의 최근 연구동향: 상담 및 심리치료학회지 게재논문 분석(2000∼2009).한국심리학회지: 상담 및 심리치료, 23(3),521-542.
김영란, 연문희 (2002). 상담단계별 상담자 공감과 내담자 체험 및 상담성과와의 관계.한국심리학회지: 상담 및 심리치료, 14(1),19-38.
김정욱, 권석만, 정남운 (2000). 한국판 대인관계 문제 척도(K-IIP)의 개발: 요인구조 및심리측정적 특성. 한국심리학회지: 상담 및심리치료, 12(1), 153-175.
손진희, 유성경 (2004). 내담자의 자기은폐 (self-concealment) 수준에 따른 상담회기, 작 업동맹 평가 및 상담자-내담자의 언어적 상호작용 분석: 초심 상담자를 대상으로. 한국심리학회지: 상담 및 심리치료, 16(3), 327-435.
이상희, 김계현 (1993) 상담회기 평가 질문지 (Session Evaluation Questionnaire)의 타당화 연구. 한국심리학회지: 상담 및 심리치료, 5(1), 30-47.
이장호, 김정희 (2000). 현대심리치료. 서울: 중앙적성출판사.
이정화 (1999). 내담자의 애착유형과 작업동맹에관한 연구. 연세대학교 대학원 박사학위논문.
이정화, 연문희 (2009) 치료 동맹의 발달 유형과 상담 성과. 한국심리학회지: 상담 및 심리치료, 21(1), 1-24.
정은미, 이소희 (2004). 상담회기평가에 영향을미치는 내담자의 작업동맹특성 분석. 한국청소년복지학회, 6(1), 89-102.
정은주 (2005). 놀이치료 내담아동이 지각한 부모와의 애착이 치료관계에 미치는 영향. 숙명여자대학교 대학원 석사학위논문.
조성호 (2003). 상담심리학 연구 동향: 상담및 심리치료학회지 게재논문 분석(1988~2003). 한국심리학회지: 상담 및 심리치료,15(4), 811-831.
조수현, 권경인 (2011). 초기상담에서 상담자가경력별 공감정확도와 상담만족도: 임상실제자료를 기반으로 한 내담자지각을 중심으로. 한국심리학회지: 상담 및 심리치료,23(2), 257-275.
조현춘, 조현재 (2011). 심리상담과 치료의 이론과 실제. 서울: 시그마프레스.
황옥경 (2002). 내담자의 애착유형 및 지각된 사회적 지지와 작업동맹과의 관계. 연세대학교 대학원 석사학위논문.
Barkham, M., Hardy, G. E., & Startup, M. (1996). The IIP-32: A short version of the Inventory of Interpersonal Problems. British Journal of Clinical Psychology, 35(1), 21-35.
Berkvist, L., & Rossiter, J. R. (2007). The predictive validity of multiple-item versus single-item measures of the same constructs. Journal of Marketing Research, 44(2), 175-184.
Bordin, E. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy, 16(3), 252-260.
Buboltz Jr., W., Deemer, E., & Hoffman, R. (2010). Content analysis of the Journal of Counseling Psychology: Buboltz, Miller, and Williams (1999) 11years later. Journal of Counseling Psychology, 57(3), 368-375.
Buboltz, W. C., Miller, M., & Williams, D. J. (1999). Content analysis of research in the Journal of Counseling Psychology (1973-1988). Journal of Counseling Psychology, 46(4), 496-503.
Cepeda-Benito, A., & Gleaves, D. H. (2000). Cross -ethnic equivalence of the Hopkins Symptom Checklist-21 in European American, African American, and Latino college students. Cultural Diversity and Ethnic Minority Psychology, 6(3), 297-308.
Constantino, M. J., Arnow, B. A., Blasey, C., & Agras, W. J. (2005). The association between patient characteristics and the therapeutic alliance in cognitive behavioral and interpersonal therapy for bulimia nervosa. Journal of Consulting and Clinical Psychology, 73(2), 203-211.
Cox Ⅲ, E. P. (1980). The optimal number of response alternatives for a scale: An empirical investigation. Journal of Social Behavior & Personality, 15(1), 137-152.
Dawes, J. (2002). Five point vs. eleven point scales; Does it make a difference to data characteristics? Australasian Journal of Market Research, 10(1), 39-47.
Derogatis, L., Lipman, R., Rickels, K., Uhlenhuth, E., & Covi, L. (1974). The Hopkins Symptom Checklist(HSCL): A self-report symptom inventory. Behavioral Science, 19(1), 1-15.
Dinger, U., Strack, M., Sachsse, T., & Schauenburg, H. (2009). Therapists' attachment, patients' interpersonal problems and alliance development over time in inpatient psychotherapy. Psychotherapy Theory, Research, Practice, Training, 46(3), 277-290.
Donnell, C. M., Strauser, D. R., & Lustig, D. C. (2004). The working alliance: Rehabilitation outcomes for persons with severe mental illness. Journal of Rehabilitation, 70(2), 12-18.
Egan, G. (2002). The skilled helper: A problemmanagement and opportunity-development approach to helping. Pacific Grove, CA: Brooks/Cole.
Foreman, S. A., & Marmar, C. R. (1985). Therapist actions that address initially poor therapeutic alliances in psychotherapy. The American Journal of Psychiatry, 142(8), 922-926.
Fuertes, J., Mislowack, A., Brown, S., Gur-Arie, S., Wilkinson, S., & Gelso, C. (2007). Correlates of the real relationship in psychotherapy: A study of dyads. Psychotherapy Research, 17(4), 423-430.
Gelso, C. J. (2002). The real relationship: The “something more” of psychotherapy. Journal of Contemporary Psychotherapy, 32(1), 35-40.
Gelso, C. J. (2011). The real relationship in psychotherapy: The hidden foundation of change. Washington, DC: American Psychological Association.
Gibbons, M. B. C., Crits-Christoph, P., De La Cruz, C., Barber, J. P., Siqueland, L., & Gladis, M. (2003). Pretreatment expectations, interpersonal functioning, and symptoms in the prediction of the therapeutic alliance across supportive-expressive psychotherapy and cognitive therapy. Psychotherapy Research, 13(1), 59-76.
Green, D. E., Walkey, F. H., McCormick, I. A., & Taylor, A. J. (1988). Development and evaluation of a 21-item version of the Hopkins Symptom Checklist with New Zealand and United States respondents. Australian Journal of Psychology, 40(1), 61-70.
Greenberg. L. S. (1986). Change process research. Journal of Consulting and Clinical Psychology, 54(1), 4-9.
Heppner, P. P., Wampold, B. E & Kivlighan, D. M.. (2008). Research design in counseling (3th ed.). Pacific Grove, Calif: Brooks/Cole Pub. Co.
Hill, C. E. (2004). Helping skills: Facilitating exploration, insight, and action. Washington, DC: American psychological Association.
Hill, C. E., & O'brien, K. M. (1999). Helping skills: Facilitating exploration, insight, and action. Washington, DC, US:: American Psychological Association.
Hill, C. E., Sim, W., Spangler, P., Sthal, J., & Sullivan, C., & Teyber, E. (2008). Therapist immediacy in brief psychotherapy case study Ⅱ. Psychotherapy, Theory, Research, Practice, Training, 45(3), 298-315.
Hill, C. E., & Williams, E. N. (2000). The process of individual therapy. In S. D. Brown & R. W. Lent (Eds.), Handbook of counseling psychology (3rd ed., pp.670-710). New York: Wiley.
Hoglend, P., Johnsson, P., Marble, A., Bogwald, K-P., & Amlo, S. (2007). Moderators of the effects of transference interpretation in brief dynamic psychotherapy. Psychotherapy Research, 17(2), 160-171.
Holloway, E. L, Wampold, B. E., & Nelson, M. L. (1990). Use of a paradoxical intervention with a couple. Journal of Family Psychology, 3(4), 385-402.
Horowitz, L. M., Rosenberg, S. E., Baer, B. A., Ureño, G., & Villaseñor, V. S. (1988). Inventory of Interpersonal Problems: Psychometric properties and clinical applications. Journal of Consulting and Clinical Psychology, 56(6), 885-892.
Horvath, A. O., & Greenberg, L. S. (1989). Development and validation of the Working Alliance Inventory. Journal of Counseling Psychology, 36(2), 223-233.
Ivey, A. E., & Ivey, M. B. (1999). International interviewing and counseling: Facilitating client development in a multicultural society (4th ed.). Pacific Grove, CA: Brooks/Cole.
Kasper, L., Hill, C. E., & Kivilighan, D. M,. JR. (2008). Therapist immediacy in brief psychotherapy: Case study Ⅰ. Psychotherapy Theory, Research, Practice, Training. 45(3), 281- 297.
Kisler, D. J. (1988). Therapeutic metacommunication: Therapist impact disclosure as feedback in psychotherapy. Palo Alto, CA: Consulting Psychologist Press.
Kivilighan, D. M., & Shaughnessy, P. (1995). Analysis of the development of the working alliance using hierarchical linear modeling. Journal of Counseling Psychology, 42(3), 338-349.
Kivilighan, D. M., & Shaughnessy, P. (2000). Patterns of working alliance development: A typology of client's working alliance ratings. Journal of Counseling Psychology, 47(3), 362-371.
Kokotovic, A. M., & Tracey, T. J. (1990). Working alliance in the early phase of counseling. Journal of Counseling Psychology, 37(1), 16-21.
Krosnick, J. (2009). The optimal length of rating scales to maximize reliability and validity. http://comm.stanford.edu/faculty/krosnick
Kurtz, R. R. & Grummon, D. L. (1972). Different approaches to the measurement of therapist empathy and their relationship to therapy outcomes. Journal of Consulting and Clinical Psychology, 39(1), 106-115.
Lambert, M. J., & Hill, C. E. (1994). Assessing psychotherapy outcomes and processes. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change (4th ed., pp. 72-113). New York: Wiley.
Lingiardi, V., Colli, A., Gentile, D., & Tanzilli, A. (2011). Exploration of session process: Relationship to depth and alliance. Psychotherapy, 48(4), 391-400.
Malan, D. H. (1976). The frontier of brief psychotherapy. New York: Plenum Press.
Mallinckrodt, B. (1993). Session impact, working alliance, and treatment outcome in brief counseling. Journal of Counseling Psychology, 40(1), 25-32.
Mallinckrodt, B., Coble, H. M., & Gantt, D. L. (1995). Working alliance, attachment memories, and social competencies of women in brief therapy. Journal of Counseling Psychology, 42(1), 79-84.
Marmarosh, C. L., Gelso, C. J., Markin, R. D., Majors, R. Mallery, C., & Choi, J. (2009). The real relationship in psychotherapy: Relationships to adult attachments, working alliance, transference, and therapy outcome. Journal of Counseling Psychology, 56(3), 337-350.
Mohr, J. J., Gelso, C. J., & Hill, C. E. (2005). Client and counselor trainee attachment as predictors of session evaluation and countertransference behavior in first counseling sessions, Journal of Counseling Psychology, 52(3), 298-309.
Muran, J. C., Safran, J. D., Gorman, B. S., Samstag, L. W., Eubanks-Carter, C., & Winston, A. (2009). The relationship of early alliance ruptures and their resolution to process and outcome in three time-limited psychotherapies for personality disorders. Psychotherapy Theory, Research, Practice, Training, 46(2), 233-248.
Orlinsky, D. E., Grawe, K., & Parks, B. K. (1994). Process and outcome in psychotherapy- Nocheinmal. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change (4th ed., pp.270-378). New York: Wiley.
Orlinsky, D. E., Ronnestad, M. H., & Willutzki, U. (2004). Fifty years of process-outcome research: Continuity and change. In M. J. Lambert (Ed.), Bergin and Garfield's handbook of psychotherapy and behavior change (5th ed., pp.307-390). New York: Wiley.
Puschner, B., Bauer, S., Horowitz, L. M., & Kordy, H. (2005). The relationship between interpersonal problems and helping alliance. Journal of Clinical Psychology, 61(4), 415-429.
Raudenbush, S., Bryk, A., Cheong, Y. F., & Congdon, R. (2004). HLM 6. Hierarchical Linear and Nonlinear Modeling. Chicago: Scientific Software International.
Rhodes, R. H., Hill, C. E., Thompson, B. J., & Elliott, R. (1994). Client retrospective recall of resolved and unresolved misunderstanding events. Journal of Counseling Psychology, 41(4), 473-483.
Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 21(2), 95-103.
Rossiter, J. R. (2002). The C-OAR-SE Procedure for Scale Development in Marketing, International Journal of Research in Marketing, 19(4), 305-335.
Rubjno, G., Baker, C., Roth, T., & Fearson, P. (2000). Therapist empathy and depth of interpretation in response to potential alliance ruptures: The role of therapist and patient attachment styles. Psychotherapy Research, 10(4), 408-420.
Safran, J. D., & Muran, J. C. (2000). Negotiating the therapeutic alliance: A relational treatment guide. New York: Guilford Press.
Safran, J. D., Muran, J. C., Samstag, L. W., & Stevens, C. (2002). Repairing alliance ruptures. In J. C. Norcross (Ed.), Psychotherapy relationships that work: Therapist contributions and responsiveness to patients (pp.235-254). New York: Oxford University Press.
Sauer, E. M., Lopez, F. G., & Gormley, B. (2003). Respective contributions of therapist and client adult attachment orientations to the development of the early working alliance: A preliminary growth modeling study. Psychotherapy Research, 13(3), 371-382.
Sauro, J. (2010). Should you use 5 or 7 point scales? http://www.measuringusability.com/blog /scale-points.php
Seo, Y. S., Kim, D., & Kim, D. (2007). Current status and prospects of Korean counseling psychology: Research, clinical training, and job placement. Applied Psychology: International Review, 56(1), 107-118.
Stiles, W. B., Glick, M. J., Osatuke, K., Hardy, G. E., Shapiro, D. A., Angnew-Davies, R., Rees, A., & Barkham, M. (2004). Patterns of alliance development and the rupture-repair hypothesis: Are productive relationships U-shaped or V-shaped? Journal of Counseling Psychology, 51(1), 81-92.
Stiles, W. B., & Snow, J. S. (1984). Dimensions of psychotherapy session impact across clients. British Journal of Clinical Psychology, 23(1), 59- 63.
Strupp, H. H., & Binder, F. L. (1984). Psychotherapy in a new key: A guide to time-limited dynamic psychotherapy. New York: Basic Books.
Taber, B. J., Leibert, T. W., & Agaskar, V. (2011). Relationships among client-therapist personality congruence, working alliance, and therapeutic outcome. Psychotherapy, 48(4), 376- 380.
Teyber, E. (2006). Interpersonal process in psychotherapy: A relational approach (5th ed.). Pacific Grove, CA: Brooks/Cole.
Tracey, T. J., & Kokotovic, A. M. (1989). Factor structure of the Working Alliance Inventory. Psychological Assessment, 1(3), 207-210.
Wampold, B. E., & Kim, K-H. (1989). Sequential analysis applied to counseling process and outcome. Journal of Counseling Psychology, 36(3), 357-364.
Wheeler, C. D., & D'Andrea, L. M. (2004). Teaching counseling students to understand and use immediacy. Journal of Humanistic Counseling, Education and Development, 43(2), 117-128.
Yalom, I. D. (2002). The gift of therapy. New York: HarperCollins.
