Verbal interventions in significant psychodynamic-interpersonal and cognitive-behavioral therapy sessions

The interventions used by 13 psychodynamic-interpersonal (PI) and 18 cognitive-behavioral (CB) therapists in sessions representing client change were explored. The most frequently used verbal interventions by both orientations were Questions, Reflections, and Interpretations (defined broadly as the therapists providing their own perspective on the client's functioning). For the sessions as a whole, PI therapists made significantly more use of Reflection, and CB therapists more use of Advisements and Acknowledgments. During the specific portions of sessions judged by therapists as most closely tied to client change, both orientations used equivalent amounts of Questions and Interpretations, whereas CB therapists' were more likely to use Advisements, and PI therapists to use Reflection. In significant portions of sessions, CB therapists used more Interpretations, and fewer Questions and Acknowledgments than they did in less significant portions. In portions of sessions that PI therapists judged to be associated with change, they used more Reflections and Interpretations, and fewer Questions and Acknowledgments relative to the rest of the sessions. These findings are discussed in terms of similarities and differences in the change process as construed by therapists of the two orientations.