Rupture Resolution Rating System (3RS)
The Rupture Resolution Rating System (3RS) is an observer-based coding measure designed by Catherine Eubanks, Christopher Muran, and Jeremy Safran in 2015 to identify in-session rupture and resolution behaviors and evaluate their impact on the therapeutic alliance. The 3RS codes for withdrawal markers - behaviors which move away from the work of therapy or the therapist (e.g., avoidant storytelling), or toward the therapist, but by denying an aspect of the client’s experience (e.g., excessive deference) - confrontation markers - behaviors which move against the work of therapy or the therapist (e.g., non-collaborative complaints) - and therapist resolution strategies (e.g., validating the client’s defenses). Additionally, overall evaluations of rupture resolution and therapist contribution to ruptures are scored.
Segmented- Working Alliance Inventory- Observer Version (S-WAI-O)
The S-WAI-O coding group uses the Segmented Working Alliance Inventory Observer Measure to capture fluctuations in the therapeutic alliance over the course of a therapy session. Safran lab member Elizabeth Berk developed S-WAI-O by basing it off of the fourth revision of the Working Alliance Inventory-Observer Form (WAI-O) (Darchuk, Wang, Weibel, Fende, Anderson & Horvath, 2000). This observer-based measure incorporates aspects of Bordin’s (1979) theoretical model that suggests that the therapeutic alliance is comprised of three components: agreement on the tasks of therapy, agreement on the goals of therapy, and a personal bond between the therapist and client. Coders assess five-minute segments of the session in the dimensions of therapeutic bond and agreement on tasks.
Facilitative Interpersonal Skills (FIS)
Facilitative Interpersonal Skills (FIS) are a core set of skills used by various helpers that are believed to be encourage a person in emotional and psychoilogical distress to initiate change toward improved emotional and psychological well-being. These skills are presumed to be common, not only in that they are found across all forms of psychotherapeutic relationship, but also in that they are found across different helping relationships. The FIS, or Facilitative Interpersonal Skills (Anderson, 2009) coding groups look at therapist skillfulness in the context of both the FIS performance task and in-session work with clients. The coding system rates therapist behaviors across eight different items on a 1-5 scale, with 3 representing neutrality. Coders are assigned to either the FIS-Task or FIS-IS (in-session) group, which are designed to assess the same construct, though differ in the type of video material used for coding.
Classification of Affective Meaning States (CAMS)
The Classification of Affective Meaning States or CAMS was developed by Antonio Pascual-Leone at the University of Windsor. It is used to measure the presence of different emotion states in video recordings os psychotherapy sessions. CAMS also tracks the flow of these emotions across the session and differentiates between primary and secondary emotions. Currently at the Safran Lab, CAMS is being used in the Verification Initiative to begin to see which emotions occur over the course of a rupture event and how those emotions change as a result of interventions designed to repair ruptures in the therapeutic alliance.
Structured Analysis of Social Behavior (SASB)
The SASB, or Structural Analysis of Social Behavior coding group looks at interpersonal process as it emerges in the here-and-now of psychotherapy sessions. We are currently using the SASB to examine how interpersonal process may change with the implementation of Alliance Focused Training for patients with Cluster C personality disorders. As therapists gain awareness of in-session process and ruptures in the therapeutic alliance, we expect their interpersonal behaviors to change. In the context of a treatment for individuals with Cluster C personality disorders, this may include therapists non-defensively acknowledging their own contributions to ruptures and facilitating patients’ self-assertion and expression. Following SASB’s roots in interpersonal theory, we expect a complementary change in patients, such that they begin to assert and disclose more and defer to therapists less.