Association for Behavior Analysis International

Observational methodology could be useful to analyze verbal interaction micro-processes set in motion during adults’ clinical interventions. This type of analysis makes it possible to link the events occurring in the clinical verbal interaction with behaviors outside the clinical setting and to analyze the clinician's performance in providing services. The purpose of this talk is to introduce to the audience this methodology to present the symposium titled “Cross-Cultural and Gender Differences in Therapist-Client Verbal Interactions in Clinical Settings”. First, the characteristics of this methodology are going to be presented. Secondly, the major data analysis techniques will be reviewed. Then, to illustrate with an example, a descriptive and sequential analysis of the performance of two groups of therapists is presented. In this study 24 cases divided in two equal groups were analyzed; 12 cases the therapist had behavioral training, and12 cases the therapists did not have training in behavioral analysis. Sequential results in this study are compared with the therapy outcomes. Finally, the virtues and limitations that this type of research proposes will be discussed.

Sequential microanalysis has been advocated as a strategy able to capture the ongoing verbal interactions in clinical settings. This type of research detects the contingencies involved in the therapist and client verbal behavior, answering questions such as "which client processes are triggered by which therapist responses and under which conditions?". To synthetize the information in this field, we conducted a systematic review, distilling findings from 28 out of 1408 peer-reviewed papers across 10 countries. The search was carried out through seven databases, encompassing three languages, and focused solely on outpatient clinical contexts. We did not set limitations based on intervention type, date, or client problems. Bias risk was evaluated via the Cochrane Effective Practice and Organization of Care's standard guidelines and the Critical Appraisal Skills Program tool. By employing narrative and descriptive analysis, we established a relational network of verbal sequences spanning different therapies and cultures. Our findings highlighted consistent verbal interactions between therapists and clients. Nonetheless, therapists occasionally used inconsistent strategies when clients strayed from therapeutic goals. This accentuates how sequential microanalysis might amplify our understanding of change processes in psychotherapy, hinting that verbal interactions can form patterns on a worldwide level.

The study of gender in the field of psychology began in the 1960-70s. From this scientific development, psychology moved towards a critical look at the context and socio-cultural learning, decreasing the likelihood of gender bias in the therapeutic context. After an extensive literature review, it was identified that there is no unified and operationalized protocol for the training of therapist in this intervention that specifies what contingencies are occurring in this therapeutic interaction. A systematic review of psychological interventions with a feminist perspective that have been published in the last ten years was conducted. A search was conducted in PubMed, Psicodoc, PsycINFO and DANS EASY Archive databases for articles published in English, Portuguese and Spanish between 2013 and 2023 using search terms to find psychological interventions based on feminist principles. Rayyan© program was used for the article review and filtering process. A total of 48 studies were identified and analyzed in order to compile the different behaviors carried out by therapists in interventions with a feminist perspective regardless of the therapeutic approach carried out. The results allowed for a possible operationalization of the therapist's behavior from this type of intervention, thus achieving the creation of an intervention guide with a gender perspective from the behavioral analysis.

Transgender (Trans) and non-binary (TGNC) people are at higher risk of serious mental health problems compared to their cisgender heterosexual counterparts. TGNC individuals present higher loneliness rates and suicidal behaviors related to a history of interpersonal punishment and poor contact with social nurturing environments. Functional Analytic Psychotherapy (FAP) provides a therapeutic context that fosters intimacy repertoires in TGNC individuals by promoting healthy relationships within session and discrimination of nurturing social environments. FAP studies have shown good outcomes on increasing intimacy a key repertoire for building up deep social connection, demoting perceived isolation. This study conducted a randomized non-concurrent multiple baseline design to examine the effect of FAP on intimacy repertoires (outcome) in nine-TGNC individuals by promoting contingencies of reinforcement (process/principle) in session. The FAP Rating Scale (FAPRS) was used to code therapeutic sessions and evaluate the contingencies of reinforcement across research phases and their impact on intimacy repertoires while the FAP Intimacy Scale (FAPIS) was administered to measure intimacy behaviors. Results indicate that providing contingent social positive reinforcement in therapeutic sessions are related to gains in intimacy repertoires in TGNC people. These results provide useful treatment information for a population who lacks evidence-based interventions that fits their particular needs.