Segments versus whole sessions: Which is the better unit for psychotherapy process research?

Recorded 15 psychotherapists in 2 early sessions with 2 of their patients. 3 4-min segments were rated on a variety of process variables and compared with ratings of the entire session to determine whether the dimensions judged from segments were similar to those from whole sessions. Average rater reliabilities of the 2 sets of ratings did not differ. Factor analyses showed segment-based judgments to be reasonable approximations to session-based judgments of most of the basic dimensions (factors) with 1 notable exception: "optimal empathic relationship." it is concluded that reliance upon brief segments, as is done in most psychotherapy process research, misses an important aspect of patient-therapist interaction. Finally, patients judged to be relatively healthy at the start of treatment had better outcomes, in terms of therapist outcome ratings of "success plus patient satisfaction," in using either segments or sessions, but predictions based on multifactor combinations were less successful from segments than from sessions. (20 ref.) (PsycINFO Database Record (c) 2006 APA, all rights reserved).