Facilitation of insight in psychotherapy: Technique variables

Open Access
McAleavey, Andrew Athan
Graduate Program:
Master of Science
Document Type:
Master Thesis
Date of Defense:
October 19, 2011
Committee Members:
  • Louis Georges Castonguay, Thesis Advisor
  • psychotherapy
  • insight
  • psychotherapy techniques
  • multilevel linear modeling
The facilitation of client insight – broadly defined as forming new connections about one’s self, others, and emotions – is viewed as a key element in many forms of psychotherapy. Despite this, relatively little empirical work has addressed what types of therapeutic techniques may facilitate or hinder insight, especially an applied setting. In this study, clients and therapists completed questionnaires following 452 sessions of psychotherapy focused on rating the extent of insight achieved by clients and the types of techniques used by therapists in those sessions. Multilevel linear modeling was used to test the hypothesis that techniques from exploratory psychotherapies would be more frequent in high-insight sessions. Counter to the hypothesis, higher exploratory techniques were associated with lower client-rated insight at both the client and session level. In addition, interaction effects (including a four-way cross-level interaction) revealed that a complex interpretation of the data was necessary. Though it was the case that therapists reported using more exploratory techniques when insight was low, the typicality of different interventions appeared to play a substantial role in determining both the strength and direction of effect between different types of techniques and insight. These findings show that while significant relationships between techniques and insight exist across clients and therapists, what specific techniques facilitate insight may vary substantially across treatments.