Process Coding as Clinical Training

Improve psychotherapy outcomes in real time by developing your attunement through process coding.

Traditional model-based approaches to psychotherapy training often leave clinicians without the tools to recognize and respond to what truly matters in-session. This groundbreaking volume is a compendium of current best practices in process coding—a research-backed method for observing, categorizing, and analyzing therapy as it unfolds. By watching therapy videos and coding transcripts to track subtle verbal and nonverbal signals, therapists and clinicians in training can identify alliance ruptures, engagement shifts, and other critical markers that predict outcomes—before it's too late.

Leading experts Henny Westra, Catherine F. Eubanks, and Tali Z. Boritz bring together validated coding systems, practical demonstrations, and video-based examples to show how process-centered training enhances responsiveness and complements any therapeutic model. Designed to be used either alone or in tandem with select APA therapy videos, the book shows clinicians and trainees how to do the right thing at the right time by improving their flexibility, attunement, and client outcomes.

Introduction

• Chapter 1. Leveraging Process Science to Develop Moment-by-Moment Observational Skills
  Henny A. Westra, Tali Z. Boritz, and Catherine F. Eubanks

Part I. Coding Systems Focused on Dyadic Processes

• Chapter 2. Working Alliance Inventory – Observer Version (WAI-O)
  Timothy Anderson, Adam O. Horvath, and Mia Schmittenberg
• Chapter 3. The Rupture Resolution Rating System (3RS)
  Catherine F. Eubanks, Kaitlin M. Williams, and Dustin Phan
• Chapter 4. The Motivational Interviewing Skills Code 1.1 and the Adapted Client Resistance Code (A-CRC)
  Alyssa D. Bartolomeo and Henny A. Westra
• Chapter 5. Therapeutic Collaboration Coding System (TCCS)
  Eugénia Ribeiro and Dulce Pinto
• Chapter 6. Structural Analysis of Social Behavior (SASB) Interpersonal Gestalt Coding
  Kenneth L. Critchfield, Caroline Ball, Akiva Gornish, Nina L. J. Rose, Hallie R. Goldman, Eleanor G. Harrison, and Julia E. Mackaronis

Part II. Coding Systems Focused on Client and/or Therapist Processes

• Chapter 7. Multicultural Orientation Performance Task (MCO-PT)
  Emma Freetly Porter and Jesse Owen
• Chapter 8. The Experiencing Scale (EXP)
  António Pazo Pires, Ana Daniela Barreto Aleixo, and Carolina Seybert
• Chapter 9. Classification of Affective-Meaning States (CAMS)
  Antonio Pascual-Leone and Florencia Cristoffanini
• Chapter 10. Assimilation of Problematic Experiences Scale (APES)
  Isabel Basto, Isabel Caro Gabalda, and William B. Stiles
• Chapter 11. The Innovative Moments Coding System (IMCS)
  Miguel M. Gonçalves, João Batista, and João Tiago Oliveira
• Chapter 12. The Narrative-Emotion Process Coding System (NEPCS)
  Tali Z. Boritz and Lynne Angus
• Chapter 13. The Pausing Inventory Categorization System (PICS)
  Heidi M. Levitt, Javier L. Rizo, and Nicholas A. Pierorazio
• Chapter 14. Client and Therapist Vocal Quality Measures (CVQ & TVQ)
  Jeanne C. Watson and Hadas Wiseman
• Chapter 15. A Measure of Expressed Empathy (MEE)
  Jeanne C. Watson and Signe Hjelen Stige
• Chapter 16. Resource-Oriented Microprocess Analysis of Patients (ROMA-P)
  Christoph Flückiger and Greta Probst

Part III. Conclusions and Future Directions

• Chapter 17. Integrating Process Coding into Clinical Training: Key Considerations and Training Suggestions
  Tali Z. Boritz, Catherine F. Eubanks, and Henny A. Westra
• Chapter 18. Conclusions and Future Directions
  Catherine F. Eubanks, Henny A. Westra, and Tali Z. Boritz

Henny A. Westra, PhD, is professor emeritus in the Department of Psychology at York University in Toronto, Canada. She has held numerous positions over her 30-year career including professor, researcher, workshop presenter and teacher, frontline clinician, and program developer. She has written, published, and presented widely on ambivalence, resistance, anxiety, training and the development of expertise, motivational interviewing, and cognitive behavioral therapy. She is the author of the book Motivational Interviewing in the Treatment of Anxiety and is a principal developer of the Adapted Client Resistance Code (A-CRC), featured in this book alongside numerous other process coding schemes.

Catherine F. Eubanks, PhD, is a professor at the Gordon F. Derner School of Psychology at Adelphi University and codirector of the Center for Alliance-Focused Training. She is coauthor of Therapist Performance Under Pressure, and coeditor of Rupture and Repair in Psychotherapy. She was previously an associate editor on the Journal of Consulting and Clinical Psychology and is currently the managing editor of Psychotherapy Research.

Tali Z. Boritz, PhD, is an assistant professor in the Department of Psychology at York University in Toronto, Canada. She is a clinical psychologist, researcher, and educator. Her work focuses on psychotherapy process and outcomes, with an emphasis on translating research into practical training tools for clinicians and trainees. She has authored numerous peer-reviewed publications and is coauthor of the book Deliberate Practice in Dialectical Behavior Therapy. She is past president of the North American chapter of the Society for Psychotherapy Research.