Using Thin Slicing to Detect Client Resistance in Psychotherapy

Abstract

The present study developed and examined the merits of a “thin slice” (Ambady & Rosenthal, 1992) approach for the detection of client resistance in psychotherapy. Thin slice clips presenting resistance (n = 20) and non-resistance (n = 20) were derived from previously resistance-coded sessions (Aviram et al., 2016) of 20 therapist-client dyads from a larger RCT (Westra et al., 2016). Seventeen untrained raters rated the clips in randomized order. Untrained raters’ (1) thin slice ratings on 90-s of client behaviour significantly differentiated resistance from non-resistance, (2) thin slice ratings on resistance strongly predicted expert coder-ratings of resistance for the 1-hr session, and (3) thin slice ratings on resistance moderately predicted client working alliance ratings for the 1-hr session. Key observable client behaviours of “annoyance”, “anger”, and “frustration” were also identified as correlates of resistance. This study demonstrates the utility of “thin slicing” as a novel and efficient approach to resistance-detection.