Purpose

The ETTH (Expressive Therapy Questionnaire) evaluates the mutual recognition between therapist and client, using external observer-raters. During this process, the therapist’s consistency with the client and the performance of the therapeutic role between them are assessed, with the aim of improving the therapeutic process.

Brief Description

The Expressive Therapy Questionnaire (ETTH) consists of 20 questions divided into three categories based on factor analysis: imitation, identification, and non-verbal behavior.
Imitation refers to the way the client copies the therapist’s verbal reactions and behaviors, with examples including the use of words or mimetic orientation.
Identification refers to the acceptance and adoption of the therapist’s values and views by the client. Examples include adopting values or accepting the therapist’s worldview.
Non-verbal behavior concerns the client’s motor expressions, which are considered to be the result of their interaction with the therapist. Examples include imitating movements or mirroring the therapist’s body posture.

Sample

The research was based on a sample consisting of 18 psychotherapy sessions, drawn from a single case that underwent psychotherapy using the synthetic model. The raters, who were trained second-year clinical psychology interns in the Organized Postgraduate Program in Clinical Psychology at the Department of Psychology, University of Crete, evaluated these sessions. Their training included both theoretical components—such as definitions and examples regarding identification and the concepts covered by the scales—and practical training in identifying phenomena during videotaped sessions of the synthetic model, using another individual client as an example, different from the case under examination.

Scoring Method

Each of the 20 questions is rated on a five-point scale (1 = minimal, 5 = absolute). Three of these function as control questions, scored in reverse. The questions are distributed across three subcategories (derived from factor analysis): imitation, identification, and non-verbal behavior. The score for each subcategory results from the sum of the scores of the respective questions. In addition, a total questionnaire score is calculated.

Validity

This excerpt provides an overview of how face validity was assessed and how the examination of criterion validity was limited. A paraphrase could be stated as follows:
“The raters evaluated face validity through their comments on the logical relevance of the questions to the purpose of the questionnaire. The examination of criterion validity was not conducted, as no equivalent questionnaires existed in the Greek language.”

Reliability

Inter-rater reliability was satisfactory, as statistically significant correlations were observed among the ratings given by the three raters on the Expressive Therapy Questionnaire (ETTH) across all 18 sessions they evaluated. Specifically, the correlations between raters’ scores were as follows: Rater 1–Rater 2: r = 0.72, p < 0.01; Rater 1–Rater 3: r = 0.76, p < 0.01; Rater 2–Rater 3: r = 0.77, p < 0.01.

Main Bibliographic Source

Kosmidou, R. V., Kalaitzaki, A. E., & Nestoros, I. N. (2003, May). The client’s identification with their therapist in the psychotherapeutic process. 9th Panhellenic Conference of Psychological Research, Rhodes.