Date of Award

Winter 2003

Document Type


Degree Name

Doctor of Psychology (PsyD)



Committee Director

Michael Nichols

Committee Member

Larry Ventis

Committee Member

Janis Sanchez-Hucles

Committee Member

Glenn Shean

Committee Member

Joy Kannarkat


In an era where the effectiveness of many forms of psychotherapy has been thoroughly examined, the focus of many researchers has shifted from investigating outcome to exploring therapeutic processes. Process studies serve to identify the active ingredients of therapy—that is, those interventions that bring about in-session changes. This process study examines the relationship between the use of enactments, a structural family therapy intervention, and in-session change as observed over the course of the session. Change was measured by the amount of change that occurred in the core problem dynamic, that is, the most prominent pattern of dysfunctional family interaction. The sample consisted of ten videotaped family therapy sessions, representing ten families and four therapists. Clinician judges rated change on a seven-point Likert-like scale. Trained undergraduate raters rated successfulness of enactments and degree to which enactments and other meaningful moments addressed the core problem dynamic in each session. Pearson Product-Moment correlations were calculated to assess the relationship between change occurring in the core problem dynamic by the end of the session and several variables, including successfulness of enactments, and the extent to which enactments and meaningful moments addressed the problem dynamic. In addition, possible relationships between each of the variables were investigated, as well as relationships between the number of meaningful moments occurring within enactments and successfulness of enactments and extent to which enactments addressed the core problem dynamic. Results suggest a positive relationship between successfulness of enactments and both change in the core problem dynamic at the end of the session and number of meaningful moments occurring in enactments. Implications and limitations are discussed.


A Dissertation Submitted to the Faculties of The College of William and Mary, Eastern Virginia Medical School, Norfolk State University, and Old Dominion University in Partial Fulfillment of the Requirements for the Degree of Doctor of Psychology in Clinical Psychology through the Virginia Consortium Program in Clinical Psychology.