University of Isfahan Research in Cognitive and Behavioral Sciences 2251-7642 13 2 2024 02 20 Constructing and Validating the Therapists' Emotional Experiences in Treatment Sessions Questionnaire in Isfahan Constructing and Validating the Therapists' Emotional Experiences in Treatment Sessions Questionnaire in Isfahan 97 116 28710 10.22108/cbs.2024.138400.1799 FA Anahid Delavar Ph. D. Candidate, Department of Counseling, Khomeinishahr Branch, Islamic Azad University, Khomeinishahr, Isfahan, Iran. Fahimeh Namdarpour Assistant Professor, Department of Counseling, Khomeinishahr Branch, Islamic Azad University, Khomeinishahr, Isfahan, Iran. Mehdi Tabrizi Assistant Professor, Department of Counseling, Khomeinishahr Branch, Islamic Azad University, Khomeinishahr, Isfahan, Iran. Journal Article 2023 07 18 This article is derived from research in the field of therapists' emotional experiences in the treatment session, with a mixed-methods and sequential exploratory approach (qualitative-quantitative), that is related to the quantitative phase of this study. This article reports the construction and validation of a relevant questionnaire. The primary purpose of this article was to create and validate a questionnaire on the emotional experiences of therapists, based on the five main factors identified in the qualitative phase (emotional abilities, emotions related to job burnout, emotions related to job challenges, emotions caused by the type of communication with clients, and the type of emotions experienced). The statistical population was all psychotherapists working in Isfahan City in 2022-2023. The sample size consisted of 235 psychotherapists. Data collection was done using the quota sampling method. Data analysis was carried out by the two methods of exploratory factor analysis and structural equation modeling with a partial least squares approach. The software used for data analysis was R 4.3.0, SPSS Statistics 26, and SmartPLS. The initially designed questionnaire consisted of 54 items. After performing preliminary data analysis, preliminary data verification, and exploratory factor analysis on the final data, the items reduced from 54 to 35. Based on univariate, bivariate, and multivariate outlier data analysis, six people were excluded from the samples. The final factorial structure included six factors of emotions related to job burnout (8 items), emotions related to job challenges (7 items), emotional abilities (5 items), type of emotions experienced (5 items), emotions caused by the type of communication with clients (7 items), and emotions caused by doubt and uncertainty (3 items). The analysis results of the variance-based structural equation modeling confirmed the hierarchical nature of the obtained factor structure. The distribution of scores for all factors was almost normal. The convergent validity, based on the correlation of scores from the therapists' emotional experiences, was 0.739 (P<0.001). Additionally, the reliability coefficients using the test-retest method were calculated for 32 therapists across two sessions with a two-week interval. These coefficients were above 0.70 for all subscales. Clinics and psychotherapy centers can use the validated questionnaire to diagnose the emotional experiences of therapists and their possible injuries. Introduction The emotional experiences of therapists are crucial for analyzing the quality of patient care. If therapists cannot manage their emotional reactions effectively, they are more likely to fail in providing effective services to their clients. It is generally believed that uncontrolled emotional behavior in therapists can negatively impact treatment outcomes (Gelso et al., 2002; Rossberg et al., 2008; Rossberg et al., 2010). A review of the literature shows that, among domestic studies, there is no one specifically focused on identifying the emotional experiences of therapists. In international studies, the topic of therapists' emotional reactions and the extraction of related factors have been analyzed using quantitative tools, such as emotional word checklists (Dahl et al., 2012; Lindqvist et al., 2017; Ulberg et al., 2013; Whyte et al., 1982). Since each society has unique cultural and social conditions that can lead therapists to different emotional experiences, it is essential to address this issue in the Iranian context. This article is derived from a mixed-methods study on the emotional experiences of therapists in Isfahan. Conducted using a mixed-methods approach and a sequential exploratory design, it focuses on the quantitative phase of the study. The qualitative phase, using thematic analysis, identified five main factors contributing to the emotional experiences of therapists in Isfahan. These five factors include emotional abilities, emotions related to job burnout, emotions related to job challenges, emotions caused by the type of communication with clients, and the type of emotions experienced. In the quantitative phase, efforts were made to validate the identified factor structure through the development of a questionnaire and the collection of quantitative data. Method The study employed a correlational and factor analysis method. The statistical population included all counselors and therapists working in licensed psychology centers in Isfahan, who were active between 2022-2023 and had a minimum of two-year work experience. Data were collected from winter 2022 to spring 2023. The sample size was determined to be at least 235 participants, based on the perspective of Hair et al. (2021). Statistical analyses were conducted at both descriptive and inferential levels. To test the hierarchical nature of the final factor model (the possibility of defining a second-order factor), confirmatory factor analysis (CFA) and partial least squares structural equation modeling (PLS-SEM) were employed. Cronbach's alpha coefficients, Composite reliability coefficients, and the Fornell-Larcker matrix were used to assess the validity and reliability of the factor measurements. Convergent validity was also assessed and confirmed using the anxiety scale. Reliability coefficients were estimated using the test-retest method and were found to be satisfactory for all factors. Findings The results of the exploratory factor analysis led to the identification of six main factors. These six extracted factors, based on the content and semantic similarity of the items, were as follows: emotions related to job burnout (Factor 1), emotions related to job challenges (Factor 2), emotional abilities (Factor 3), type of emotions experienced (Factor 4), emotions caused by the type of communication with clients (Factor 5), and emotions caused by doubt and uncertainty (Factor 6). Consequently, the final scale was defined with 35 items (after removing 19) and six factors. The factor loadings for all items were within an acceptable range and were statistically significant. Convergent validity was also confirmed, with the correlation between the scores from the therapist's emotional experiences scale and the anxiety scale calculated at 0.739. Furthermore, the reliability coefficient, calculated using the test-retest method, was found to be 0.878 for job burnout, 0.908 for job challenges, 0.769 for emotional abilities, 0.867 for experienced emotions, 0.917 for type of communication, 0.795 for doubt and uncertainty, and 0.922 for the overall therapist's emotional experiences scale. Discussion and Conclusion This study presents the first localized tool designed to measure therapists' emotional experiences. The identified factors for therapists' emotional experiences differ from the findings of previous studies. This tool is beneficial for identifying potential emotional vulnerabilities in therapists and can help prevent many negative outcomes in the therapeutic process. Additionally, the tool is useful for identifying necessary training areas for therapists. Moreover, it can aid in planning related to education, human resource development, and the formulation of relevant strategies by clinic and counseling center managers. It is also advisable for future research to analyze the results based on the therapeutic approach, therapist's work experience, field of activity, and type of client. To further validate the findings of this study, it is recommended that future researchers explore therapists' emotional experiences using qualitative methods in a larger sample. Additionally, conducting studies to identify therapists' emotional experiences from the client's perspective can further validate the results of this study. This article is derived from research in the field of therapists' emotional experiences in the treatment session, with a mixed-methods and sequential exploratory approach (qualitative-quantitative), that is related to the quantitative phase of this study. This article reports the construction and validation of a relevant questionnaire. The primary purpose of this article was to create and validate a questionnaire on the emotional experiences of therapists, based on the five main factors identified in the qualitative phase (emotional abilities, emotions related to job burnout, emotions related to job challenges, emotions caused by the type of communication with clients, and the type of emotions experienced). The statistical population was all psychotherapists working in Isfahan City in 2022-2023. The sample size consisted of 235 psychotherapists. Data collection was done using the quota sampling method. Data analysis was carried out by the two methods of exploratory factor analysis and structural equation modeling with a partial least squares approach. The software used for data analysis was R 4.3.0, SPSS Statistics 26, and SmartPLS. The initially designed questionnaire consisted of 54 items. After performing preliminary data analysis, preliminary data verification, and exploratory factor analysis on the final data, the items reduced from 54 to 35. Based on univariate, bivariate, and multivariate outlier data analysis, six people were excluded from the samples. The final factorial structure included six factors of emotions related to job burnout (8 items), emotions related to job challenges (7 items), emotional abilities (5 items), type of emotions experienced (5 items), emotions caused by the type of communication with clients (7 items), and emotions caused by doubt and uncertainty (3 items). The analysis results of the variance-based structural equation modeling confirmed the hierarchical nature of the obtained factor structure. The distribution of scores for all factors was almost normal. The convergent validity, based on the correlation of scores from the therapists' emotional experiences, was 0.739 (P<0.001). Additionally, the reliability coefficients using the test-retest method were calculated for 32 therapists across two sessions with a two-week interval. These coefficients were above 0.70 for all subscales. Clinics and psychotherapy centers can use the validated questionnaire to diagnose the emotional experiences of therapists and their possible injuries. Introduction The emotional experiences of therapists are crucial for analyzing the quality of patient care. If therapists cannot manage their emotional reactions effectively, they are more likely to fail in providing effective services to their clients. It is generally believed that uncontrolled emotional behavior in therapists can negatively impact treatment outcomes (Gelso et al., 2002; Rossberg et al., 2008; Rossberg et al., 2010). A review of the literature shows that, among domestic studies, there is no one specifically focused on identifying the emotional experiences of therapists. In international studies, the topic of therapists' emotional reactions and the extraction of related factors have been analyzed using quantitative tools, such as emotional word checklists (Dahl et al., 2012; Lindqvist et al., 2017; Ulberg et al., 2013; Whyte et al., 1982). Since each society has unique cultural and social conditions that can lead therapists to different emotional experiences, it is essential to address this issue in the Iranian context. This article is derived from a mixed-methods study on the emotional experiences of therapists in Isfahan. Conducted using a mixed-methods approach and a sequential exploratory design, it focuses on the quantitative phase of the study. The qualitative phase, using thematic analysis, identified five main factors contributing to the emotional experiences of therapists in Isfahan. These five factors include emotional abilities, emotions related to job burnout, emotions related to job challenges, emotions caused by the type of communication with clients, and the type of emotions experienced. In the quantitative phase, efforts were made to validate the identified factor structure through the development of a questionnaire and the collection of quantitative data. Method The study employed a correlational and factor analysis method. The statistical population included all counselors and therapists working in licensed psychology centers in Isfahan, who were active between 2022-2023 and had a minimum of two-year work experience. Data were collected from winter 2022 to spring 2023. The sample size was determined to be at least 235 participants, based on the perspective of Hair et al. (2021). Statistical analyses were conducted at both descriptive and inferential levels. To test the hierarchical nature of the final factor model (the possibility of defining a second-order factor), confirmatory factor analysis (CFA) and partial least squares structural equation modeling (PLS-SEM) were employed. Cronbach's alpha coefficients, Composite reliability coefficients, and the Fornell-Larcker matrix were used to assess the validity and reliability of the factor measurements. Convergent validity was also assessed and confirmed using the anxiety scale. Reliability coefficients were estimated using the test-retest method and were found to be satisfactory for all factors. Findings The results of the exploratory factor analysis led to the identification of six main factors. These six extracted factors, based on the content and semantic similarity of the items, were as follows: emotions related to job burnout (Factor 1), emotions related to job challenges (Factor 2), emotional abilities (Factor 3), type of emotions experienced (Factor 4), emotions caused by the type of communication with clients (Factor 5), and emotions caused by doubt and uncertainty (Factor 6). Consequently, the final scale was defined with 35 items (after removing 19) and six factors. The factor loadings for all items were within an acceptable range and were statistically significant. Convergent validity was also confirmed, with the correlation between the scores from the therapist's emotional experiences scale and the anxiety scale calculated at 0.739. Furthermore, the reliability coefficient, calculated using the test-retest method, was found to be 0.878 for job burnout, 0.908 for job challenges, 0.769 for emotional abilities, 0.867 for experienced emotions, 0.917 for type of communication, 0.795 for doubt and uncertainty, and 0.922 for the overall therapist's emotional experiences scale. Discussion and Conclusion This study presents the first localized tool designed to measure therapists' emotional experiences. The identified factors for therapists' emotional experiences differ from the findings of previous studies. This tool is beneficial for identifying potential emotional vulnerabilities in therapists and can help prevent many negative outcomes in the therapeutic process. Additionally, the tool is useful for identifying necessary training areas for therapists. Moreover, it can aid in planning related to education, human resource development, and the formulation of relevant strategies by clinic and counseling center managers. It is also advisable for future research to analyze the results based on the therapeutic approach, therapist's work experience, field of activity, and type of client. To further validate the findings of this study, it is recommended that future researchers explore therapists' emotional experiences using qualitative methods in a larger sample. Additionally, conducting studies to identify therapists' emotional experiences from the client's perspective can further validate the results of this study.

https://cbs.ui.ac.ir/article_28710_7d2058856c7e0ddd603625558834b4d0.pdf