<%BANNER%>

Me Now, Me Then

Permanent Link: http://ufdc.ufl.edu/UFE0021898/00001

Material Information

Title: Me Now, Me Then Therapists and Constructions of their Epistemic Journey
Physical Description: 1 online resource (129 p.)
Language: english
Creator: Toska, Gizem
Publisher: University of Florida
Place of Publication: Gainesville, Fla.
Publication Date: 2008

Subjects

Subjects / Keywords: Psychology -- Dissertations, Academic -- UF
Genre: Counseling Psychology thesis, Ph.D.
bibliography   ( marcgt )
theses   ( marcgt )
government publication (state, provincial, terriorial, dependent)   ( marcgt )
born-digital   ( sobekcm )
Electronic Thesis or Dissertation

Notes

Abstract: Our study investigated the epistemic change processes of psychotherapists and attempted to identify the nature of the epistemic journey of this group. We conducted a retrospective study where therapists were asked to reflect on their current and past epistemic commitments as well as theoretical orientations and therapeutic styles. This method provided us with a unique set of data where we learned about the therapists? personal constructions of their epistemic journeys and other professional change processes accompanying this journey. Findings suggested that when reflected on their current experiences and their initial experiences as blossoming practitioners, therapists perceived their commitment to constructivist epistemology as amplified, and their commitment to rationalist epistemology as reduced over their practice. The cohort effects failed to explain these changes or to differentiate therapists' initial constructivist commitments. The obtained results also indicated that the perceived change in epistemic commitments predicted therapists? theoretical and stylistic commitments. Our study facilitated our understanding of the developmental trajectory of therapists' epistemic commitments as they perceive it and it provided empirical data with respect to how therapists construe the professional change processes that accompany their epistemic change.
General Note: In the series University of Florida Digital Collections.
General Note: Includes vita.
Bibliography: Includes bibliographical references.
Source of Description: Description based on online resource; title from PDF title page.
Source of Description: This bibliographic record is available under the Creative Commons CC0 public domain dedication. The University of Florida Libraries, as creator of this bibliographic record, has waived all rights to it worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law.
Statement of Responsibility: by Gizem Toska.
Thesis: Thesis (Ph.D.)--University of Florida, 2008.
Local: Adviser: Neimeyer, Greg J.
Electronic Access: RESTRICTED TO UF STUDENTS, STAFF, FACULTY, AND ON-CAMPUS USE UNTIL 2010-08-31

Record Information

Source Institution: UFRGP
Rights Management: Applicable rights reserved.
Classification: lcc - LD1780 2008
System ID: UFE0021898:00001

Permanent Link: http://ufdc.ufl.edu/UFE0021898/00001

Material Information

Title: Me Now, Me Then Therapists and Constructions of their Epistemic Journey
Physical Description: 1 online resource (129 p.)
Language: english
Creator: Toska, Gizem
Publisher: University of Florida
Place of Publication: Gainesville, Fla.
Publication Date: 2008

Subjects

Subjects / Keywords: Psychology -- Dissertations, Academic -- UF
Genre: Counseling Psychology thesis, Ph.D.
bibliography   ( marcgt )
theses   ( marcgt )
government publication (state, provincial, terriorial, dependent)   ( marcgt )
born-digital   ( sobekcm )
Electronic Thesis or Dissertation

Notes

Abstract: Our study investigated the epistemic change processes of psychotherapists and attempted to identify the nature of the epistemic journey of this group. We conducted a retrospective study where therapists were asked to reflect on their current and past epistemic commitments as well as theoretical orientations and therapeutic styles. This method provided us with a unique set of data where we learned about the therapists? personal constructions of their epistemic journeys and other professional change processes accompanying this journey. Findings suggested that when reflected on their current experiences and their initial experiences as blossoming practitioners, therapists perceived their commitment to constructivist epistemology as amplified, and their commitment to rationalist epistemology as reduced over their practice. The cohort effects failed to explain these changes or to differentiate therapists' initial constructivist commitments. The obtained results also indicated that the perceived change in epistemic commitments predicted therapists? theoretical and stylistic commitments. Our study facilitated our understanding of the developmental trajectory of therapists' epistemic commitments as they perceive it and it provided empirical data with respect to how therapists construe the professional change processes that accompany their epistemic change.
General Note: In the series University of Florida Digital Collections.
General Note: Includes vita.
Bibliography: Includes bibliographical references.
Source of Description: Description based on online resource; title from PDF title page.
Source of Description: This bibliographic record is available under the Creative Commons CC0 public domain dedication. The University of Florida Libraries, as creator of this bibliographic record, has waived all rights to it worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law.
Statement of Responsibility: by Gizem Toska.
Thesis: Thesis (Ph.D.)--University of Florida, 2008.
Local: Adviser: Neimeyer, Greg J.
Electronic Access: RESTRICTED TO UF STUDENTS, STAFF, FACULTY, AND ON-CAMPUS USE UNTIL 2010-08-31

Record Information

Source Institution: UFRGP
Rights Management: Applicable rights reserved.
Classification: lcc - LD1780 2008
System ID: UFE0021898:00001


This item has the following downloads:


Full Text
xml version 1.0 encoding UTF-8
REPORT xmlns http:www.fcla.edudlsmddaitss xmlns:xsi http:www.w3.org2001XMLSchema-instance xsi:schemaLocation http:www.fcla.edudlsmddaitssdaitssReport.xsd
INGEST IEID E20101111_AAAAAQ INGEST_TIME 2010-11-11T08:52:04Z PACKAGE UFE0021898_00001
AGREEMENT_INFO ACCOUNT UF PROJECT UFDC
FILES
FILE SIZE 2230 DFID F20101111_AAAJGE ORIGIN DEPOSITOR PATH toska_g_Page_083.txt GLOBAL false PRESERVATION BIT MESSAGE_DIGEST ALGORITHM MD5
7b94f47b5e4b6abfd9051880a4e78780
SHA-1
2a7fcf0ad118b5af550ec2fe987c845c23e66d56
9108 F20101111_AAAKJG toska_g_Page_123thm.jpg
0ce4f753b2af76164ee747fb09f5b989
80360bfb2667b209489af2b8e57b9650298d146a
1051932 F20101111_AAAJFQ toska_g_Page_092.jp2
057ef560578b15be6561659a165b24b0
20e9470c5c17ca36853529affcf005c65726043f
36536 F20101111_AAAKIS toska_g_Page_064.QC.jpg
f77dde04b7d65bfa3a2ca700fa531b09
a4b94490bd94d6ba618b7a98b45c7adf8472665d
109169 F20101111_AAAJGF toska_g_Page_045.jpg
4acc5c6c58b3f6e4a46a23f97cbbbffc
f312af7d0c3850acf0fb0ee6d984a7251fa1b14a
38108 F20101111_AAAKJH toska_g_Page_051.QC.jpg
9c9cc1ebe048baea6185abe65f75321b
256018bab4e6c32096b922d03ca05e9ce6a64074
48496 F20101111_AAAJFR toska_g_Page_037.pro
7c0b0bcd47a80007744b732050ccfe49
f37111de3793af39c8ac88b3f18fb3e6c13a4bbd
8814 F20101111_AAAKIT toska_g_Page_094thm.jpg
16aa4660a14c5c54866d96efb2879546
7f1f89492e95e19b9e43179cc3d0ab2f90caa01d
58054 F20101111_AAAJGG toska_g_Page_044.pro
9c8291a1f5543e076576e395e4932841
1fc5625c652365103b1085df2835b7abea435dc7
8805 F20101111_AAAKJI toska_g_Page_045thm.jpg
19411cb44902623fffb4f486b578052a
ff7b6513436c58d0a9c857ee4d580a845460bd33
25271604 F20101111_AAAJFS toska_g_Page_018.tif
b472fbc8ee26e8e5beb8bd7c78147aae
ddf0514c552c3d6498686579e8aa1fa9169ed126
8334 F20101111_AAAKIU toska_g_Page_026thm.jpg
327cec75cc0960e5084e6621207f082d
f485eed9d736474287f9177eb1d2bf1c554026dd
8348 F20101111_AAAKJJ toska_g_Page_092thm.jpg
1dc7bcfa2fe9325d9b2ddb476b99933b
d4b25cca8b0bfb7c14692aeb82c033225546d736
110104 F20101111_AAAJGH toska_g_Page_089.jpg
d4955e55a7a5d57b58cf056f0e3208e6
07ca44d9428cc05f0f6b895618dab0d5af9bd9d9
2107 F20101111_AAAJFT toska_g_Page_077.txt
fca4cc82daf6216b458611ee39d7a796
c18c483b1f1a47ed87ffd826eba23d3c2f9f4d9a
35496 F20101111_AAAKIV toska_g_Page_071.QC.jpg
e90679195af33fb9cd50f93aeefeda15
36d054e57d2cf0ba298f70296a1428a70784d2ab
37236 F20101111_AAAKJK toska_g_Page_034.QC.jpg
49e66ed09fb18352b77240807f59fa36
0d467d1416fafe7fa543f4e6f714d0ea5477e415
395658 F20101111_AAAJGI toska_g_Page_004.jp2
5207b402bd40203f02d0e6c8c0aa7d47
e02f5628f64015d8ef61c08f8520ea1db5325b05
F20101111_AAAJFU toska_g_Page_076.tif
cad86d66733e8631ed48d08a42b4d142
3f08944508a46d84cb95a6b9192cf5e013e670f1
8351 F20101111_AAAKIW toska_g_Page_100thm.jpg
3bb92055455dc6df6ea9cf946df4a1a5
8b81637d57be86e36239c3459459b58a1bd67b52
8672 F20101111_AAAKKA toska_g_Page_019thm.jpg
01cadde65b642d0aeac5b6d66bb2b774
e5e167474e64393de0e1dac1ae6ed605dd26164f
35260 F20101111_AAAKJL toska_g_Page_089.QC.jpg
f9722e580c7b5dd24d2bacfc9ea58966
f69f858fa33bbce62100ac469b5bd60f1f2afdcd
6982 F20101111_AAAJGJ toska_g_Page_080thm.jpg
9e342b77242d861c1df72e6483b19707
ee67dd5740e4157e226037bc810fdbae25d63790
F20101111_AAAJFV toska_g_Page_065.tif
73cec43f51bf870ed49aa5d31cc27ccf
e52a6cfd154badbbb13b6b74a92ec6b435086b5a
36544 F20101111_AAAKIX toska_g_Page_046.QC.jpg
95910cca62562f28abe4ab3c6cc50fc3
4b401fa3b4f8a264d4469704ff489e235151509a
8495 F20101111_AAAKKB toska_g_Page_112thm.jpg
14b61c67c32b267e8734661f292bf1a1
81d4debedd452427a37a5ebe574a47af10c0e5ca
36830 F20101111_AAAKJM toska_g_Page_124.QC.jpg
1f4050f2027f4a8412abe7289871136a
cd2d6a7645959041d2cc300b540b4594cb31005b
1051950 F20101111_AAAJGK toska_g_Page_061.jp2
9e2ba75f7387960c3563970bde77560f
c43443e23d3eb2c3b4ba0b1a223cc209e2d39785
8817 F20101111_AAAJFW toska_g_Page_061thm.jpg
aa5678be212fa6630c0b5e14a18418d0
f52c30a62fd7a1723d7f0f29f2513e98ea5977a5
35601 F20101111_AAAKIY toska_g_Page_045.QC.jpg
a7e351db0a837db8677fcd3d8f17551e
4ac671eb2b51b4764bc6039a2a372059d1018be7
8638 F20101111_AAAKKC toska_g_Page_121thm.jpg
3bdd5ba57564695fe8fb64085bec2868
8b09589d44405c91aa439ae4755a4b9ad06fc3ae
8258 F20101111_AAAKJN toska_g_Page_043thm.jpg
61260dabd25b63af05be15ba0f335a87
f542ae18a8765372067ef42021bc4cc8b8a8f468
F20101111_AAAJGL toska_g_Page_100.tif
d7019de8a3fcf7b4bc11cbd7bad910de
2658fc82ebd0a9ab9d8df85d4072d0538b7067bd
2011 F20101111_AAAJFX toska_g_Page_008.txt
a63e401516907dae32b7852fc0caad9a
514c3df81ab6a0a63d50140d81261fa42c44253b
33380 F20101111_AAAKIZ toska_g_Page_029.QC.jpg
cdc1c6fdda4c0d2986b9ec69d3116084
98ad511444e89be3acb275310c57980b97b4dfba
35177 F20101111_AAAJHA toska_g_Page_105.QC.jpg
937f31fb98901c664e8ff267a5c54da5
adb8a49048a7a8e939647962ed2e3702a2ba7f82
8945 F20101111_AAAKKD toska_g_Page_099thm.jpg
4f93d79bfe481e4f06bccc74a0a958e6
bf6799311596d3aebec179bd700fc4306d7402fd
32481 F20101111_AAAKJO toska_g_Page_014.QC.jpg
cc8577702846bfaad5b65d51bddcd5ce
86433e740f5b70dda997211d284099349b288e41
8690 F20101111_AAAJGM toska_g_Page_095thm.jpg
9b76e578773e7c322bd95e8da3af4f3b
88dcf6e61563d53de251aa1d82e3316408da3135
355 F20101111_AAAJFY toska_g_Page_128.txt
ee6180fc486d58e11d74c91e545cff81
124d448dcd1c5b0b361bcc382aa5256dd38211d3
54719 F20101111_AAAJHB toska_g_Page_069.pro
afab7aeb89b21aad1c10d15a0a7a4144
397512ba674e4e3d0aeea13331e86ecd456b75cb
31773 F20101111_AAAKJP toska_g_Page_028.QC.jpg
1ce767308d4c629a34120dc71fc9da9e
85e762300fb8c54ea3e8c4384c51ac6e008fcd63
1051967 F20101111_AAAJGN toska_g_Page_009.jp2
21ac981cecac9baf2850ca918dc95313
b8614aac133429ddc069edef7d6775d4c78c986f
8405 F20101111_AAAJFZ toska_g_Page_014thm.jpg
007c8c995400ac28494c58e9d503aa5d
c6a955786cd4e162c286446b0920bcf0ecf0593b
8531 F20101111_AAAKKE toska_g_Page_074thm.jpg
ca3c7c9c15e69ecd2326b5d05ab9187c
cbd16859229d50c9732c98d63f6cafa0a0c400be
2764 F20101111_AAAKJQ toska_g_Page_062thm.jpg
f164094c537c2802dd21c59ae78f1cad
61a1714fb8108d7666adf7d0d8666a31f3111386
1051981 F20101111_AAAJGO toska_g_Page_090.jp2
046ad449275a9ca4d25f09993548484c
7ef4c1b50cff0b67e3a5cd09be7ed05f8c8c7131
55890 F20101111_AAAJHC toska_g_Page_066.pro
6b8d1db99154ad4ff421f529cd828e80
77f26e1029df205b519e81fd4e309a5a3c26e691
34048 F20101111_AAAKKF toska_g_Page_013.QC.jpg
726b5193afc2a6536d2f02f25a33d7ef
e3fe1bb17f638e8ff056544ad120625c7f734c9c
33970 F20101111_AAAKJR toska_g_Page_115.QC.jpg
cc1f98675008f0ae800205e1d4559821
7ae05bad6cdbe2356c3c988a1ffd4817c30070ae
F20101111_AAAJGP toska_g_Page_106.tif
879b9e27cd6f804017e456a4f6e4aeb6
c6bf99f43315ec31495bf4528d2a7f9b175d0828
8585 F20101111_AAAJHD toska_g_Page_078thm.jpg
3e2c87ebcdf53e88f7e30085552852b1
2f5e788a62da4e8735d586bacdaafa56f2cc4ae3
32324 F20101111_AAAKKG toska_g_Page_070.QC.jpg
236aca7383191d241ea7ab6ad54879d8
4f6aed04351328856fa131716e870c2a5f5fedd6
31361 F20101111_AAAKJS toska_g_Page_024.QC.jpg
92fa6c5da2a27d79092b7836cd13477f
8053402b4bbd2dbd19a0c171767879d1a4b03d55
36037 F20101111_AAAJGQ toska_g_Page_010.QC.jpg
9f68b2172c395cc2886b1cd9194eba58
15fa378bc3719475e3727eb6242fa791850c8fed
29871 F20101111_AAAJHE toska_g_Page_063.QC.jpg
e28a06f3ee0f324183ff9c765e2d8068
5bb974dacb437f1813788f9075defa0034d1ebe2
33159 F20101111_AAAKKH toska_g_Page_119.QC.jpg
d1732fae2cda09179c8e0a5ccdcf6775
c1f983362a0c975ef1a6dc2079d75bef762f1be8
35313 F20101111_AAAKJT toska_g_Page_019.QC.jpg
e3cfc73d33cb5af5769fc04618d120fa
0e4432e3ffb4c7e36eaeeb4892276f84cd757dd3
F20101111_AAAJGR toska_g_Page_042.tif
aae7cd980aa30e661d4be2942cdf53cf
6fd56fcd17407cde4d6f9df02893c6f37d467e70
104960 F20101111_AAAJHF toska_g_Page_065.jpg
923a5f2f8e4919df8fd5d5a3b7d8ffef
2be2ddfe153a1eb41e5ab140651856f6a604da8f
34493 F20101111_AAAKKI toska_g_Page_095.QC.jpg
a3d9e516567f0ff7f5f83aea2fc86730
7486fa05c5e4833a625bd314f5401bd9b9794f24
33163 F20101111_AAAKJU toska_g_Page_036.QC.jpg
00a11e658bc377bfcc04a01c38262e63
1288bcb2165620fc8bd8eacd72e171a3d14c51b2
119310 F20101111_AAAJGS toska_g_Page_127.jpg
69603215b26da0b1a57c62e21843272e
cfe1beda8506aa51fe51e5a27f664b51e60ab371
35909 F20101111_AAAJHG toska_g_Page_025.QC.jpg
f0028e5bba305e402b125cd5da527322
25e2c97368b59e8b0eadff5b30d5a96a37bf9227
9315 F20101111_AAAKKJ toska_g_Page_122thm.jpg
2909bec69cb45731ff73e879e83876cf
6cbcb8033c70c4a5d9b013be87c6edf356091d4f
33823 F20101111_AAAKJV toska_g_Page_107.QC.jpg
2cf0c76b16fa40f0dd4e2eaa6893fd6a
56613e766eef65264254cd4fc629bd760d16f323
101996 F20101111_AAAJGT toska_g_Page_029.jpg
52ceea49fe0e998373227668d7e2a542
dfb058f195c0f486b41a3384bf4acf0242b71dd2
F20101111_AAAJHH toska_g_Page_062.tif
ed10a4b15402f085ab952f7e760be56e
d50384d182b4b40f3e4d18efa1a448ae7a1bcb18
20248 F20101111_AAAKKK toska_g_Page_007.QC.jpg
6a500ba26aab6d926021607411c898a1
67214490e961fb86f91fceb2acdf13846e1da2f0
4440 F20101111_AAAKJW toska_g_Page_057thm.jpg
8b6cd5a0f1e89b428641727aadf23b14
431bfb7e062d336300389fb5574e503856d36a96
102878 F20101111_AAAJGU toska_g_Page_036.jpg
d5bc1d4b792edd6fa1c64a2ebd8eb579
8dba50cb587d599309c93740b205a8c544eabefe
26144 F20101111_AAAJHI toska_g_Page_005.QC.jpg
f9ffcf1a67cf1eacb905f927f23f463f
c398eccd787695e0bb49ef5de2b9c489da07d6c5
8756 F20101111_AAAKLA toska_g_Page_105thm.jpg
9f85b5a74af8bcd97109599d63f6d862
98ffd22f1668cb2a9ee686dd20c07f00d6b65eb8
34234 F20101111_AAAKKL toska_g_Page_100.QC.jpg
01832cdaa6d4de2e28a4a7222bda0e06
1c1bdc87dfb618b5a9c4b57b66487e054b7d0f94
35411 F20101111_AAAKJX toska_g_Page_049.QC.jpg
79616956ea6bfcfcb91868f670b74143
af3ed6c6e02e005140e55d102571d0d392cca306
F20101111_AAAJGV toska_g_Page_028.tif
01ed14f0b77ed4a821ab9e972e8e2e65
621bbf69f02f8bff3d1a019963424cb64c98bfdd
109177 F20101111_AAAJHJ toska_g_Page_106.jpg
d75c56c28723ec0f44d83c1a13404c52
cabffa3890c9a27dce67c75be469e9baf9fbd82b
8990 F20101111_AAAKLB toska_g_Page_046thm.jpg
981906bc2dfd1296255d537a00384e4b
d7357219660d594a73b486a7165c44d8f0f4aeb9
34692 F20101111_AAAKKM toska_g_Page_042.QC.jpg
f42d30eb028ac595d5cfa91277355428
d1b284b974d53fc94ba6d8441222f1d367e3e212
34294 F20101111_AAAKJY toska_g_Page_118.QC.jpg
81e4463000ee883d94b721f05287ac4d
d3161913908ad304e6e9ecac61cd85ce57cd6dd1
35327 F20101111_AAAJGW toska_g_Page_043.QC.jpg
d6416621a2b9bb9bb8e1276f3ba466bf
df4db90a5c45261c51960afd67dc8c9c3942036a
53669 F20101111_AAAJHK toska_g_Page_049.pro
40ac9edf83a720e550f5fc976c358e7e
3a1db539a54e85d788b828f2f547f53cd68a0d56
8735 F20101111_AAAKLC toska_g_Page_125thm.jpg
c969d861d359e7a32d1e13bc26749c69
36ece694870975231825819a307e5c0a2829fe1e
8608 F20101111_AAAKKN toska_g_Page_109thm.jpg
d13192df033ec152b0d56cf70c8d1c84
9231049f9f645b7afb33495384430fb44dfc62e2
9090 F20101111_AAAKJZ toska_g_Page_051thm.jpg
3660c618dd24e1babd083363371e368a
d23b43fc96aa5a2656c26ca32916c52f08323559
52785 F20101111_AAAJGX toska_g_Page_030.pro
1cfc5a4088dbd53823d9f05406d13d83
a587152376d7dcb2d20a6bb7e27fccc00b47714f
8689 F20101111_AAAJIA toska_g_Page_127thm.jpg
8f10076357d6c197bef853b24542df57
074a7a9dff0ff2afce42499a7a9b1ab4e1493b5c
F20101111_AAAJHL toska_g_Page_111.tif
a196e5c2c3ccbed9c6d2557234d336a1
aa3b8be504dd1b164baaa061d465e840f08ab84f
8369 F20101111_AAAKLD toska_g_Page_030thm.jpg
f40bb2f1d1ca4db5ce47db696e4ec996
0a2d8d369d6d40c8622550bfb1e50cdb77780503
32120 F20101111_AAAKKO toska_g_Page_031.QC.jpg
d9e09ee26ed64362ec54281e79c58bfa
f4ca3502425c2e3f7c6f6a25d9f2a3586f780eae
1051969 F20101111_AAAJGY toska_g_Page_054.jp2
c21890f17e3d4f9997bcd48be562ab57
a77329c7b660f774513eddf1d135fa55f18a8d09
11021 F20101111_AAAJIB toska_g_Page_129.QC.jpg
c961936e47b402929cc78f72aa3b6eed
245fa8bf133321a5bca764fc965751ad0c50e676
7695 F20101111_AAAJHM toska_g_Page_063thm.jpg
7f866ed53f48d9da756897393a254a10
7c96fde775c346b8fc65422927b3a4d2cf8fb234
8515 F20101111_AAAKLE toska_g_Page_098thm.jpg
de47d28b22ee35d2a16983631ca06f38
3c26923b70a81eb80c17fbfc0f5f07b08cd23454
8054 F20101111_AAAKKP toska_g_Page_001.QC.jpg
108b112f0eef6066295e0debcf68428b
00398f26a1cf0e5c25b4206b2980e23a769a7f47
1051978 F20101111_AAAJGZ toska_g_Page_076.jp2
322aba35b2afb979a0f153f5fe571b73
8ca765738cc80e56f4af6a644912de46ff62670a
49873 F20101111_AAAJIC toska_g_Page_029.pro
4a14bb08765ac6527a31ceaff7b9724e
ab21076670684401c58c2429f5056cc26abeb832
1051926 F20101111_AAAJHN toska_g_Page_101.jp2
4e9325f24d3320254ed5ba5223597705
e532a708c8d4d7ccb81f29b68dec230ec86ea61b
5930 F20101111_AAAKKQ toska_g_Page_003.QC.jpg
539fd8ddbacd68f66afd72687b336c8b
f1c68291865e7cf78816c3d8469e8e406bd729f1
33836 F20101111_AAAJHO toska_g_Page_050.QC.jpg
7afb80e0be3a04b0c4db6fef31511874
a6cb2f5424f9a541690aa43fbd842e00c87d76b0
36000 F20101111_AAAKLF toska_g_Page_030.QC.jpg
9a7cb238debbf9aeaadaba34428a4c72
18d44d3133d94de5d09ff2cb287abba78db7e8d2
36868 F20101111_AAAKKR toska_g_Page_068.QC.jpg
cae3b097419882af816faa1abac98403
3df668b591b32109636355f719918bd34d3c8e1e
106322 F20101111_AAAJID toska_g_Page_074.jpg
621a6026d6205a3cee0378cb35aaa5ef
208bfee7960c992b67d266c373ca992f3679155e
F20101111_AAAJHP toska_g_Page_104.tif
fb9733ff4705c3e6087edb4dbec3227c
f39b9952c01035c6d1cba1e5264cc2a9b44b6f78
8043 F20101111_AAAKLG toska_g_Page_081thm.jpg
61f9d50d564e1733a9b4bbbc538cd336
af598b187ca657e1ceaf8eb7100658719e2c4edc
8781 F20101111_AAAKKS toska_g_Page_041thm.jpg
e02855e4c42c94c1675ff122c135bb45
341f7221d13d8c4055d3e8a72cfaf23f16a4118b
F20101111_AAAJIE toska_g_Page_052.tif
c3ad9c736b7072f05f0a66e2fdc5c554
2d1e020e4e03d155a0e6badbbd9f6b063c800647
55386 F20101111_AAAJHQ toska_g_Page_093.pro
1bb034207a6294bf1b7eda33b8869a8a
c75e6a97879f142d55923ed8701703af0e96552d
8768 F20101111_AAAKLH toska_g_Page_066thm.jpg
ef882496c1330f4447a8e9b901df2a08
8b6740a15af7bc47ba48826c04b16f7dee45f002
8895 F20101111_AAAKKT toska_g_Page_023thm.jpg
743de8a768c3e4c9fd6f930fd53e657d
96691468d81c9b7dc27bb3578617fd63af17257a
1051971 F20101111_AAAJIF toska_g_Page_127.jp2
3e8ac1c7c8060c617d52813be9ffd021
03cd86ab22f0294671933a91c268b8a7d4434c67
2089 F20101111_AAAJHR toska_g_Page_041.txt
47976f6ab6d0a9b302cce45865d6651f
1fba946c5282322374dbaf39214e08c70ef9ad81
8379 F20101111_AAAKLI toska_g_Page_067thm.jpg
89974d17f439f8c05319d8ce37db9de0
1c30c9502aa55a238434ef49cf7017638f7581d2
35602 F20101111_AAAKKU toska_g_Page_055.QC.jpg
7f31d4deeb723a5fb2c57f86eefe5eab
eff7ad2142afdcaf255147e1386322910dedb48e
35874 F20101111_AAAJIG toska_g_Page_061.QC.jpg
d4c24b2062183519ea5b0d0fd77c7142
57664e236a2dd4eeeac9808571cb9f4dff83ebc2
335255 F20101111_AAAJHS toska_g_Page_062.jp2
b96740a487327cc22d4af814a736b595
8361fbcf5a0283750fb489ce0f1fbf4e2a7e4894
18427 F20101111_AAAKLJ toska_g_Page_057.QC.jpg
95d94283d0f17037241f41078752253a
d9a6758cad3e56df3ac03f68e5d21b067e2433ff
8669 F20101111_AAAKKV toska_g_Page_096thm.jpg
08dce5586a55b16a69ddae227b153140
fea926aea9821e3086e27cf569156e3b5bea5472
7418 F20101111_AAAJIH toska_g_Page_008thm.jpg
51ddcce5e2787bf84f1f3ebdd4df4ae6
0474d529d062021d4b9bb4d01402519156b9a0f1
2170 F20101111_AAAJHT toska_g_Page_061.txt
de3d0dd3b6bd2a2b61160d9b855e2798
5c3a338192f82b917c55ad7dade8e48f1c0231d6
8794 F20101111_AAAKLK toska_g_Page_104thm.jpg
3f360b7beacc90b511fe30f399b6da38
bb71067d02d8a4f11bc2cb761ac7738117373cb9
7661 F20101111_AAAKKW toska_g_Page_017thm.jpg
27507f205f066592dfbd9d9448c1da43
4b375500ccc7dff871961b9ddd4fa4c4dac52b9b
1051980 F20101111_AAAJII toska_g_Page_014.jp2
c60f850d19c12b0d97fb06e902853969
7b9ea4f2036765f884cf75619026cc76806ae7b9
99180 F20101111_AAAJHU toska_g_Page_037.jpg
48b532c1435ba4d28b75f7aa81cd91c1
084f24c4aef807442919b9c91b906c645d152c4c
35961 F20101111_AAAKMA toska_g_Page_090.QC.jpg
01b2e2d531c515415a8e7cacf30f7f40
6ff5f41b8740c4ee52021a805891011b60f1bd19
8412 F20101111_AAAKLL toska_g_Page_050thm.jpg
73bce1902fab4943b61f0f22c6f8adcd
94e553f784b2c4e51f1f694db42371b6dacecd41
8986 F20101111_AAAKKX toska_g_Page_064thm.jpg
954037b1b170cc89c74d271433cb9fe3
a87fb3a9d6ccc148fac30cc9e2c70289c63ab20b
108492 F20101111_AAAJIJ toska_g_Page_095.jpg
1d5b7684ab8845f74c0b3124e95f21e6
7fcef6792f81cf7322abb252aa66c1d1e483a221
1051958 F20101111_AAAJHV toska_g_Page_121.jp2
dcf6c9506a0743d627cf9b3d002b919b
4d934f85d51470186a83ca15c56ca1e2b6943c54
3038 F20101111_AAAKMB toska_g_Page_129thm.jpg
6776a4e383a9945b84844f5d6b76cc1e
726278cf19f31e3b28b41d367bf825ab9119a6f5
35104 F20101111_AAAKLM toska_g_Page_081.QC.jpg
378877f738f89be92c035448b0d5db0c
de3b0d477ef410db848abb68ae978d6080911975
32266 F20101111_AAAKKY toska_g_Page_037.QC.jpg
62ab5fe61b587cbee8d9f0d3a6891f35
497173b73d6498855159706be3e9f5228238e543
F20101111_AAAJIK toska_g_Page_011.tif
225f998d69ac8bf2a30d966702ae007e
b9de901c59ab92e6bb0234ce1102044ddb11b31f
50967 F20101111_AAAJHW toska_g_Page_086.pro
0c820934efa60cf22e2799c39b61bf22
57752ee44d1e5c8a863da915b05a28bac6c553bb
33451 F20101111_AAAKMC toska_g_Page_032.QC.jpg
33d0c29e08d43a5fb8ab5ae751c71b94
f1dee9f7adf7cb326207a6e9dd4780872b07df59
8678 F20101111_AAAKLN toska_g_Page_048thm.jpg
09860c9a4459dff81bbd2f4ec2ea62f2
a881f6d773656beb74143be598c424e2b87bb3c8
20843 F20101111_AAAKKZ toska_g_Page_116.QC.jpg
822b9592c8ecf9106e6fe8a61b492efc
5fe567c016f03483a47665b7d424041fef0d2da4
1563 F20101111_AAAJJA toska_g_Page_012thm.jpg
aafc5708ee0186a6d25976e9d71e904c
e0239a50dad374da7ff3190864355eec185b70ac
35229 F20101111_AAAJIL toska_g_Page_076.QC.jpg
d52e5d7cd6b3b5bc66b123469284e7ac
be561e2c4dea5e629d1c41c7d9df013998891cc8
7782 F20101111_AAAJHX toska_g_Page_117thm.jpg
85caaab93e4ae2d01ce272cf3fe928fd
a3cc08d87b66a5b7dcf9b403dc338d0b19904362
7918 F20101111_AAAKMD toska_g_Page_119thm.jpg
20f94e6f4edf4e2ac2d13ab01e9185d8
0f91ced23049c52c300d55fd81e88761672ae1d0
35454 F20101111_AAAKLO toska_g_Page_103.QC.jpg
e5ce86c6b3e5a032a0879deb744481cc
998b64ba41f69e853db7f714a419d32bd30d4c18
97042 F20101111_AAAJJB toska_g_Page_080.jpg
d14000d73f429cf58404d8265e826c09
19c49fe8b62fd82d8e83ef04130aebad921e1f89
1859 F20101111_AAAJIM toska_g_Page_031.txt
543d96362b1aef696d2c5bce873f57a9
3bc8afb30fe10dd599b6389e0f7cc651d83e6c79
8644 F20101111_AAAJHY toska_g_Page_102thm.jpg
549cc28c27511353a0cd14abdc060d0d
da69ceaabe7ec41d4cb58713fb475c00260428b9
34833 F20101111_AAAKME toska_g_Page_108.QC.jpg
2d87c5144d9acc6f576e37e0139f76c7
d48aead6b1207bad6996a8a4d4039563c70a5f05
8803 F20101111_AAAKLP toska_g_Page_052thm.jpg
c36b0b09a5006e3fcaba829841b87714
074e24458c9d5f482e69add144da5ab59ef907a8
F20101111_AAAJJC toska_g_Page_021.tif
1ce079ac2a5420e57fb40f8d384c55e1
4a60c3b1fa5dcea8e47b8942c1558c57f069607d
53968 F20101111_AAAJIN toska_g_Page_019.pro
04c1fd707d9c3b53f9da2fd5b5aa3284
a180f588ecc27b0d9481ef5f97e7a86f6ee1eaaf
109402 F20101111_AAAJHZ toska_g_Page_019.jpg
d633f015515362c6ebead260d97e975c
c8a1ba78b4b79bf23339c4fdc7f9bcc7c75344ec
7778 F20101111_AAAKMF toska_g_Page_031thm.jpg
770e90f698d1b896d12a36a03f84f424
1a0cd79994377406171956461fe2b48bf0f2d8d9
33143 F20101111_AAAKLQ toska_g_Page_072.QC.jpg
03042143d270b73c2080a74d505129fa
08d79b96a74033e5de2e3185e7ec83bed5a9f15b
16218 F20101111_AAAJJD toska_g_Page_012.jpg
181e153aa6fe198198ef79235be60320
91104cf3ba7b25b86ed3af1661a67053d43b0aa9
F20101111_AAAJIO toska_g_Page_058.tif
1e696543153d1a20f1c05bf1241ed8d5
02c9e6dbc038f308e89b7d87146d6ed6fc568b3e
8453 F20101111_AAAKLR toska_g_Page_091thm.jpg
06185570db8bfacf0d638b942d618ee4
df63ae9086b2e5afcf6510c589b921e9cb98fa20
2154 F20101111_AAAJIP toska_g_Page_071.txt
9981453ef24acb5497b7fcbafa1eaf08
fde8aca724848fe8c2253839d5fa8bf8d2c60c04
29679 F20101111_AAAKMG toska_g_Page_080.QC.jpg
914e42cf7a156dc9e779c6ef58f77807
5b4a704180c2aeaf2061cb9b8a515c7878a7f5f3
8561 F20101111_AAAKLS toska_g_Page_047thm.jpg
6fb0a6dfde70b155f11a8bd426812bd9
cb36140bfbb52fc0e22637881f2dc3f1885598d2
600830 F20101111_AAAJIQ toska_g_Page_057.jp2
b28fec939c4ac5518192fb3c25936a29
0799c3082de66879c8023afead9716e21c2042eb
F20101111_AAAJJE toska_g_Page_005.tif
25e9d828441485e87bdd7c762c608987
27af81989a6d08bd0e54768bfff7869862117c76
33828 F20101111_AAAKMH toska_g_Page_059.QC.jpg
9095b0c0a9585d7ee7291eb24c35e280
41e30661b9ea3ce3ea62bcc1c5310909c1f16ae7
6817 F20101111_AAAKLT toska_g_Page_114thm.jpg
f39c8053ac097a544efaba34c5b9c840
bd7164c5a497cc5916c205390a7abbdf6ed1ce0c
154499 F20101111_AAAJIR toska_g_Page_012.jp2
d48a4dcdad6aa45fb9716b96b130b2d8
126e5169ffda6ccb0ca2a3f2f0855246f87781a6
29836 F20101111_AAAJJF toska_g_Page_008.QC.jpg
d6e001356c0cf79df1740827ba478c47
901708960868fd3e676b41a9e37bb62246a5b0e4
37363 F20101111_AAAKMI toska_g_Page_123.QC.jpg
bab3d320de0e4b0140420740e84aea79
70d7e8ea50b3d65e69cee2e28ab51a316a1f76ac
9073 F20101111_AAAKLU toska_g_Page_068thm.jpg
6ca2f0a839d232795ed317d8834b34bc
d5646e36618c02607b56e84e9054055eccd3f7d4
1051984 F20101111_AAAJIS toska_g_Page_050.jp2
e0eb976db75853d80170edff51176a1c
8839b53deb4c3d62c8a00f231e309fc45ed45290
57286 F20101111_AAAJJG toska_g_Page_075.pro
82dadb0f164387ebf831314397f9968b
eae3f069108a0af1fb75749e0eaa9f9b5e8774b2
35224 F20101111_AAAKMJ toska_g_Page_096.QC.jpg
3e29e08605da4f47c2c467835fea4496
309d1ac2bc07314dc972980b0956e5ac0e786a40
8251 F20101111_AAAKLV toska_g_Page_032thm.jpg
824795fe3df50f58a50290d4a5ee8701
7514a7fb07af2e365d321f5776eda99a04e9aec4
2173 F20101111_AAAJIT toska_g_Page_093.txt
89e4eb8695bfbfc73145b9d03e90bef4
fa939ea9248f7d9c6d8dec61b76b55bc0cfea2a3
110906 F20101111_AAAJJH toska_g_Page_049.jpg
832bbd730c2548fb7b75bed4c5238d6b
048f84d23c0ad8f311f3f0b3e91a08b3970465ae
8728 F20101111_AAAKMK toska_g_Page_039thm.jpg
5768798b908e21e3a9525b50bf609b7f
7a695c3179751c77dd7d4f94f4f1356b4bc81612
10402 F20101111_AAAKLW toska_g_Page_062.QC.jpg
b18c0381a058e6411402aebd0ece8c89
f43a1a950cc720208c285c2b9233b16af49a6a88
33234 F20101111_AAAJIU toska_g_Page_009.QC.jpg
2a553ff66d44c5701c50dc5d8d3d521f
ca4bde53c7bbf14deef19f4d77c91ab171a5cb1f
66044 F20101111_AAAJJI toska_g_Page_122.pro
23c3bd6a080ec9c5e4fdac7cfbae75ea
55744a81d8acb7facce0a645026a501a7f2fa55a
35707 F20101111_AAAKNA toska_g_Page_040.QC.jpg
83c7e997e403f460e8f63c222efe0697
eec7c48c3774d80ea769ed01719ae18d76aaa669
34519 F20101111_AAAKML toska_g_Page_094.QC.jpg
0889081ecda2dc4ac06e8831665db4a1
ae7f3eef1f20438e772d02d535e05a1a07799b3e
34771 F20101111_AAAKLX toska_g_Page_121.QC.jpg
dbaf9a638eb4e538f7de91ad713fe3b0
d6d0ef589b7f4c3c62ec6dcaf4a865998317c671
109120 F20101111_AAAJIV toska_g_Page_104.jpg
ca7c264714d93a604e45b94d53a51be6
716dc7b869549008190ed8048b9651c15a731db0
8716 F20101111_AAAJJJ toska_g_Page_016thm.jpg
07155000899daaa1dc078eeedc68f37d
0387855b20f2b14bfca0f288f155bfa4397c4f66
9008 F20101111_AAAKNB toska_g_Page_040thm.jpg
3b3debc078136d90d74164e350bb813a
d9cd5278a77e6cd466d20c14dc22aeeaa80147ed
25486 F20101111_AAAKMM toska_g_Page_083.QC.jpg
177f092b5e73bf8632702446efcccdfb
cf37d2cd1fa13e61168ad0684f817d39297a97b4
8449 F20101111_AAAKLY toska_g_Page_053thm.jpg
6c944dd2345754cad6853eb8a780c29c
5f5524cfb3f3a0225fd071239cd9666521da8490
108903 F20101111_AAAJIW toska_g_Page_056.jpg
2c46aacf213b28fbec07d4f0f6ec8eca
2b02626c8b1bc935e3d55641d59de6a54fc9cfe5
34427 F20101111_AAAJJK toska_g_Page_041.QC.jpg
fdddf7674907965ceda7f89b208beddc
988d14aa1c9067d68cae3d9470f5f21bcfc6dce1
36345 F20101111_AAAKNC toska_g_Page_044.QC.jpg
998a9d593a142ea8da99c37e4bd65bc0
e3ee527d2256829bd0ac994d4298dcfc808d79b7
8920 F20101111_AAAKMN toska_g_Page_025thm.jpg
a38781730bd17e2d0ce5e6648de1c4e4
3578a0fd0e57a97bcf8a872f7092fe6b10a97412
33692 F20101111_AAAKLZ toska_g_Page_065.QC.jpg
1373971b504d600539c3ed29f565c6dd
7a5216160f8cda447bf1112c691fde4848391aa7
2031 F20101111_AAAJIX toska_g_Page_073.txt
4391d56347f2783984cef0972aba69e8
bff48457be838303f0c1dfce8b1bc661d3a49037
F20101111_AAAJKA toska_g_Page_078.tif
81eaf09fe7f4d104eaf46a80e171ede5
88319decbd9af4fe8e234652239a5d9fb3008cd3
58127 F20101111_AAAJJL toska_g_Page_118.pro
60018c0fa973ae3eb74feddca51d52ec
5a223b2ff62bc9a84173ca8df82e81a1e5542f36
8746 F20101111_AAAKND toska_g_Page_049thm.jpg
91f85736d7847860bf86faedfcbc4adb
a18b0c32cca529ebb7cd89740843353a80e2e078
8451 F20101111_AAAKMO toska_g_Page_042thm.jpg
0e59003a827fc37c126c7d57e53ad94c
f393e2d7ef2d650b80d6e13df75c58c746068aeb
8935 F20101111_AAAJIY toska_g_Page_126thm.jpg
c4d02d9aaaf29d3f27bb18d9fb166d57
c5cc35b9c6dc63b841ede7b2bceb2756dbeb9dd9
34883 F20101111_AAAJKB toska_g_Page_015.QC.jpg
64a9b10558437edae9860e70760c206c
43933df90100c975575b45727aa710a03797caea
104627 F20101111_AAAJJM toska_g_Page_035.jpg
5ca7e538e5f82ce0f9a4f7c1d4a82167
8112de590356517d9542f9bdc8b41e6220469d1e
34445 F20101111_AAAKNE toska_g_Page_053.QC.jpg
159b1ed70255f991342e6f6ac4a50735
bd4d9dc4ac9c4090f5df67c072caddc32ec94064
33921 F20101111_AAAKMP toska_g_Page_092.QC.jpg
2d6323bd6c49b7236b3ef328be82079f
ae691871e2e1b860626f3182cad04be998b49672
25838 F20101111_AAAJIZ toska_g_Page_006.QC.jpg
6352869e75544c82bdfe211966349146
a37af0a5904e8b23dd461d6893025fbdb6a4f19e
1051942 F20101111_AAAJKC toska_g_Page_088.jp2
b3215bb3e577c398c39932ed13325e62
86389be3a019193bfbf04bd3ec58f4b9b8d852ee
1051970 F20101111_AAAJJN toska_g_Page_039.jp2
459c6e781e9a2d9733ba874743bcfe5b
fe841f70b9f29d3e6a5fe3c3ae02fedad70351bb
36590 F20101111_AAAKNF toska_g_Page_054.QC.jpg
48abb190700cf8f9909ce912f16f1c3e
10a6d5101aea7b79eb335af5f0d8e1782f466f6b
6347 F20101111_AAAKMQ toska_g_Page_005thm.jpg
067e411ee6ade15177386140773cd66b
e69cd2b77e22a2adae43a076dab11183926d7a26
8240 F20101111_AAAJKD toska_g_Page_018thm.jpg
d43e965f034ab08d499a1db54bc77847
157f7e285c0a0f95b53f7fb85d85bf5158357f0f
F20101111_AAAJJO toska_g_Page_103.tif
ef4a30e9265c4f8ba5b0713f616bbf09
5917e326037415ec3dfdb854a8a9a62a1c092139
8772 F20101111_AAAKNG toska_g_Page_056thm.jpg
9e052d0a7862d148bc929cb856a8c294
b915e141dfa2ac931b4d7cc8d5061848b934a44c
12468 F20101111_AAAKMR toska_g_Page_004.QC.jpg
8ce8a16a0ac8e83add3e6d8fcb05e6d4
0b288fa9c185f42da2de9f696095a2f3b2972db1
F20101111_AAAJKE toska_g_Page_015.jp2
fa63db6bc9f0f9d6428d5072a45cebc6
2f13bc248a9ecaa61df56edb65b3b2a3da7ba391
951382 F20101111_AAAJJP toska_g_Page_119.jp2
27c86e0f44dba15bc5b0036254902583
893b1c8bd884e1610905a95df68d86984836b5c1
192733 F20101111_AAAKMS UFE0021898_00001.xml FULL
95d3fe8137867d73077bd424475e82d0
0378e7ffc30b57b78823a2bcef57ccd5aec00987
F20101111_AAAJJQ toska_g_Page_029.tif
04c2fa721949d0e441f878c38b71612f
16b63adb23453c5d9a856faf2be99396ceca358a
8198 F20101111_AAAKNH toska_g_Page_070thm.jpg
68a4aee6919f9d1c52385cca56749ad0
db0508324a9cf5e8ace0afa2afc73bb844f06525
8930 F20101111_AAAKMT toska_g_Page_010thm.jpg
a45fdbfc803e11c3843a27055c8691bd
5523a3a3b0133496c6b1279543f3e53457d895ba
38317 F20101111_AAAJKF toska_g_Page_126.QC.jpg
35e387c91ff6dd6e3f2fe92db98d455a
7e94c97fb3b5b88d5f576cce9ee0905e4cfb55c1
106410 F20101111_AAAJJR toska_g_Page_112.jpg
8d79204642a5a30994ea2036d9bc8f61
cbf24e62ea11d825446ca5990f1df97cc00bab61
33272 F20101111_AAAKNI toska_g_Page_073.QC.jpg
e706af0736bedd41821e895bc73a7df0
19f28897c93b1b2150d6d94c423cf0699d61af23
38019 F20101111_AAAKMU toska_g_Page_021.QC.jpg
b1f456a1f25be45ba47e3d84508c097e
9397960111edba658b0fcef0da3db91d19e580a7
2250 F20101111_AAAJKG toska_g_Page_054.txt
faac9fee4a49a2fed81910a47b38edc7
c9ee4e3809ec6f401b4a49090d286681064ffc3a
35307 F20101111_AAAJJS toska_g_Page_085.pro
18827612761e6a3a1de52f2bd88a1f8a
1a6eeb204ca7ace7132259d57e09e518facd2bd9
8925 F20101111_AAAKNJ toska_g_Page_079thm.jpg
a4f13794337a9acf82b7a1168f0d6541
90e72bacfd005ef98bc3ca337a1ab94333efeaeb
36178 F20101111_AAAKMV toska_g_Page_023.QC.jpg
2b4e34e36bb8fecc628fd62a8b51bcdb
85b095be1c3cb8d01c9fb518f03653c04f60a628
F20101111_AAAJKH toska_g_Page_021.jp2
9da3afe4b5337a61acb42962f8adc147
74244a3d5c3457f7d6373a0b4a2b76e4e5a75124
31255 F20101111_AAAJJT toska_g_Page_117.QC.jpg
b52134e5e8679fbab70c1010ba303e52
75fb4d0101462ef3db83eb100c9221a528b01bc3
31407 F20101111_AAAKNK toska_g_Page_082.QC.jpg
0dfb89499ca824d1abbc128fcb608119
90d87fc0a4dfaf52275513ba1df33a3d5f023963
8639 F20101111_AAAKMW toska_g_Page_033thm.jpg
6c640915377a9d522e1d6042a076faaf
d8b49d8830cfbfadaccfb9addd8b1b04c54b4955
23800 F20101111_AAAJKI toska_g_Page_084.QC.jpg
7fd4794d093ce671de19ffe6c9e6f09f
6e7a057275de45fabdbedfa94ce51feacb9e40bc
49945 F20101111_AAAJJU toska_g_Page_022.pro
69eb5851edb369ff275c3138f88d7124
eec7d68121253e40ccd21604b2e998c112f12a82
5955 F20101111_AAAKOA toska_g_Page_128.QC.jpg
d1f4f4905ebaa34b549859ebc22a293a
f852071df6af4db0454514bcd3ad7937b4713f4e
7564 F20101111_AAAKNL toska_g_Page_082thm.jpg
39bc5408f5e98645fcefd6601253fb3f
c2766f4c4acd62952bf13de1dcb2703d8e9cbaac
8839 F20101111_AAAKMX toska_g_Page_034thm.jpg
9f088ca126d27bbb5ad381845c243777
a8c03e46bbd48f78ea5437a6fbbdb39c6c3ffb26
1051973 F20101111_AAAJKJ toska_g_Page_073.jp2
a4f312adaf7cc9e0f8559141576a3de0
68493257ddd11bbc548c03d9c5f6edf86971a5c1
46620 F20101111_AAAJJV toska_g_Page_063.pro
0d990c0d1c4a35532d923c239f30a116
2a760e157de90ffcb3167e45dd0050ed83352ce1
21105 F20101111_AAAKNM toska_g_Page_085.QC.jpg
8145fd3b37354c2615fe67e4d6da5043
64dcb7c35a3d7535ceb085a23ce5d41fa04d547a
34815 F20101111_AAAKMY toska_g_Page_038.QC.jpg
1024cce9473e06825d6c66fee6bd049e
12bcc0183278bc5da028b88997394089a312da7b
34734 F20101111_AAAJKK toska_g_Page_069.QC.jpg
36963e79c7f7880f25310bad78de0b4b
87f79ba7345599259f99c92ee2436286a9f9b310
F20101111_AAAJJW toska_g_Page_116.tif
9aede7904e0f21089b2016a3726e1919
987986cb5b46c72c8b38d56b3f3e1569934c13d5
8547 F20101111_AAAKNN toska_g_Page_087thm.jpg
aa4fdbf22bae7a9abe3ee8e39e637757
b78486e23c88211a6796ea8eeb69c1733fcd9b0a
8479 F20101111_AAAKMZ toska_g_Page_038thm.jpg
32c4bbeda52a79da9f3a8a1a6975e3a9
b29b000aa6cdca5bd4d987305bd1820d5483e44b
F20101111_AAAJKL toska_g_Page_032.tif
e153d734a00c76642b8eebf9dedaf88e
03c804fb291b8028fe581bf32232505de23bfbde
102479 F20101111_AAAJJX toska_g_Page_059.jpg
3b3b93d594fe644ad0ef70b6d76c123b
3bd73b45923f8d3d90423dbedbd839655bc5b2a8
36581 F20101111_AAAKNO toska_g_Page_088.QC.jpg
cfae1b6e7c5fc30cce30dbf2659b7b81
44dc4bcc55c749c185b341b795140c8a3693e37f
25022 F20101111_AAAJLB toska_g_Page_001.jpg
624cff500adfe80132e2442481445d0e
4f88b5bb25c20ec9b75988e8b1a46815f57cdecb
2174 F20101111_AAAJKM toska_g_Page_010.txt
5eb95ad91651c780df7969c8afe2c8d8
08963286f990cc06dc896b7362c9790e412d3da6
8432 F20101111_AAAJJY toska_g_Page_128.pro
98aed98f3c5298d527a3d9ca57ab6491
b091d72b22c0ddec890960cf63a6212065e5b20a
F20101111_AAAKNP toska_g_Page_089thm.jpg
aa22251204e4ab790f2c3061f68104e6
4f3a7584bc6715ea9cf41ee8cfe05c755d2a5a12
3723 F20101111_AAAJLC toska_g_Page_002.jpg
1d237cf140d5491c4e7580553b577492
50e2383b21cb227f41f7c13b9918b23280901346
8398 F20101111_AAAJKN toska_g_Page_024thm.jpg
160a1ccc21a63c08af3fd4af1a6bc9be
1a2e9b6d904ddbb3c76a8c6f14756e67ecb6ad35
36755 F20101111_AAAJJZ toska_g_Page_075.QC.jpg
268aa54e8fbfe635fd6eed28cc25e73d
32d9b65d821881c85305d5d491a381476062b83f
8852 F20101111_AAAKNQ toska_g_Page_093thm.jpg
e8f04dfe7027602dc39b580aa0cde42a
639afa869e5aad39665ac9eba19b3b03397cf9d6
22582 F20101111_AAAJLD toska_g_Page_003.jpg
32341c6a65b91a121a64841e4d409896
c62483925384f7b86b2a1ac2c67e647a0053c3b7
32850 F20101111_AAAJKO toska_g_Page_086.QC.jpg
382b08f445113e5530741f5348691fda
7fd42e33a091084faaebb9720944e93b37399482
8326 F20101111_AAAKNR toska_g_Page_097thm.jpg
efd2426c39a1d8a6065cfd6f26853a52
ee09e2ef3ccc055b7963e4eeef496f8c0fbff67d
39579 F20101111_AAAJLE toska_g_Page_004.jpg
5f9f1cf70b10044a3b308a8d9541f7f1
97ddb3b65a3504898cb3b08e24fd368e936eab21
107333 F20101111_AAAJKP toska_g_Page_091.jpg
e7b25617b32fd513741793ecc27e2db5
a204fbd5787365d2af86228d9044ef78963a882b
34281 F20101111_AAAKNS toska_g_Page_098.QC.jpg
0582ed5f1a75bef4b879cf78f04fca28
cd7e66d8a1bd5ea5c0353fbbaf3172238708efd3
119611 F20101111_AAAJLF toska_g_Page_005.jpg
807eee53918294c9d41029bda6a27b27
c022d1adada484579e67e22351eb2990cfba85f1
8354 F20101111_AAAJKQ toska_g_Page_059thm.jpg
53768e14120d3c9176189f1cc7a43b1b
8aeb47606d150ad765a9bf4dae07c4a8c7b3ad62
35592 F20101111_AAAKNT toska_g_Page_099.QC.jpg
9e87081c194615dff842f9c222266889
dd056b243192ccfd41604c95d931d3990e21f2f9
1051966 F20101111_AAAJKR toska_g_Page_029.jp2
bb5d04e7c7057f5045cd332f7514e7d9
d311733e2b91a879fc14b848629eabfd97f7ab64
36096 F20101111_AAAKNU toska_g_Page_101.QC.jpg
696350fb548e4c18ec839bf3879c239a
a31ef52590f3c2b8c2664d0cd1c7f240f46b249b
105630 F20101111_AAAJLG toska_g_Page_006.jpg
33d6363f571e3ca72115cc72191d8448
ba6c934601627a715ca85cb362711cec04d96cc8
53639 F20101111_AAAJKS toska_g_Page_042.pro
f75d273f67e29b7d8e543e90de2f253b
12d9acf02b934f48a3a5e16733a29cb0c6a8c5af
9116 F20101111_AAAKNV toska_g_Page_110thm.jpg
20da9f30bea1ac56cc20a4068bb24a16
bb4c68ab8092966a6b3288a63576f7f45498f8b3
74073 F20101111_AAAJLH toska_g_Page_007.jpg
7149892f47edbf2887524ba21a3699f3
091283d88ed7036227e68f73ca0a1fccd359c695
36595 F20101111_AAAJKT toska_g_Page_027.QC.jpg
886bf71d65cb0d01be4e16e812b91aa7
07efb6ed7f01e0322054ef8570195aeefe3d9aae
34805 F20101111_AAAKNW toska_g_Page_113.QC.jpg
791876b349cec0d58ca2177e6d2ca780
4b57ac3bf132e7e064a5c9ee74e74cddacff2197
94738 F20101111_AAAJLI toska_g_Page_008.jpg
59fba109cb427bd705dc697aecf3b0ef
0a1da4294b2d166060271b230db5a9cbcdeb4b5e
52379 F20101111_AAAJKU toska_g_Page_112.pro
33bb307bd4313d6b8ced86a92ee33e85
5ca3c7723d9c29ce4bc4e4bc78d8a85ea80fa4e0
8549 F20101111_AAAKNX toska_g_Page_113thm.jpg
a61f81ac0833937081d87c42ec3b25d1
8e90dd5bce29b5acdaaaf39cbbe46052b6c0474c
102284 F20101111_AAAJLJ toska_g_Page_009.jpg
a37dfe490e41fe5d780840fb796abc9f
03951dcbafbd4871678847f8f2978c3440f2a25b
841157 F20101111_AAAJKV toska_g_Page_083.jp2
3de0fccf3e120c3c429014ee22096957
061a813132f7cf8b06b9a6e05c1640354de77af6
21691 F20101111_AAAKNY toska_g_Page_120.QC.jpg
22613db0281b22eb757feb5ca319d011
9e02cf30efa77edc770d0b252ba8905c28f411f8
111526 F20101111_AAAJLK toska_g_Page_010.jpg
84cabdb302ee4bd1671267e7c363aec8
f3d70ccc082f32b062bca517180bea6a03115ad6
225583 F20101111_AAAJKW toska_g_Page_003.jp2
e2c66687105f76adf39a7a9582d27426
4c0e9bff54ae432d2e6cc7dff8064c7e9abe80b9
9170 F20101111_AAAKNZ toska_g_Page_124thm.jpg
a1da1c6702e89115b50d171f3a38df63
353f4f6e1b92fd4a4d9e73ab555c65ad07db82e4
104461 F20101111_AAAJLL toska_g_Page_011.jpg
6585f477cc9c3fd8abbf0d7f039f82aa
3797a2f189fbb42813001e6ce063b65713dd7cd5
31648 F20101111_AAAJKX toska_g_Page_017.QC.jpg
ffdb86cfe90e942945aa8c8279d91fb6
ffcae3b7d64aa03d1f7e376f95567c47cb80f4e7
107471 F20101111_AAAJMA toska_g_Page_030.jpg
1f703f8531048f4f4898004616ae996b
b942dc0813c870df0db28f667315224b0e6188fe
101619 F20101111_AAAJLM toska_g_Page_013.jpg
a11e5b2e805513051c345a509925860f
49c21abebe2a06cb800f091f63c40acdba24dd2a
148989 F20101111_AAAJKY UFE0021898_00001.mets
11ff6c004e342cfbacad374ecbdcddc6
db780c90525cb8d05d8d791e89d839ec8d962211
96001 F20101111_AAAJMB toska_g_Page_031.jpg
2c543e2de9dbe42444151cee13efd7a2
21713c7e95e173b2a4c3e1a00f84fbd2937c744d
101824 F20101111_AAAJLN toska_g_Page_014.jpg
9f06ede23200dcddf74d23a423f5c57d
c69ca786c87840bb7af2d5aa743f6fa3e294458a
103157 F20101111_AAAJMC toska_g_Page_032.jpg
fa70c169284ad1e2616db8c0754a6b0c
519e2f18a4a32c2dea886d10af436976efd71dab
111428 F20101111_AAAJLO toska_g_Page_016.jpg
a93f7df9b0a8815c3792bcd71c337900
0c9fec26c5db8d195d3dcf8ea1483990e9647290
115654 F20101111_AAAJMD toska_g_Page_034.jpg
96ab3578829dedd298aa8418d43a78c6
3e9346177d5b18ca7e72389182ecb8406d5c2166
94315 F20101111_AAAJLP toska_g_Page_017.jpg
b1bc3dd898514619d91d018d313ca4b8
50a7421c0cb6cc9fee62ae3fdc6ecf42fab8c317
105203 F20101111_AAAJME toska_g_Page_038.jpg
8ceaceac1e48b34d90b600a3fe1278ed
a45e2ab6d4d104123eea12c83accdc7f799d0216
105045 F20101111_AAAJLQ toska_g_Page_018.jpg
c3088f146454e61e689d022aff2697a6
1f97bc6c050d8df0c11d96d36d2a2397d3ac53c5
106757 F20101111_AAAJMF toska_g_Page_039.jpg
5db2c60139c57ec32508ea59ee2643f3
ae564cb476761e396a50fec6f261f2af726e49e0
111255 F20101111_AAAJLR toska_g_Page_020.jpg
1281f860ceed476396cc8bd1b2b306a1
975487bf1df01d8e3b06d9bb84e3218b3726b8b4
107781 F20101111_AAAJMG toska_g_Page_040.jpg
6677af1069cfe10a205269ecde1aa0dd
809a49fc5a4b876e5c5aa194037a6cf218a347d5
115125 F20101111_AAAJLS toska_g_Page_021.jpg
ee41fa9170a69ec8d8db26a25aae6ddc
3ad16f857c819a49f03452669eb527bb7e0d4aa4
102983 F20101111_AAAJLT toska_g_Page_022.jpg
e53e8b3f297583f24b15433e0a1225be
3ed1d67258a8d738a51ded3bc80388807a07b089
106129 F20101111_AAAJMH toska_g_Page_041.jpg
068ed4fc1c6f6fafeffac7ff1783e8c5
87287cdb720a16f6654bba495f377f5da097d907
110305 F20101111_AAAJLU toska_g_Page_023.jpg
ccd100176dc3bb1463ba8d54cc0bfe4e
55e44d35379d424713251c01a469dcd48477097e
107752 F20101111_AAAJMI toska_g_Page_042.jpg
fbe3ce04c2eb8d0839235ad6541a37c8
0458a85466c93bcec99b4086b153ee171073253d
100225 F20101111_AAAJLV toska_g_Page_024.jpg
7139ee9de97f8bf8fd36108747424e24
4a66c877d0eecdc02902f2e212acc761020c8124
107426 F20101111_AAAJMJ toska_g_Page_043.jpg
a806dfdfd367710cbcc25cd30783ad55
e655c3466bdd9f687264b40274aee45ab5fa0d74
109397 F20101111_AAAJLW toska_g_Page_025.jpg
823c0b1162138ff9efcc80d309f67ba2
0b86cd0e537ed223238d1bf1a773c51461e0c13b
113852 F20101111_AAAJMK toska_g_Page_044.jpg
a14351fd11cbde1ce6ebc18565109b45
c6d5d30e11e7fb4307159800078cbc7c2bab5be9
104824 F20101111_AAAJLX toska_g_Page_026.jpg
12a7af46de0c71ab9b0fffa92cb7e8e6
0288c9b2ef59724b6df43db3dbb6769c30dff89d
110583 F20101111_AAAJNA toska_g_Page_066.jpg
95b1ada7df98a40047166cb746593836
bbe91fcef063d4e98ef5757de9e13cb3eceeb5fb
110920 F20101111_AAAJML toska_g_Page_046.jpg
b1f33ab7d29cefdd8bf862b998683de8
d83c1b3866a98944729d6dd9d2908b74bb99d7bf
110135 F20101111_AAAJLY toska_g_Page_027.jpg
47a4c8f122b6e651699591f36134a85a
c720872cea0b62ad86494973f3ba22f5dfca7399
102459 F20101111_AAAJNB toska_g_Page_067.jpg
24ab3f33a30f38b3ccbd4cf54e52f6a5
c112c688d8c945453276e5de2228a9bb8f8e95b9
107365 F20101111_AAAJMM toska_g_Page_047.jpg
edd2a0499ea928d51b68454469207a58
9abbb554387a4ae4f769feb0fb48c7f51139a024
99153 F20101111_AAAJLZ toska_g_Page_028.jpg
09d0e3184d07f57e45e7298b5ccde280
353f5e3600819a0877482f72c3fec04b68cbb9c2
115496 F20101111_AAAJNC toska_g_Page_068.jpg
4d41177317fa5fb42df96408bba85dbc
de95231b31cc8b6218d51f088e5299d7595db734
106758 F20101111_AAAJMN toska_g_Page_048.jpg
ebb0ca5a47b669aa2406d7db73b292c5
636eeecf624bb897814c5160323cd842f324354b
103353 F20101111_AAAJND toska_g_Page_070.jpg
7bdb6b523597cea9eb99e86c029c27e0
718af889b3a729969a45c14657e69e274028c503
105487 F20101111_AAAJMO toska_g_Page_050.jpg
65112f22e2c6b42f75c1fb27e94043fe
f6b0a0d668e0047456a7ded6da95a106e00ceb01
108100 F20101111_AAAJNE toska_g_Page_071.jpg
450cb8fb1a9bf75504909882857b97a5
b56cc5fb83f084dda0c53172d41e8a256a578f28
108261 F20101111_AAAJMP toska_g_Page_052.jpg
3baf0acc30e6dbc8d3ce51502e8195ea
f086fee11a30f4c736142490db2f7b4017625d25
100879 F20101111_AAAJNF toska_g_Page_072.jpg
b746c6206f59bc5483dce09272d97d2c
24e1477f95818bd755cf53f19929e80c8f9e5032
104976 F20101111_AAAJMQ toska_g_Page_053.jpg
58b354b4fc0ffa41533aa1e4b3872b7f
5ad47d168b701627739063ce2cc5f11ea02c592d
104418 F20101111_AAAJNG toska_g_Page_073.jpg
4f07dfc593ba363f0486266a4d3c96f0
480754a072aaab2c080a4f60869cd8b6a424c8d3
114640 F20101111_AAAJMR toska_g_Page_054.jpg
e49533d0eda5f22aa1333069e322c68e
e06c0793bc7c95590abe41e2d3948e0dfe1152d7
113566 F20101111_AAAJNH toska_g_Page_075.jpg
145891400a90ce0c3de69e67cd205c38
39ef20e633ceda9d461805fa9fb32404a6e54309
109710 F20101111_AAAJMS toska_g_Page_055.jpg
feaea8169037310722364f3915e12975
39f2f613c293c8f8ee0dce1293024a73ef0afc05
55952 F20101111_AAAJMT toska_g_Page_057.jpg
e2567f0a4b277c2cdd77e4d38e1c9435
fec57e68b34cdc770339f8c80a05ff20be34eb0f
108541 F20101111_AAAJNI toska_g_Page_076.jpg
67e7415ed5248962319e7fd0be6facc1
ba35c973f6e8b5ffd1e546746f52d419e639b427
89461 F20101111_AAAJMU toska_g_Page_058.jpg
ca0220614141998fac359a085c738a89
cb9fa9f23c5953e13727fe374a31199804d8bd39
105813 F20101111_AAAJNJ toska_g_Page_077.jpg
82c62a777976e1bcf920567f9fa97491
eb05269d3efc1668fd3466b591493556fc300a8a
109830 F20101111_AAAJMV toska_g_Page_060.jpg
7a775585f387f8f52ec15f8dade5d079
0888225e37e835f8096ab9ee096704b73f2cc18e
107469 F20101111_AAAJNK toska_g_Page_078.jpg
495612d4b33e805ddc7bdb637fd8d789
e762fb7f6677497c6078389e0440ff6ca34d9b3b
109913 F20101111_AAAJMW toska_g_Page_061.jpg
4bd232561495604e0318e993afe229ee
96f4f25fbb8a6adcbbf7757366656159ffd5c2d3
105400 F20101111_AAAJOA toska_g_Page_098.jpg
5c92a0c88e16a5c8821efbe95de9e4f6
a5a6d016b26f28004d0fc366990a5b65fc7d498f
113588 F20101111_AAAJNL toska_g_Page_079.jpg
c728307b6d38a3a914413ba575cd2ee7
7bca7f36d2abe17ea32907cc1dbff0c2a96c2ef0
33248 F20101111_AAAJMX toska_g_Page_062.jpg
40fece3f1c267600154b5516e8edca21
618efb1a20c93a9e31fcca09b4a2fd87c1d49dd8
110255 F20101111_AAAJOB toska_g_Page_099.jpg
5f5410e32670f3bc4ba44c5e97de843d
5e038d43d01de4997306125512dce7c8df6ebb4a
118194 F20101111_AAAJNM toska_g_Page_081.jpg
30718eff83712c8badc251623a1c785a
fe56eb654424d35db86be7c7d59040a0ee945495
95566 F20101111_AAAJMY toska_g_Page_063.jpg
36eef0b0240d9299fd5fd2a045cc1b8c
ddf45a3692b15ebb0aba781bd29840de6351d1c2
100186 F20101111_AAAJNN toska_g_Page_082.jpg
dfaede6e40147b8216f998e77413e09e
d1572e450fdb8bf3e6e4772a727925a1e34e1f0f
110365 F20101111_AAAJMZ toska_g_Page_064.jpg
8b65b9a646f8c132e4482fbfc8acbad4
8df7a16b5b37de604cfa6160a7bc8e8280f1f1c2
107804 F20101111_AAAJOC toska_g_Page_100.jpg
a2a51da3e779b32c8c0adc71ddef5b6a
9978a39c7dc58478c1a9921aa62c1b08cd793b7a
81420 F20101111_AAAJNO toska_g_Page_083.jpg
70a7182d85623b6e69f59209ec837498
fdba684c1a70ac52044af13555537b009a8479f7
110222 F20101111_AAAJOD toska_g_Page_101.jpg
dddb2fdac5d2b39a971af3f5f5a605aa
2164f55320547a0b3a5584d799e8f75ac4c67141
74258 F20101111_AAAJNP toska_g_Page_084.jpg
b97e595519d5d155b375ee853aee9ff1
0c3e3ea9a56746538fa2e1bc1fe5e914796751d1
106649 F20101111_AAAJOE toska_g_Page_102.jpg
ea437d73a91d30d0e2b020dc12a56a62
6d597c80b3f8d29ac24f74bf0e101c91cf6389b6
66986 F20101111_AAAJNQ toska_g_Page_085.jpg
2cdd926d7db2b6e727f79a25631407d4
c0ef89954de2247e2c4d8d3a65981ebce6ce9bb5
110126 F20101111_AAAJOF toska_g_Page_103.jpg
c4d8d63d77208c0df63f6b365776923a
5235223c20e8d92174c10747b62acc00e86fbf2a
101839 F20101111_AAAJNR toska_g_Page_086.jpg
1de5d30291aa49fea7bbe716ce135d62
b16e5d05bdfecadd858dccdeebb07122e69953a2
108909 F20101111_AAAJOG toska_g_Page_105.jpg
26a12531e2f59d6a6ef5380880f3c4d5
8463c209671626e52a189747d46109912cbef90a
105384 F20101111_AAAJNS toska_g_Page_087.jpg
f33fcfbc48c085ef8cbfa1b6f70f38eb
f46309d633ca24da25b39ba49c1367e0253331f9
104615 F20101111_AAAJOH toska_g_Page_107.jpg
a0583dc6faf71e39c91b3e090049e97c
adf4f47409968f646907ba74386bcd4765543202
111645 F20101111_AAAJNT toska_g_Page_088.jpg
77952281cf4c4bca09558342aaad67c4
5b89e898d71e5ddbd966f16887f57404d7432c27
105340 F20101111_AAAJOI toska_g_Page_108.jpg
9bc84bccf6114daf45232cf51115bca6
08d3f58e5a78ca6f8dc6e1d434706a41b96d4027
111345 F20101111_AAAJNU toska_g_Page_090.jpg
bec4fc2bcb58442aa167438af7ef2bab
df1527a4af82bea4ea020a584648945881c363b6
103124 F20101111_AAAJNV toska_g_Page_092.jpg
349ea56ab53d46d82cbba1c6499ca438
679336d0c9191c8c3bce131e74ceb605a5e581f3
108949 F20101111_AAAJOJ toska_g_Page_109.jpg
eb92e1a6636965ebd19b7b53a111f0bf
2354e9b410aa5365b9873c47d6aec9136ed1fc28
109241 F20101111_AAAJNW toska_g_Page_093.jpg
8cb1cc4c271e93fd85e50934f7c59049
145b2f0379454f7ab54e69210940bd409dfd139a
115238 F20101111_AAAJOK toska_g_Page_110.jpg
10c82bf8f518d29118d48801c3c4d671
0490a1f4159aa8ca9e14604c4bfab39ad3d1a720
105154 F20101111_AAAJNX toska_g_Page_094.jpg
7256e77a6b0b6ee95d564051fdb2b028
2d50041e3062eebe179f2950029f12e4957c48a4
35910 F20101111_AAAJPA toska_g_Page_129.jpg
e5209716500f354ec2f6d62400587164
cb1b7a44bded50dc07ec944cd6424271d57fe1ba
104527 F20101111_AAAJOL toska_g_Page_111.jpg
c6737b5399d6cc52e23709792c876895
f82b0eee26cba02bf9831b650f89fee05ff59480
110117 F20101111_AAAJNY toska_g_Page_096.jpg
73a5d053616467509895f4936ce4644f
4f8f4defc8fbc4d7a256d1ea3716af57baa99b17
237341 F20101111_AAAJPB toska_g_Page_001.jp2
36601e5929dde14041ef49edaca0f740
1f1ad27428be47ab8a6def25aedb43a10519260c
107860 F20101111_AAAJOM toska_g_Page_113.jpg
96e46f49ddc11589762bc7c7936cff22
970156feaa1dab3ea1f34981ade31df51b77ab95
107050 F20101111_AAAJNZ toska_g_Page_097.jpg
537b83fc93b77cc861e09e15eb1c0f07
cf62d5bd1adf67d6fc045a6ca9fbc9e8a2807dad
23302 F20101111_AAAJPC toska_g_Page_002.jp2
94a42b5a6e8ac0aac15c13ca6179ec20
a3823c1cf866f7a1fad3ae43c0da4abcecafd50a
87184 F20101111_AAAJON toska_g_Page_114.jpg
8cf1c9ae167a3baaf84242716b423d66
ac04e2e1fe1d12caee8bf94c4e836eefc58a6b5a
F20101111_AAAJPD toska_g_Page_005.jp2
18fe8df17c6911daccb9717ff87e501f
363a18ffb42c39f4ff3101bee45b9fd913e454ee
110682 F20101111_AAAJOO toska_g_Page_115.jpg
2752023bd981673dde78de695448d2a2
7446511e4e2752782372bc97b0b984d1680673a3
1051985 F20101111_AAAJPE toska_g_Page_006.jp2
e2131a400709cfad931ea0fe7dd796ed
14fee6306b75b3228aeb107545ce4b9f7420e7de
71078 F20101111_AAAJOP toska_g_Page_116.jpg
bcfaf126caf7873e9b038b23ceabffc6
939625d2f513409ebac2eb8fbff4a781bcf9c4a1
1051943 F20101111_AAAJPF toska_g_Page_007.jp2
95f1cc473789f3d161fe5a4581e4cceb
6bb727dcccf31a5dc17d5c2e4b0cd0628c78a426
105193 F20101111_AAAJOQ toska_g_Page_117.jpg
c1b9511cbe74022691f253faf47bf0d7
8a2dda7961b165f78bad629f8c1e0df111412dcc
1033760 F20101111_AAAJPG toska_g_Page_008.jp2
3d5e8f1c51eaa6237c7f4154f8bce0b2
2e21d645332aa066f92c7df1e320ce990b144806
107863 F20101111_AAAJOR toska_g_Page_118.jpg
0c0eb0d78eb33b6850b67abe9efd9314
fc2bf9e7fe9764c97df64c96ae71286ad37b6894
F20101111_AAAJPH toska_g_Page_010.jp2
eb703f6f8d1d83437698423699a75937
3b011ea3a182fa64287d6c530e490d435d7cc1ef
105291 F20101111_AAAJOS toska_g_Page_119.jpg
e6d00892524d5d719fcef552685a9171
cf61025e0b0bd63e7428a4512cd3439b06b4cbc5
1051986 F20101111_AAAJPI toska_g_Page_011.jp2
2b6db3cc7b20ae220e75842a2c5c2636
1dec1ebbfd7413bb3c10b971fc8b9eb55374577b
70163 F20101111_AAAJOT toska_g_Page_120.jpg
d6b3133bd63de040c4cefe505c06335d
386d66244a785591570d97d3a375d316d8a83890
1051968 F20101111_AAAJPJ toska_g_Page_013.jp2
40f240686a3d5882df2cf47ede79fad9
c0df8b5d94487eb113a21ae6f38302e8f9601333
122448 F20101111_AAAJOU toska_g_Page_121.jpg
5d4dfc7cffcba68c6c3202d7d163eb7e
266caf27d8baaf8c9d3416eacd512f8ff6af462a
124538 F20101111_AAAJOV toska_g_Page_122.jpg
c3e7c441fd9fca8602efecf2fe4a16fb
4e961d7e60f3e3ed276784489030120451a7c4f1
1051928 F20101111_AAAJPK toska_g_Page_016.jp2
280e1ec348756947f75d9cf63f14d998
5cdb230428ef45afd09eeeb2a52c960335d67d47
130455 F20101111_AAAJOW toska_g_Page_123.jpg
2494fc91e882347378c2f924b9c15d74
cd25cf9866c8ea6f68f2c95663ca0060925a13c8
1051937 F20101111_AAAJQA toska_g_Page_035.jp2
1a9f783d9ebfb2af6103de77a643ddbe
95396a7f920aa6511f6b215efcee4994a9ce0ce3
1051951 F20101111_AAAJPL toska_g_Page_018.jp2
fdf7e5cd86e94910a698163997e11c71
87de6dbe2c20988b0c7d3676afe8ca5fdd8d3ef1
126232 F20101111_AAAJOX toska_g_Page_125.jpg
878f0bafa1cf74b39095183a59457d84
7f17b62c4b88d0969705a9813974b36571e241d8
1051952 F20101111_AAAJQB toska_g_Page_036.jp2
183a2fb56d50d9f87739e62aa04c9ca5
56af3e43a2ae8e0a0ecb660d7527d6b14ccde0b7
1051945 F20101111_AAAJPM toska_g_Page_019.jp2
921a5766d2cdfdb83c466bec8b74d917
d32c4a753d18a324486e1386acc7028ca9da83cc
135409 F20101111_AAAJOY toska_g_Page_126.jpg
b42ad0e9f3ef4e0233f2fbdeea5c0c74
dafcb8a383343ab919357a4a17aaef51491cf8b2
1051949 F20101111_AAAJQC toska_g_Page_037.jp2
1fdf50559a8867ac669f8ba6839d07a4
2330aab538ba010045e63028af0abc5a24b51d94
1051895 F20101111_AAAJPN toska_g_Page_020.jp2
262327a33250083dadcf29b23689ec4e
10a71bcf429f1280de10335ef4568786648a32af
20741 F20101111_AAAJOZ toska_g_Page_128.jpg
2f6bdf5cca99ee1b248511e2ce338bc2
3fafda64260269a3b9ccba3991ef3a67a12cad25
1051959 F20101111_AAAJQD toska_g_Page_038.jp2
644d424009c385f674044fc3a6db07c3
954ce9fc942730a9b1c11715b21d54c9dc8dac2a
1051963 F20101111_AAAJPO toska_g_Page_022.jp2
5f7e096306f92b2fd1f6663c2140a0ef
2f783efdddaed7cd5260aa4d83038c517ab3cc6f
1051979 F20101111_AAAJQE toska_g_Page_040.jp2
ea65b701cec0fa66123170d6525bfcf2
3a0514015560d6d241095b6332ef339ea4e2bce0
1051955 F20101111_AAAJPP toska_g_Page_023.jp2
671672c703c15c9ce49b75538d88df6a
504e0956ebaf4c633fd00876b7bcc72eee5b2bee
F20101111_AAAJQF toska_g_Page_041.jp2
fe622339156e28a3cc7ea786eadabd07
29d421f14737ad07912a8b23c0508857c3864c29
1051956 F20101111_AAAJPQ toska_g_Page_024.jp2
cc836dd9982592fc240986dd0a8775d5
11c9ec33073cb46df5f1f016fe382fc5169ae889
F20101111_AAAJQG toska_g_Page_042.jp2
13e4c98d0ae32b273cec00290a8f4f77
a2e59430e9e48b275764efa66037cdd538123a73
F20101111_AAAJPR toska_g_Page_025.jp2
13c9533c8870cd5db3612f11d4707cbb
221492850e7f016b590a1af94e4441962f191397
1051957 F20101111_AAAJQH toska_g_Page_043.jp2
53d9978f486a70ffcfe7afe41df3ed1a
36495c55856bba5bcae9026a3389f4740b694fab
1051982 F20101111_AAAJPS toska_g_Page_026.jp2
62162cfc750643a492b36c3adcf3a8b1
88dd5d6c2e674154ac81a8d4467c6343b9ea4759
F20101111_AAAJQI toska_g_Page_044.jp2
5cf5a27df100e73c5d6c081665c386b9
060a8770244cfc614d24c6c09072273056342613
F20101111_AAAJPT toska_g_Page_027.jp2
65e24b87946db042fdb64cea8955d902
0a8fa5bdd442766b5438ca44bfa739b67844da6d
1051934 F20101111_AAAJQJ toska_g_Page_045.jp2
d3748271eb3d8e90a64b51e1b7e5d97a
1e7fbf353754193a320c935abedf9c08f59db27f
1051927 F20101111_AAAJPU toska_g_Page_028.jp2
d46f97a0ec3a2b066a2386dcc6d26577
89328dbaf5b06306023321764bf9d44b108e65d4
F20101111_AAAJQK toska_g_Page_046.jp2
e069c8ffa4d2da97de029f9bc2580367
adf756c742f816ce41725155208ffd8f4f333339
F20101111_AAAJPV toska_g_Page_030.jp2
8af9a9691f1a33e5a4ad180adfadd785
1d552b0d1dad85246b1179d8fa90da56d9d7a6a8
1051941 F20101111_AAAJPW toska_g_Page_031.jp2
eb6231bb8651de83750d8c80a52d5cd4
91c55c1d435da26ddf4890a8b49066a2367aa8cc
F20101111_AAAJQL toska_g_Page_047.jp2
78e58862e0f6c293dca64ecb399176fd
41719104bb7ad697aa5a217415b4008129e2bdf0
1051964 F20101111_AAAJPX toska_g_Page_032.jp2
72bc058eed1a06d718f13b9b8ec5ba34
ec39d606c40e2cc7d61c69f45745558cc059f5e2
F20101111_AAAJRA toska_g_Page_067.jp2
c307cf203ca7b6064d95077e0cb75809
858d8baccb85e13c4a0bfd602926f06f1c9c4953
F20101111_AAAJQM toska_g_Page_048.jp2
e8590838deca35d6e05b6d9512d77700
811bd92669e5e30ebe6374325fb444e766870862
1051924 F20101111_AAAJPY toska_g_Page_033.jp2
e1ddade81900dd9f9a8f2bb636c03188
fc7a1fec1c0c5b1f238dcbbca4469b37bea963f3
F20101111_AAAJRB toska_g_Page_068.jp2
fed6adecc0406cec5644c29ec636e32a
b0e4751412a4f96792835d47856329f2e5356056
1051933 F20101111_AAAJQN toska_g_Page_049.jp2
677be133dee752af7bfad99d3f414287
fdeff319c8149d27e31e8d645ef5de9d811382ef
F20101111_AAAJPZ toska_g_Page_034.jp2
aa5e1f41abfb7f09315c852341af6dc3
401d89b7aa502a0e197772bd97909400cb3edf45
1051947 F20101111_AAAJRC toska_g_Page_069.jp2
d9a7158de9083bc68218f2b2098ecb5c
55ad8030803eb25a88d6e7457558dbf17388b859
F20101111_AAAJQO toska_g_Page_051.jp2
fe2374dc76ae3cf1ecf07087afdad3df
3dfbfd95f7a65fa08b8c5e7cbbcce4bdac0a8416
1051915 F20101111_AAAJRD toska_g_Page_070.jp2
4d5fbacb0832c7d69f5213e04d819ca7
14bc94585f07fd3d54f10da3132adcdd2088dade
F20101111_AAAJQP toska_g_Page_052.jp2
3e85b1cb0ac52d59c4859561ca32ee1f
f1225812482592356087e2730cc742fdd9e33fc1
1051930 F20101111_AAAJRE toska_g_Page_071.jp2
53b6f822c42bcaf3753aa5966ffdac2d
bf076de8ed1994feedfccd660cedda6d589ecc9f
F20101111_AAAJQQ toska_g_Page_053.jp2
023b15a544a3b092505c75fca765171a
e4db2c08913700716cdaf53de34538729597d005
F20101111_AAAJRF toska_g_Page_072.jp2
2db49f0c320cd0429561674edd09547c
bac29facdab670597df37d93b2595cd622b93729
1051960 F20101111_AAAJQR toska_g_Page_055.jp2
e9003631b541b1b695f64372ca1f5174
bd0d47d2fb4b78e3f5a92fc02d3e6d2f924a09b0
F20101111_AAAJRG toska_g_Page_074.jp2
a2f63f507f9f9fdc881e07cbcdb2d2cc
eb629044f2445327e9c253f1293e2fec32294bbd
1051913 F20101111_AAAJQS toska_g_Page_056.jp2
704240c65c04e36493d01422406b9b47
7151e8811897850874a9f05705ab3e7ea9374715
F20101111_AAAJRH toska_g_Page_075.jp2
7ddacdbf632d02be713c5f77ee4be782
b2fa623f75fbd18f03206e670bf3501c4fed2d0b
990821 F20101111_AAAJQT toska_g_Page_058.jp2
a06f8637f04d9a127d562ccb39a418e2
d53dea809654151e95f5797db3f33768695ed9b0
F20101111_AAAJRI toska_g_Page_077.jp2
ad7a07693d138887f76e8d53f84325eb
8a97191c86c9cb28fe4d38ca96fca9652ed20d00
F20101111_AAAJQU toska_g_Page_059.jp2
6df123f637f65672a443765698f3d52b
9cf8bbd4ab16fba45fee582ceda469dfb31fbdfe
F20101111_AAAJRJ toska_g_Page_078.jp2
fd0b344fe8388b47a1cefa0a0500b983
1d07bbc594a071798b5283758f1800467396f4f3
1051893 F20101111_AAAJQV toska_g_Page_060.jp2
d4b2fdde1b34fe1562f4ec86f839bf01
bea497467bd27154a387741ec4d15cbc55fe8dd7
1051975 F20101111_AAAJRK toska_g_Page_079.jp2
5f89362b05bb2f17a836c8fd65ad75b2
14b5408ce2ed9cf9d16eaa45edb113308b65681c
F20101111_AAAJQW toska_g_Page_063.jp2
e1c00ddae72c7ef89522632cb7396593
eb24b8c53752543d4917556a8a0cba481da2aeff
961314 F20101111_AAAJRL toska_g_Page_080.jp2
3bd760c79b0af93cf4655d6878ea34d0
c25468921573b2151469b89988e53f180016af64
F20101111_AAAJQX toska_g_Page_064.jp2
b0b5b16ad47454356ae3b38731b16e5d
873b7bab9ffdd8ab50a5600146f8c93d39e2f664
1051938 F20101111_AAAJSA toska_g_Page_099.jp2
9450a38dc5f1cc9f916c18d336536b75
320748ebcfabf22efedd47f5087a4e8171aa9a0e
1051906 F20101111_AAAJQY toska_g_Page_065.jp2
00f6474502ae2b3c1ab65807c574fef8
b32afa19d8ea7e608c2d6bb48b058f07a94027d6
F20101111_AAAJSB toska_g_Page_100.jp2
15514c9844b36b3e597d0c5deddfec6e
b9afbfb38ffb8233ef94deb9f27a08ff96acb86d
F20101111_AAAJRM toska_g_Page_081.jp2
c53eac23fa4d7d6bb4320929cde95f12
3530d0b3498ae4c6798d70bcbba7afc89de108b8
F20101111_AAAJQZ toska_g_Page_066.jp2
39dc4c11f24589dea3c724320283c64c
4495b4e82b944959567d5286bc3c1b41972a50ce
F20101111_AAAJSC toska_g_Page_102.jp2
1fe8b14233b6c2940e6fa6d27834a092
3f0940daeaf1fd597806157ac1c890ad2d0a4cf2
1028530 F20101111_AAAJRN toska_g_Page_082.jp2
0ee93c56004140c0ed797ab700d4371b
8e94accd27b1d2c369ac0d958356dcc7f6adb9bf
F20101111_AAAJSD toska_g_Page_103.jp2
b791e5729ea4d704992abd4c58ed2528
cf259416db1525f69949048245360ea67554593f
757921 F20101111_AAAJRO toska_g_Page_084.jp2
7817eec554fb803a03dbc44b968fb759
fc4e120e080ac26a25d03319a138cdbdd8dd4c3c
F20101111_AAAJSE toska_g_Page_104.jp2
0c90e96be3ecd4d4f0118d52e237c55f
592b44c1636563341b0e1c3e9be7a752b493256d
673543 F20101111_AAAJRP toska_g_Page_085.jp2
067d0171f8581caea81ad685771d5e25
45edf65b0b1dd8c3865fcdcbe84fa3e2d1c92974
1051903 F20101111_AAAJSF toska_g_Page_105.jp2
7fe460a5b287446b486e18c5f7198de0
646e0fd539c19da8c0770f8202d39b19c0ec8df8
1051944 F20101111_AAAJRQ toska_g_Page_086.jp2
0a8f8cb5306506b6d5eb0de64e3113b3
bbb24c0ff2e064d3916ec20b651658e24be6f3b3
F20101111_AAAJSG toska_g_Page_106.jp2
92e08af60516ecd51fc1b258dbb130de
9b6e435830830a6ea260011cde189589a8db29d9
1051912 F20101111_AAAJRR toska_g_Page_087.jp2
31d195d361be557c85053c770c6b57e7
573f47446bdf550360d812e9da15e6aea576fbb0
1051936 F20101111_AAAJSH toska_g_Page_107.jp2
abd97c795292fa4c3f785ff062eb9b1f
4704e59fb4b3460690d2c5b4b5f91f18f2e0acfa
F20101111_AAAJRS toska_g_Page_089.jp2
5cd40bacb3461a635b1be897f42640dd
bee51839042c7037b4b61ae63b6bb437c64526d3
F20101111_AAAJSI toska_g_Page_108.jp2
b81378a6e52ce337f1ae0d81c6f48bfe
2a63b71d0aa969de44bfafb9a26acfff25b6698c
F20101111_AAAJRT toska_g_Page_091.jp2
6f20d7dd8207ba0115696d236f23d6fd
cac82339bc9030594126f7fb275300ce26365796
1051983 F20101111_AAAJSJ toska_g_Page_109.jp2
c1ef03e3b66d4c12daa7acbc29e9e9fa
0c5de7f34735f8f2d0382f9efda1235b825605d6
1051974 F20101111_AAAJRU toska_g_Page_093.jp2
e3b9974e47b228a3de0c53b33fe864a6
1253a409a879cc41d50b8b3af4c983a89adc83ad
F20101111_AAAJSK toska_g_Page_110.jp2
397c8761839024fbcccac6e91c0d6add
656d98661e2abd04cb473d7a4441ae94ea4472cb
F20101111_AAAJRV toska_g_Page_094.jp2
5408eed72026974bcf05c0440175c338
aaae2844db6275cf53cac737e563038b8bbb6429
F20101111_AAAJSL toska_g_Page_111.jp2
2e12395843abeed551288406b55c9fbf
0dd5bb03433e6ef66cf8245b6a525b3aade44e9b
1051910 F20101111_AAAJRW toska_g_Page_095.jp2
ea24d6cccef063c9298f2f4315ca1a23
b2384bb227e14702d4d204ab10d1dababeeec800
F20101111_AAAJSM toska_g_Page_112.jp2
3244e3f60660a269d6d69d85ee675878
2a7906d908202f607484fe6bf3fceae6892ab2e1
F20101111_AAAJRX toska_g_Page_096.jp2
df5f643e0b0ea4a44609a0bc544208f8
d86c54830e5567e361a67dcef48cbf381f78a6d2
363480 F20101111_AAAJTA toska_g_Page_129.jp2
c892637e83458889bcbe5b26c5d2f9e7
598e995245dc406b81886113c41605b60dd41afd
F20101111_AAAJRY toska_g_Page_097.jp2
29d9ec09e2b88adbe2907112fa15cfcd
16ddb383cff12eed3fb9bd1e4ebbac3507d8a3fc
F20101111_AAAJTB toska_g_Page_001.tif
2754ff455986f4170689b3d1b92cbc51
9786160b66eadef56749a2533e0f438c8227a452
F20101111_AAAJSN toska_g_Page_113.jp2
794dd7a7ff3201d0eabaf980c4453578
97d4672344a6b4d5d9a12d79970a20bd86e4048c
F20101111_AAAJRZ toska_g_Page_098.jp2
fcfca831cd7687cc483e436ce4e8c6b7
37dcd139ff4b3e283a78022afcb879ff1639631a
F20101111_AAAJTC toska_g_Page_002.tif
72938e675a2ad40bf17493e5a54a6da0
433a41e9331d57b4a9e47ed469f1872470a99e8e
963530 F20101111_AAAJSO toska_g_Page_114.jp2
6479a0e9f508de060d12c7480b578c34
a0d319a876d4693e412c72fbdee9f6799f94d67c
F20101111_AAAJTD toska_g_Page_003.tif
6272542c6e1036344f9896286e72a79f
4593a8c8081e92f70d1cfb56a1a6bbea90baa8e1
F20101111_AAAJSP toska_g_Page_115.jp2
1c83628a763bf3383984b4d75eafea0f
02f32eb49e38066e313eeb77b604e6bf95a84073
F20101111_AAAJTE toska_g_Page_004.tif
8b7e0a1963447aa50289793bf7ce8505
9f2315aeefd08a1933448769dab5586398adb07f
717770 F20101111_AAAJSQ toska_g_Page_116.jp2
a54457c2c5a22632ce08d54a2696a4ba
127e402a68f81f8966619056e53a3af0586fdf3f
F20101111_AAAJTF toska_g_Page_006.tif
c359d347aba5c67cf8be80e25536c8e4
dba8a4371ab7d76ba611220357a80674f0a01fee
1033357 F20101111_AAAJSR toska_g_Page_117.jp2
8f3d7ce50eff7a3573afa80f19c4ece8
0f9eab282a67e6f259564dbb0f836e3d4df6fd9c
F20101111_AAAJTG toska_g_Page_007.tif
d4ffadc73ca4065ebfb0f2e735166d7b
ab1895238986fe518e5a97bc462b45b0887986eb
F20101111_AAAJSS toska_g_Page_118.jp2
23ca1a107610c21aec0f5466783ff480
879a50b3ccf532e9cdc1f0f89d867c16194a4dda
F20101111_AAAJTH toska_g_Page_008.tif
dbf7ab4c39728277fa14d611072d5645
8b44f808e5ca25a6160aa0d0ea44355faa56d248
742258 F20101111_AAAJST toska_g_Page_120.jp2
dd875afd08ba4c8405661aa8e419b74b
56a4d09806663ac643202fcff7f43ea455766fa3
F20101111_AAAJTI toska_g_Page_009.tif
d3c4037bb18ca315b56a380c64f5d373
ee55085de813bbf32152e07218f67fe0cb40eb80
F20101111_AAAJSU toska_g_Page_122.jp2
910c14951638c36fe26e9f0f210bf655
299ab268686f922fe4c545ddd9fe28dfd03fbe5e
F20101111_AAAJTJ toska_g_Page_010.tif
4b262e8cdeba26fd63cf7f6580a432c4
cc2ea4643238efba55a23bd09c377fd649a6eeed
F20101111_AAAJSV toska_g_Page_123.jp2
6b62a695645003bc453dda626d37eec7
dfd45f9ecb6378a164abeae8515faf622371fcbf
F20101111_AAAJTK toska_g_Page_012.tif
1d97a13d394d2678b3e9654421ca1e7c
7be94874062e072d4775ab17f7f4c54dcb78e1c8
F20101111_AAAJSW toska_g_Page_124.jp2
601297f61b31c5c3e26d835cdb99777f
ca19e7a99ee5e75b12ea10ac2e71e78962e3b6c9
F20101111_AAAJTL toska_g_Page_013.tif
1fdc9b392751b7a3d7d303953d4ef06b
f15b9cebfe4be8c854e45fe63aa3ff23bfa8ae88
1051972 F20101111_AAAJSX toska_g_Page_125.jp2
02da408a1ddc8a3f3e379f33604966e6
6fede455b4086d225e4ba3ed10ae08a0e16276a6
F20101111_AAAJUA toska_g_Page_034.tif
724cc1f31cd1c307ac221c573b6099ef
da3080f61da03d01cfcc1b6cca4f6fa826f54321
F20101111_AAAJTM toska_g_Page_014.tif
4ab870df570ddddf0b537a32282b6f36
35ebfc46ff60586379c9a0d6fe146698ac334aca
1051900 F20101111_AAAJSY toska_g_Page_126.jp2
fed56903ac9943fe0a411b33324b3913
68fcf839493e73ccd2346cbf72c85f9a645a0a60
F20101111_AAAJUB toska_g_Page_035.tif
0a1183a3565ed7e8afd036a9ffa86afc
cdae3683944fb76ef8544f0ac3bebe4a917c9ea4
F20101111_AAAJTN toska_g_Page_015.tif
b9ad2fb9d13ab741b6c0879933ace0bb
c8a9a4544f8d6d723fa65a3dcba4552ddca047aa
199106 F20101111_AAAJSZ toska_g_Page_128.jp2
fe9bfea9031cc6eb2513412ae4520470
0e4762204005b464fb2d08c7768fe87c0f935557
F20101111_AAAJUC toska_g_Page_036.tif
7e15d2d2fb4a0f219f189d6f23896c4d
c21719ab5e5eb325d803e84601b0266ab4d49d2a
F20101111_AAAJUD toska_g_Page_037.tif
59c6d8761a6b2134a12bfa86c762c021
36a43b2ae74869afeec9851d1d78c852b50d9837
F20101111_AAAJTO toska_g_Page_017.tif
75946753f48d7c71838c7cf8a5960153
642c59824cafa87ecddbf1ce89c08862d6721346
F20101111_AAAJUE toska_g_Page_038.tif
0093c39578638948e60031c280b08002
551e666442e0b7400b55afbdd90244b2269ad6a9
F20101111_AAAJTP toska_g_Page_019.tif
d79e42154a39c81c4c115d71bec0fbb9
94c2523cead1477eef0173779778e35962fca472
F20101111_AAAJUF toska_g_Page_039.tif
aaa4511fa8c0f0df66f133af3b51ba9a
2ac2494660e99edd4f97a95fe2b67b0a0d77869d
F20101111_AAAJTQ toska_g_Page_020.tif
ec33d4b8003bebd1b0aef7ac8dc4bfe5
3d61fca00506c24f8b0ac0e46b654ec4a3fa3972
F20101111_AAAJUG toska_g_Page_040.tif
993b4325a06c2e89ef8deabae7781ef5
b2b9774435ed9f431a2181eaf480d043cb193910
F20101111_AAAJTR toska_g_Page_022.tif
019e5181cff7bca1c881083ddb3d9e9b
7041cbdb655b8bd22a0b19796cfff09fa5beb0c5
50553 F20101111_AAAKAA toska_g_Page_092.pro
7aa908879e70731b839aa62ec3499e73
5a6e9c00853987c2a77d56bc8e9f653b0e495e20
F20101111_AAAJUH toska_g_Page_041.tif
e51ec208dbfb37d5f29a49a0531a68f2
46cee86a9f504a0dbcde69d907d51b12d44b58df
F20101111_AAAJTS toska_g_Page_023.tif
e3e18580603f5373fbc2c9ae763cd2fe
63bf0e4ee142d3065ac1cc7a9fb285e6aa987a00
52048 F20101111_AAAKAB toska_g_Page_094.pro
188700540bb0a8b4cb9e475e7724f4f5
d87e71264142bc19308a68048a6065613db8d82e
F20101111_AAAJUI toska_g_Page_043.tif
0c933a8167f3c9b451ea6a87f77b2321
38d65d3e1105b014b0388e9e32662a77240b5368
F20101111_AAAJTT toska_g_Page_024.tif
86af32bdb4c67d100eb6739670dcca78
9797b73f7ef531108cc9635a232e80f1500b49cd
53785 F20101111_AAAKAC toska_g_Page_095.pro
9d3b09ab3de8af0ab4d927fbbf574c1f
fffb5fe1046a353751145eb31d064db231afcb04
F20101111_AAAJUJ toska_g_Page_044.tif
7a5a2d5942b97833154c5c1f218e6b71
db2bb0b8eafc050c6e2a239ae65874f3a2be9961
F20101111_AAAJTU toska_g_Page_025.tif
3a163307a6daf1d5e8e14cc6acc27c9a
8e485f98c64dd2365f5fc2238ebef3cda284c229
55442 F20101111_AAAKAD toska_g_Page_096.pro
57cf0d4d7cb28790b1e17a148e91f702
227aff427a51771a7ebf686e2f64e97c5bd1362f
F20101111_AAAJUK toska_g_Page_045.tif
f3e0e994822797410f73e476bef95585
bfd93f8a9c80ce50cfa44b0246ffc4a615dc6fd2
F20101111_AAAJTV toska_g_Page_026.tif
850d02c5dc85daf7cb7610ad64aa2672
e40d9d01ea944beddfe6c82076147a7f749c442a
54075 F20101111_AAAKAE toska_g_Page_097.pro
7aba2d60db09c573a288cba3e0520364
64cd2dff489bd2a9106265b7a85d4e53b9f2d004
F20101111_AAAJUL toska_g_Page_046.tif
3f57330efc24d022ada57353433ef2c8
ff1603e9c6278e86c4a89751c3d95b55c6696349
F20101111_AAAJTW toska_g_Page_027.tif
91102c1cf8fa70bead5a418e432f9133
69bf83b19568fda096994d8baf2ec1b98f19ce9d
53492 F20101111_AAAKAF toska_g_Page_098.pro
7df04ce7532c59b1b864e64cc978ae11
6bc7d9253cae253735dc5c268a6c7f65cb842a46
F20101111_AAAJVA toska_g_Page_064.tif
de260953aac21b9050d33cb717fe7dec
8f2407d6ac4561f1b96916ffdeeea3fb32247b16
F20101111_AAAJUM toska_g_Page_047.tif
146cd2145415deacdbcc74106aafc371
212c07605795b77eaa10d7434b3a75420dd82a33
F20101111_AAAJTX toska_g_Page_030.tif
69dbaf615164e0a46957bd802235354e
584766aa859ee61b63d666c439e00309142b1d5a
54795 F20101111_AAAKAG toska_g_Page_099.pro
706a1d107161cb1fc7438976071bca8e
e2151d0aeaaf864dddca15ff6adba9ae12f38895
F20101111_AAAJVB toska_g_Page_066.tif
dc9d06063601a0d9d605f0d6382a0712
c4e1831f55148996a5b4fa6fd42b276c1f43f47d
F20101111_AAAJUN toska_g_Page_048.tif
05fd807224535895a282bdb0dd775b0d
cf6108f744bc390f62a65a80f45f11a69f40c143
F20101111_AAAJTY toska_g_Page_031.tif
42b5547413a97f44d0cf09bf956bf527
53e4819fcd613e500095b1ee9537640433a01f1d
53534 F20101111_AAAKAH toska_g_Page_100.pro
6ea914cad5c2d9def7d8ad4008fa2a16
d085d04d21e179e504b08d9d2e8adec340464578
F20101111_AAAJVC toska_g_Page_067.tif
26a8b1042e598e0491f2624719343f76
74d670f5f776c79985de35b0e08ea12ce73bc087
F20101111_AAAJUO toska_g_Page_049.tif
d9582db2cf5acfde28761aee79c68945
1af88cf672efbf29ffbe43dccaa17b2757b9dd81
F20101111_AAAJTZ toska_g_Page_033.tif
77188a9fc2fe845cbcd175b877fa1389
78912ac18389e443f2d9bbf8e29472b7d4870fac
54680 F20101111_AAAKAI toska_g_Page_101.pro
45458fc7b84a2060a0da8011cc4ce5c8
059d1aada2860e21c9901e66b721652fdda97ea8
F20101111_AAAJVD toska_g_Page_068.tif
5c7595b173f458645f0215bceeaf35d3
6f118c8c7b70f14751a3f532e9ea8be851651cfe
53500 F20101111_AAAKAJ toska_g_Page_102.pro
1d829baecf260ec787c94ac29472c526
bccccfa6d482a829a28392dbaf2d16cec2560677
F20101111_AAAJVE toska_g_Page_069.tif
8e91bde9f28ad235ce2fabdf7c3a5216
e0e5da409bc0f74232fb0359db1f3ca8ff5e2139
F20101111_AAAJUP toska_g_Page_050.tif
701c4b40a408ad78140fd748bc368620
7644dc9f1992eac3fba6f50128754d4828efdf05
55044 F20101111_AAAKAK toska_g_Page_103.pro
fd21872004be5e3ebedb1025e5163380
a09e3b29caf70b4aa08650e1b52c4433e91c2d45
F20101111_AAAJVF toska_g_Page_070.tif
066a6eab3cb7eacdc8703696f9e24dad
cdb84deb85f5fd4a38df4a9ccc523a80fd271ccc
F20101111_AAAJUQ toska_g_Page_051.tif
17efbd639a23c0b924d07250ed31102c
27f23118a496ee0d9439ce0085c6b03c5254d3f4
54951 F20101111_AAAKAL toska_g_Page_104.pro
53d753e80efaec9418fbbf67f5061048
ba00c758c7e54df6bb3d3dedcefe7a169e931739
F20101111_AAAJVG toska_g_Page_071.tif
73ce4a7db00c8b1346c55b525589bccd
3f1404edef5dfa96d4b663a4611164d82d4a6bcf
F20101111_AAAJUR toska_g_Page_053.tif
442892e5ef577ddad8c33d1e2e6a1b57
8d45b05cc49804b86b16681aa60033a51b5bfa58
62307 F20101111_AAAKBA toska_g_Page_121.pro
3838ffd7223510ed12ff8c79891eb409
3af15399138424f20115077175f17a7d63b2a71c
54320 F20101111_AAAKAM toska_g_Page_105.pro
29683859637ce84cc570530313188876
74b61fc4013df6dfd89c0d2d0f1d63519b256b73
F20101111_AAAJVH toska_g_Page_072.tif
8c10db32cf201a6cad728383fa139eae
fab0947596e41e1b6c6efe6723c6e084ea3de219
F20101111_AAAJUS toska_g_Page_054.tif
4417dd421edaa4c3d70f436acccdb1f6
35c7d4d163c88dbbcdbe1e376a55231fd9ca8a40
64284 F20101111_AAAKBB toska_g_Page_123.pro
33f3b2565c0a75a425ba5286191cf5af
7a80018cdab4cfe21967651d9889aafb7a6b9c72
54959 F20101111_AAAKAN toska_g_Page_106.pro
0ecea11291367831736a15890d98c487
deb12bb562cd4c67ac4d78f67d6398caef7d2557
F20101111_AAAJVI toska_g_Page_073.tif
00a1cf9026d6e7055907eaacc3480cae
710565ba3dcc4eb9e20c031f3b014a22f8219e8f
F20101111_AAAJUT toska_g_Page_055.tif
7ed4b02cee615c65f57c8ccadba936b9
c41375dbd62cf3bfd6bbac1a4162dd4685c87ad5
65827 F20101111_AAAKBC toska_g_Page_124.pro
7fca7192d032c2a0209cab3a5c4f1f2d
4180a08e98854df7ebeb979b32467f93d9eed67c
52298 F20101111_AAAKAO toska_g_Page_107.pro
0e47225ee6b1f613b68510365c5aacfe
8785aa529d19811118fdfa0b16b1187b001f9e84
F20101111_AAAJVJ toska_g_Page_074.tif
b5b30242daedfb4e675676f9ffa8a881
0281030b80812ffb837bbb2e12239016a8f23382
F20101111_AAAJUU toska_g_Page_056.tif
8870d3ae55d8e0cafc23332f10c00d5e
4e9ecb602fd408bbf02f891cfb19e4e5b5bdf4ff
60440 F20101111_AAAKBD toska_g_Page_125.pro
19b2eb415f55825fd66ce886c5379e0f
2a3446bf5671088b9a55d54fe6405e66d4077cf5
51234 F20101111_AAAKAP toska_g_Page_108.pro
578a953b15805c6d2eff652dd03592e0
f3d57b590263f6aaafb5ca78d491234aa19cf923
F20101111_AAAJVK toska_g_Page_075.tif
c75b5b5ca5e22590afadeee9599827c6
4ca80401506f830adfaf6394999f9818e384da0b
F20101111_AAAJUV toska_g_Page_057.tif
3edc0f677cb48dfc3b5e621b50d1a625
2f0ea8f0a273398732d20dd4cd902a264a6c7d4d
66004 F20101111_AAAKBE toska_g_Page_126.pro
872569733ad2459d8a63c7cce9a7f1e9
841d243ab0a4e40b49210d80e7e24b8d822a78c1
54385 F20101111_AAAKAQ toska_g_Page_109.pro
6e3ba1bf5e1871c4a96732c8dc6fddc2
cde0fe0bcd0270bfd96c8498230991e5f7393a3e
F20101111_AAAJVL toska_g_Page_077.tif
f16dcb0ae083e0b264153cc93d224e71
6ad97c05736c258a1328cf5f9d59c0d588b21218
F20101111_AAAJUW toska_g_Page_059.tif
aaf67188184d00573db50aa388b7f733
42c11208dc2deb4b4c561fb3b6ec38033be91eda
15107 F20101111_AAAKBF toska_g_Page_129.pro
83b18400601dca8435b3fc663717515e
75a0aba9be588a457e10861f7901af6da043ed6d
58363 F20101111_AAAKAR toska_g_Page_110.pro
cb76e4da2ad89e1846db53a03d450fb7
0d2ef1074366b6d584cdeb8afa8f1f7971a31484
F20101111_AAAJVM toska_g_Page_079.tif
805b7904b9eb421368e707de5639b2ee
0a833fa4adb9ad4cfeac42a7aee4869fc5c955e8
F20101111_AAAJUX toska_g_Page_060.tif
fb67e06526445b44b0dd2561476c8b4f
478e7244e2ce9ec322f3042e35fbffd68937658b
479 F20101111_AAAKBG toska_g_Page_001.txt
6412b46d0f0090e11709cf65eb7ef1ae
14ea123b11057bba22cecd3f5e6e3eb960638ab0
F20101111_AAAJWA toska_g_Page_093.tif
b84663365987a3be00820b223d40851b
dbe057e5c935b7ee14f7302b0058e0538f56a6b7
52194 F20101111_AAAKAS toska_g_Page_111.pro
2702760077fc6274d8e3dc307a888c96
277c97a972b89c41e986854bec6cdaf1b075c816
F20101111_AAAJVN toska_g_Page_080.tif
a5558771e44b4219685d562fda33e54c
869cf9a5c27824921b0dc95051a98f6e15aaae5a
F20101111_AAAJUY toska_g_Page_061.tif
daa3d9afe5d279fb0b25704e1c529f67
e7ea74f9d31077ba21fcdf2794d9bdfe76953e68
81 F20101111_AAAKBH toska_g_Page_002.txt
fcfe0f8cdcd4dd4da43d3ede09f0d0fb
d0fb1d0388715861d6fc4dc100c97be648c98871
F20101111_AAAJWB toska_g_Page_094.tif
8a1b010991e626d7e99bf554685c2f15
9ec95b2da765718b858df7359c1e3adbfb79e300
53584 F20101111_AAAKAT toska_g_Page_113.pro
3cba3dc0a30662df1e2487559823e2e8
877280df051f2dc2e13a727f4e393874c9b19724
F20101111_AAAJVO toska_g_Page_081.tif
5a2bf7bcbbd0342848795249c687dcd9
2f87183be503ac17a376fac125cf57fbb83b7726
F20101111_AAAJUZ toska_g_Page_063.tif
bf44e2ed6092cadf190723db77aeabf9
40ed96e5026f9a83b0ad8b435f3bf6e64e68ac75
487 F20101111_AAAKBI toska_g_Page_003.txt
afabe2c56cbf6d6b7a12f3fe6aff22e4
14165ca46e3098f6a65b6922dfafe639409732d6
F20101111_AAAJWC toska_g_Page_095.tif
1347263b74da439dc3b910b49b330ccf
3c2eb92561c6851c0896613aa159802bfc2b1676
42922 F20101111_AAAKAU toska_g_Page_114.pro
f28013c44f73be17cee56781388dde9f
b2a0d79e21e65d52b922df5646f4206f5381e5fb
F20101111_AAAJVP toska_g_Page_082.tif
0956fdc1299868e0fe6c4abcb5ff8f5a
f0807f9c99fafc663369d078df5ae5324007b7d0
725 F20101111_AAAKBJ toska_g_Page_004.txt
50245298e67d3b084d28d27a1f28b78e
ca6261d504498ba18f1686981120ffd2d157b284
F20101111_AAAJWD toska_g_Page_096.tif
8eee7e2fe14c22e4ae964e88138a65d2
b490d796460915f4a261f42418c0d709f353150f
54738 F20101111_AAAKAV toska_g_Page_115.pro
2ce108da6164fc3e8386e82d2130f74f
c9fc4160e020475470f259588b9e719fefb11d35
4017 F20101111_AAAKBK toska_g_Page_005.txt
854971448d34a55774b9450206831872
5bd6bd3a6fa9ac85e0f6efa0dd01e28ed298728d
F20101111_AAAJWE toska_g_Page_097.tif
aa592afaf96635a099caeaee22008ec4
a81e5a819721cdf3107b0ba4f6fe98ea193ba788
34606 F20101111_AAAKAW toska_g_Page_116.pro
5bd0eedb92f6816c9f551fba0236e0bd
eab39f18552553d4d102e54748ddebc68da7f12f
F20101111_AAAJVQ toska_g_Page_083.tif
ac755cff73e0331c4d418d667a7f74d2
7fdcdd90a65506e60e49be2396f64584824e2b8d
2766 F20101111_AAAKBL toska_g_Page_006.txt
e837fc81e4cd4619592153772c9682f1
f67208b40c17a83346687265a003c854e9dd7022
F20101111_AAAJWF toska_g_Page_098.tif
6a6b8f86db6f04925904ecc715fdbb6e
8047c76d95896c755947bb938931cd709755ec88
51175 F20101111_AAAKAX toska_g_Page_117.pro
01b1a55e0a9563263fcb3c18f19e98f0
06590571336a4e19679d78fc957ce13a13136cf7
F20101111_AAAJVR toska_g_Page_084.tif
0c984564bb83d48288c986f5d12228ea
eca46ba72a628af83a544fb4e6b597875afc71bd
2118 F20101111_AAAKCA toska_g_Page_023.txt
aa85303251ec98dc0edf4f0d313bfdfe
3c02b95ca536b69450c96560d63d1713c632269a
1695 F20101111_AAAKBM toska_g_Page_007.txt
43a46adc1a7aecaf4cc0d5324fb1190d
b970d5b58d58038d3593feda18b4df15ce8a3672
F20101111_AAAJWG toska_g_Page_099.tif
1c8d39b02972c65b7088049cc5862dc5
8f414d77e0c78b5eaeed02edfa37a5a4efa213fd
50097 F20101111_AAAKAY toska_g_Page_119.pro
159a1bcae04a91317883f04f16bde8bd
e6a843d142429dde8257e8ef96906ef84484469d
F20101111_AAAJVS toska_g_Page_085.tif
ef49cfb22a53f14880eb09ced2b92f3f
8b24c511f8f581bfe5fbfe407ff813c5c94db0bc
2010 F20101111_AAAKCB toska_g_Page_024.txt
a115ef16c62585b48f83c394df8c8a03
fbd198de6ea2e9c0029073adabe1ae52156feeb3
2036 F20101111_AAAKBN toska_g_Page_009.txt
e3f108ba05d151449899dd62c72db4df
bc5c116e277534bad218547d856fb97518954a2a
F20101111_AAAJWH toska_g_Page_101.tif
0a24d5eb1d6bd592d7a290b4dadac9cf
8b4b19cbbc22450e43cfcce5b017a2dd2fa21e6a
31962 F20101111_AAAKAZ toska_g_Page_120.pro
08bf4b2c2ec0af82739d6e6244c8bbff
efd272eb15dec8bad04d5a6c627e3c69267798ac
F20101111_AAAJVT toska_g_Page_086.tif
c4f983e7255c085c1ece520d285b9209
977c52440742ed3008749ad3b089fbc2eafbe9c5
2161 F20101111_AAAKCC toska_g_Page_025.txt
0772f09c596b9d8e24803297e0a176b1
88d5032de20613920d8202a6cb9d7c1b13444a29
2075 F20101111_AAAKBO toska_g_Page_011.txt
a458a60267edb9a3f8b2feaa9e12f301
15120b7cd129e3502100eb2c4c06f28a8ab09af4
F20101111_AAAJWI toska_g_Page_102.tif
6ed11e04839d2e5fa02a0681e80cdfc4
264222e792531014d29a6a0d3dc4b97a9d61b9fa
F20101111_AAAJVU toska_g_Page_087.tif
0ff77e66a42e650bc52c236369e68419
0232023bf39d7dbb29a3c296c61053a3bbf17861
2094 F20101111_AAAKCD toska_g_Page_026.txt
4bbbb5eef3b9a97c52739656d7f570c5
17a120b4a9397db0fe54063156deba959278c960
262 F20101111_AAAKBP toska_g_Page_012.txt
c51001ebf4ec15fe0a4c2388128b6a1c
adc1559dd69898e1e7d71a81fb76fdc5dc3dd5c1
F20101111_AAAJWJ toska_g_Page_107.tif
138a1efcb58fb4ef20cccc1f4a0c4514
80377fb2c68f11eda6efd97b79d168fa76d41a9e
F20101111_AAAJVV toska_g_Page_088.tif
08d7ea7ff829bb1690a11d393c958c66
53a304f10ebde0dd166c4f8a9d18755308683e49
1916 F20101111_AAAKCE toska_g_Page_028.txt
a7b0e1ca7058f593fb91656ccb188cb4
937f70c9780737d8f7ce9f5d56dc045bccf429d0
2048 F20101111_AAAKBQ toska_g_Page_013.txt
425958cb17ce978f93ddec823b4f3197
feabb90f616daa4045fdaf135c10b983ceccff67
F20101111_AAAJWK toska_g_Page_108.tif
06fafef47af45d81d9b84ea80ebbe891
1ab467a9dbd385a4e838e8f73b1714199f3d2d18
F20101111_AAAJVW toska_g_Page_089.tif
458c84c20f5e858e7162b4e340de147d
90a969de726395178d7eadb6e65d106f999aa1ae
1977 F20101111_AAAKCF toska_g_Page_029.txt
3e508ac394c591584c5022402e6a9d31
b41b9ab62537e12d1319d1e1ba4814bb549df04d
1983 F20101111_AAAKBR toska_g_Page_014.txt
ed0557b2e67d93ec29d04333de586512
4d4d5ba3478303ec20767d674a456355b28c8267
F20101111_AAAJWL toska_g_Page_110.tif
5885bcd2dd60eada417a617c308adeb8
99f9164c46f81c7aca799d2e2f227f1d0657183b
2113 F20101111_AAAKCG toska_g_Page_030.txt
0cf295cb09496b4fe7e953d4afff85a1
43f82fac38b75d11550235a2fa8f1618a4470018
F20101111_AAAJXA toska_g_Page_128.tif
cff83da00896dbfa1b469090c011d467
dd87e3356c3eaa5908031f460e4aacdf332b955a
2050 F20101111_AAAKBS toska_g_Page_015.txt
8b0d98e05dccaa580c7462b1e4471a54
2f71f541873dda06c8f32770a7b2440cdec2c8c2
F20101111_AAAJWM toska_g_Page_112.tif
f66ebea66084359bcb9cfdd66b7c4640
300e18f657b7d48ddccce9904796f992770aef5c
F20101111_AAAJVX toska_g_Page_090.tif
061cbf6408cef557091b53078074929d
cfee18c2e001bf2c74e2a9422d34a06086f39108
1980 F20101111_AAAKCH toska_g_Page_032.txt
847a263429cfe647e31065e13beca317
78e5c72ffe62952652c110f63b36943b2e2e5d4e
F20101111_AAAJXB toska_g_Page_129.tif
3f4680b6934b06cbe0753aecd1442946
cacbc3630069d5462387752ae197afc13350ce64
2087 F20101111_AAAKBT toska_g_Page_016.txt
9de1af76fdae143cebe68401deb6e547
a203e5a946c22b299c6d3fa5ee42033ec2a12d20
F20101111_AAAJWN toska_g_Page_113.tif
85f52ea5420918af628018a5a78c9f56
b772d5872dd61636e730e8bb55051bf4b3142cf6
F20101111_AAAJVY toska_g_Page_091.tif
a7635173c9d501b0f7a2d6c21fc39aa3
a8d7c3f2b50869f951b17d09cb8e6734c9c58f2a
2127 F20101111_AAAKCI toska_g_Page_033.txt
2001891b65c4fc4acab30df3624f0144
9bbab0262a73d5b98ce593abcc191253032f092c
7956 F20101111_AAAJXC toska_g_Page_001.pro
255b4b147ef9b7f7b31aad3b1d35009b
ac760b43610f7bd1ac90095d6b3fdafff6adf386
1797 F20101111_AAAKBU toska_g_Page_017.txt
63a085c31065a23582d378fdbe3355c1
2cfad591cf18a95980852118202272ae303314c8
F20101111_AAAJWO toska_g_Page_114.tif
b8307d08d2c26c870bde99672e0e4c23
1c7dd1c41aa713a8a028a4763bffe685a19a138f
F20101111_AAAJVZ toska_g_Page_092.tif
eae8eb9c66e0dd0dec9514534bf6f43b
02587f7dd73e4d06dc79cdb082c87e3da64969fb
2199 F20101111_AAAKCJ toska_g_Page_034.txt
2dc502d3bd24581322fa86ee65dff7f0
f61b7a6b3a9e7b15c22dde54947efb36e11c4a0c
756 F20101111_AAAJXD toska_g_Page_002.pro
11c72347b53522c882a076847be0f76d
6b19ca71cdae376a6a63abcc8cff8e18bc4e082c
1995 F20101111_AAAKBV toska_g_Page_018.txt
920fc0a95700c294ba948cf4d7042ae7
215c32aa641635474d23ee89a40f618a2ff0e00b
F20101111_AAAJWP toska_g_Page_115.tif
d281d475baaa58cf3ed6caf9311498cb
0eb9751b1b8bcd3578e595dc70297cd4e2976344
2025 F20101111_AAAKCK toska_g_Page_035.txt
394defc55c3b96d96ea515a46185ff9b
88833aff86a49fda22a6f8239b02479eb1cfc54b
10018 F20101111_AAAJXE toska_g_Page_003.pro
f1517d45f538bbc9059ee2fbac26e0c6
5cbb105a8381948818eef851895a25a4ae101ec1
2125 F20101111_AAAKBW toska_g_Page_019.txt
896210bcf02c70cd6bc2307d395075de
1f9ab718a2a5ab3cd2d99a39e53ba0146de55011
F20101111_AAAJWQ toska_g_Page_117.tif
9707c083f8f11709234bc98ef2fe28c5
f77bd7a8361e5e61606c5ce7093578b16d370fd5
2026 F20101111_AAAKCL toska_g_Page_036.txt
fe63cb008e5e19c84819cf9e955a2005
2b34e953e7f028045fab9e3a414e92a3e836ce28
17317 F20101111_AAAJXF toska_g_Page_004.pro
e006dfed6475b23be8575c6dafceeec7
284db21393c0e1a7ee0fa6965cfcf3876e0278bf
2165 F20101111_AAAKBX toska_g_Page_020.txt
440b0280faddcba9f211a5dbb3018f68
f5c6adeb7742fa259c28f43e1c3a9664795ad10a
1939 F20101111_AAAKCM toska_g_Page_037.txt
318f6632fc54326045a1ebc73ebf263f
588960dead317951460af8a41f7c56e9b8430b18
96980 F20101111_AAAJXG toska_g_Page_005.pro
5336a554a60b1712d3ee397eb5afb4ac
f2dbd96246810cdfbc09ee873af8f5ad323951a3
2188 F20101111_AAAKBY toska_g_Page_021.txt
b674d27bcf3437c524e780ca84bd6a14
d2e778e13ddbc4ce05dbbe2b02107c2a3b01deab
F20101111_AAAJWR toska_g_Page_118.tif
4c27955624d2e3b33349193c3e17c942
61df18a87db8de52eaad990b4e18947e74e74541
F20101111_AAAKDA toska_g_Page_052.txt
05864881fa099c9a3da3ab4a6fa23b34
225d78d704b350859b67a7c9ae973ea8d5f96038
2043 F20101111_AAAKCN toska_g_Page_038.txt
dc721ed572d533f2131b1d3acd9096bd
fad4ff226316ffe1c1fe15633c343358ad02c3d8
67710 F20101111_AAAJXH toska_g_Page_006.pro
781e9c41b89f1ecb44e7fef4906a9510
4a5dc60922c1aff4e4019b0a45e12dbfa0b77af8
1971 F20101111_AAAKBZ toska_g_Page_022.txt
841a47d8a4b6bb5c877add7f97173dfd
ab6ca94b01546c696856a8c34c4c5ed3e5dfe575
F20101111_AAAJWS toska_g_Page_119.tif
2040e9fa04bc39e6977d1532d77db410
c1747bfb88f2bce6cc91c71b41008b14b24a420b
2053 F20101111_AAAKDB toska_g_Page_053.txt
4013f140eb6b267ffab7429db56ad03d
578fbe93fb80daba082a5cf178ee0686b284d383
2082 F20101111_AAAKCO toska_g_Page_039.txt
2dc03be0fa81ad34eae65e4dfc244907
cc1f088f2522a16285488a04eb79cc2d655f7501
40850 F20101111_AAAJXI toska_g_Page_007.pro
b5e9f13fb260bdb216b460ac3d34f330
813d98dd56b9014a461106e8d8ac6c2f96c4aa2f
F20101111_AAAJWT toska_g_Page_120.tif
5bf82c48b5197871e731370dd2abbe94
23eac4bdfb30fc04bf613b001407e35c85fa5a62
F20101111_AAAKDC toska_g_Page_055.txt
64129210c84c37d94b832de9e8ab6ea8
373d51b804c91550b01bb5771d7202d73c42ad07
2091 F20101111_AAAKCP toska_g_Page_040.txt
4024a0fb117a27f347f310a35478cf9b
2daf4c8fb6d52487ccec5d49608e88d23ea63ee3
45274 F20101111_AAAJXJ toska_g_Page_008.pro
9b92c88aeecb11a32d785212a8580566
fbcd7892db13adec978946f4e4c1c83f8caff2d7
F20101111_AAAJWU toska_g_Page_122.tif
4dff4071747d81a37d1bca209ed70813
03b23cb4e554f7e39a3ee20b663929d22fe64d7f
2137 F20101111_AAAKDD toska_g_Page_056.txt
78dd8aba3cfac8f0653a0e061016b4db
54ed04012e94cdc20aa01cf7a9e4695aafffdbc5
2114 F20101111_AAAKCQ toska_g_Page_042.txt
5e851fe047db4ef5e418d28c496b7f69
f71eb0ff025f29cad52edfd9541c9d9a7d4d95cc
49527 F20101111_AAAJXK toska_g_Page_009.pro
308d190875932e405a4a49941b9b5ff8
c101251af7395d8c542351d7783491a149767a4b
F20101111_AAAJWV toska_g_Page_123.tif
acec1c5d44677718c64ad56bfaddca34
838a404c524890d679bccf4e40213c1a48df3166
1055 F20101111_AAAKDE toska_g_Page_057.txt
79dd0076701317f5a11c85377a8d987f
5750fd51328136d33fa3acec1a30786df91f3633
2121 F20101111_AAAKCR toska_g_Page_043.txt
87bfe7a15acf6735ff5df3ce4a6d1b73
0671aab769de678e5a988f4971ee889b9bc31cf5
55417 F20101111_AAAJXL toska_g_Page_010.pro
412c42823a1295c19537049c2139812a
b922f852681ccf7f71bd166f9b3c3213a2218414
F20101111_AAAJWW toska_g_Page_124.tif
8ced32a0188e4cf7054226fd915e5416
63d2e0e6224c74d6a540b31dc8695616600382b8
1935 F20101111_AAAKDF toska_g_Page_058.txt
192685c029c5f85b9726afe0673433ea
39bd4532e5ca40540b1b6205dee7aea658c4da82
2328 F20101111_AAAKCS toska_g_Page_044.txt
d60854a7226bb71fa2f08a9150a1ef52
d5f1bf5aca7b18378f26a45bd695bd6a5a541e1f
52479 F20101111_AAAJXM toska_g_Page_011.pro
da42d300a4255b470deccef0cf43a1ed
d4d9a5d29d11beb72995367d789e87687801b141
F20101111_AAAJWX toska_g_Page_125.tif
cba0ae4685843363b7e4ea622d8fdf6d
b40109afbf5e59f9b4f333c91de6a5229caa1cc2
F20101111_AAAKDG toska_g_Page_059.txt
a7051687e3c9d059e3ae1716e0d2514f
bddd0ec5085c7e382364305aff02f2e398238baf
48434 F20101111_AAAJYA toska_g_Page_028.pro
2f41fa01de9e0034f730664a9daca225
6028af7a677a92167791a1e273fd93d50c0be035
2141 F20101111_AAAKCT toska_g_Page_045.txt
258334ad2bc2408acecb4c04bf1eb811
58f567ab21c5919dc5557248768390fe45db6308
6530 F20101111_AAAJXN toska_g_Page_012.pro
720530cef99c18800597f318f5083d03
8caaf0dddbb973fa6effb45defeb291b69d63460
F20101111_AAAJWY toska_g_Page_126.tif
743eb61ae7c1d0f80bab87c3cdbb94d8
eebe5af4946d8362b2704b35b1dea5dc29c1def2
2164 F20101111_AAAKDH toska_g_Page_060.txt
f14904aab3ccf0c7429492db01bd46cc
68cea2a20446dcc9907fff123086a3cdd1be4bd9
46743 F20101111_AAAJYB toska_g_Page_031.pro
b7c810c699caaa590a87d96333401c7b
0e34e88ccf393cef207114805be44f6de3ce6064
2189 F20101111_AAAKCU toska_g_Page_046.txt
869c71a45026e3ac6538bf896bd19acd
23adc15991c14d5a5f51cb74672e282685313c07
49429 F20101111_AAAJXO toska_g_Page_013.pro
ef466962abc167f1426acb6a0d513baa
9e16f7386b7a4f7a934a8c819acefead4d189f3a
F20101111_AAAJWZ toska_g_Page_127.tif
7fd086f2fb0400dbeb5d34d2b82e4df1
b7e0540d2025095cbae1f469df7702b46cd3af7f
642 F20101111_AAAKDI toska_g_Page_062.txt
e23ede22c961e0f852b16b02863d3d8f
a9656b8336b15863e96397a192f0f141dd167422
50209 F20101111_AAAJYC toska_g_Page_032.pro
2e03a247fa439bcc079e1956d2b0d47d
8e253b04a2feff9e5e2afd7769d9bed7bf31f42d
50134 F20101111_AAAJXP toska_g_Page_014.pro
9c7fbe46e8b7b2bd79d5ca638c833dec
7189fafe0bdec31203e3de1245c5bfbe2135b063
1961 F20101111_AAAKDJ toska_g_Page_063.txt
242aaabcf5e1277205d518ee60c44bfb
e23fbcc9efe717d8fe72073d0340e6c395df15ef
53766 F20101111_AAAJYD toska_g_Page_033.pro
ba56f876db63594e2c5e9a46f2378f53
37977740fa5c2aa1ca64dd785b95f7a9d0202fb2
F20101111_AAAKCV toska_g_Page_047.txt
45f565235d50d6d3e63e61c78c979f09
ef968c550f27821093525be98ca8821ffd0c4d3d
51927 F20101111_AAAJXQ toska_g_Page_015.pro
5fa9cca58362a42eba84270b1068db00
8f581fa2c1adcecd5dd88dfc988ef930ad1b9b51
2110 F20101111_AAAKDK toska_g_Page_064.txt
c459755ce3386eac58cc583d9f8171a2
f1186be220ca268da16093f621e48da65a510957
56032 F20101111_AAAJYE toska_g_Page_034.pro
708597af5f6ea1a4fd883d41b745fd19
4c3711567a22fa1a46cd4163603c0eb6d5bdc350
2100 F20101111_AAAKCW toska_g_Page_048.txt
f3a9d5b294db18c36032837dedb63f49
fc913d3aed81bf96f0537194ae7d0148b8c0e18b
52804 F20101111_AAAJXR toska_g_Page_016.pro
560074165db1cd40221a26eecd74dc7f
2fe3910736ac91d1ffe99f288fac47846aff9ed7
2092 F20101111_AAAKDL toska_g_Page_065.txt
ae5c4db3f11106a3a1d2e55ad952d273
769ecd8519d5601e337099b93ab7999199369c3b
51400 F20101111_AAAJYF toska_g_Page_035.pro
48b790403fd0a217308bc3e9b1899bad
c28510aaa28da2bf7520a14415bbe20cc6cb49c2
2106 F20101111_AAAKCX toska_g_Page_049.txt
4a37dc2f11a8d37826863550332a4ed3
fdd0a456a729acf34cd5ea918526a99be62d4b74
2119 F20101111_AAAKEA toska_g_Page_084.txt
11c627911d2590a997f990732168429d
deb68a06428c289097a8dae526a1f4d5d9f3a5d2
2187 F20101111_AAAKDM toska_g_Page_066.txt
ffccc4a628a258b4ce72aa7896fa3c1d
663cac697932e949478b27fadf352a9528c55208
51309 F20101111_AAAJYG toska_g_Page_036.pro
a534e5eb52c660fea88362df55b1be9a
216f8de1966701cb91552750752f1d950979650a
2066 F20101111_AAAKCY toska_g_Page_050.txt
b0a130720e7fafa530f547cdef0a18a3
4ccb278886a835a7cf3f40482b2bc1a9b2336a4a
45175 F20101111_AAAJXS toska_g_Page_017.pro
ab8b5ab9fd14ccc6b5c9a3bd0f780163
0c2e5155a5e5f7356b03b45fc42969fdfa98a3c2
F20101111_AAAKEB toska_g_Page_085.txt
98678c2497f02d28b5c6853b516656ed
d4ea2149f64b4439d7105431239fa2521f2baf05
2037 F20101111_AAAKDN toska_g_Page_067.txt
c1c421946e9836d4807ed03104791d2e
7a95f384aa2df3028c51317ea9a689a377b1aa8d
51613 F20101111_AAAJYH toska_g_Page_038.pro
2bcf39073a80269493491cb0144af2d9
7baa0036d8e9ade11a575196df043e682a176f90
2259 F20101111_AAAKCZ toska_g_Page_051.txt
12e5a62049186a17efe545e0d4182010
2c27951cefc86941b43e51e5277a8ab279d352dc
49663 F20101111_AAAJXT toska_g_Page_018.pro
5b0a0092bb31107752398a1bb4425c0b
b4235b6473777383b325f4d677d4e5ed2056c8c4
F20101111_AAAKEC toska_g_Page_086.txt
ceca21572192d7f572e7064d3db5397a
9fe3b15bd2d16d0c646e67d2c1db902f5571f8f3
2268 F20101111_AAAKDO toska_g_Page_068.txt
c7a086b482a8235f16edd6758f347e51
6074e8a3cf76eb593d80722894b7162d8ca036b1
52835 F20101111_AAAJYI toska_g_Page_039.pro
18d315917f0beec1eecb180fa2bbf5c7
58b22e687d7d427ea3480962fabba569b1d16977
55162 F20101111_AAAJXU toska_g_Page_020.pro
39cbb3d5c67e83d33b60a68eda7b6060
263ad01ad4411dc7f0db231a90f5519de8530757
2063 F20101111_AAAKED toska_g_Page_087.txt
ec4c1accc0bf59b56be0a08ea78aa3db
0ce0b0186f405703c97a47e6556fce162d31900f
2155 F20101111_AAAKDP toska_g_Page_069.txt
c45db41d9e47c80d61d4a12bb1218e49
843d88b93af3e5c75cf27017d22fa18cb7869fdc
53072 F20101111_AAAJYJ toska_g_Page_040.pro
998c2a519926958d1285c8dfd140fb9f
429f78a552e04be383a58b7d05cd5cf26dda7aa5
55693 F20101111_AAAJXV toska_g_Page_021.pro
da740161d5fafa6cd62456238067eb7b
e0622b23e83da0de8441e233a5341cfff23571a6
F20101111_AAAKEE toska_g_Page_088.txt
8546d1baab1ab19b7bcb27b54da14317
65e1e3045b1d0a3b1201847f57b00037c622aa7a
2041 F20101111_AAAKDQ toska_g_Page_070.txt
85e5df5426ea706c5a74834db811018e
32d358e9d22ca666c6d4e71dbbf4fb637cee4fa4
53189 F20101111_AAAJYK toska_g_Page_041.pro
bb7b957166c27920ec46799522229ed8
5791f9451c5fd3efb1ae8952c6ad5a76efe76a47
53773 F20101111_AAAJXW toska_g_Page_023.pro
88406771b695e1168ac10f93b397ef11
6a16e30edc3308ec313591d5db7fc451f5c77540
2158 F20101111_AAAKEF toska_g_Page_089.txt
cb80179a4ce75e383fd838372fc5a9e1
cfd18dcc4fa52e8458fe1f8e5aa5a29c0424f901
2022 F20101111_AAAKDR toska_g_Page_072.txt
b5a42c80afc6ff337eefc509fbdd70bc
6f17c80a37ad7717e203a357194a2f79f566183c
53833 F20101111_AAAJYL toska_g_Page_043.pro
067f0911b63d117ea5a11429b2896f09
106da8693590702a00c46c85d06970dc55823edb
50525 F20101111_AAAJXX toska_g_Page_024.pro
528c5c15c374644115fa8f58f6ccf67c
dff424bc004d28763c68fc68acd3258dfd89ae18
2204 F20101111_AAAKEG toska_g_Page_090.txt
20036cddb04e53692cc447215aff26e6
698dac4ac1ff3e9fd9cb8aade193cb1f0dc81ec4
55090 F20101111_AAAJZA toska_g_Page_060.pro
45d3521908817e9c7e1def37719ea152
6958dd747a1b10f5e955ef9f524057f414b87337
2072 F20101111_AAAKDS toska_g_Page_074.txt
0c739be36578c9d0acc613a04dfee20e
e93b8cecbb260fdb11bc46b4352441d8fb8dd7a3
54507 F20101111_AAAJYM toska_g_Page_045.pro
ad1dab97c78912874ab7c660fb6c8d1d
b8a33bbba2b5a6074a7ebb9adf744fe0e1305234
54901 F20101111_AAAJXY toska_g_Page_025.pro
2243265a7bc73152a711f749f26972a9
b2939769598889569673125e62176d6fe2ce39c5
F20101111_AAAKEH toska_g_Page_091.txt
50be3accea474df9aea74881d11256c9
3fb70917acd9955496ad6cfc2e1c12db9fe59261
55124 F20101111_AAAJZB toska_g_Page_061.pro
b019e410e2ac3402cac2b4b89fe39016
7a96d3d7e105aeb46c1216a0c1fb4f1a198d64f7
2246 F20101111_AAAKDT toska_g_Page_075.txt
ebb01e26ca71beb092dcb3cb6b4b3b76
198572c831e783b114923da1f366fdcd029264e9
55805 F20101111_AAAJYN toska_g_Page_046.pro
2ad434672c102d6f251b18658f8e7587
d710b586f383d54979f7f8852e1fa43e6cd4f73b
53868 F20101111_AAAJXZ toska_g_Page_027.pro
7752ca2be7ddf564c142b82821369805
ef22fdc0466bd89d7ff85e038ab516a4dd5f130d
2019 F20101111_AAAKEI toska_g_Page_092.txt
6a804c949f5d687d420c1100b567e00c
07dcec3034b3fbed0e760d9e5f1eae497fb91e2c
15024 F20101111_AAAJZC toska_g_Page_062.pro
9d10e103e2948a17a83009b7fcda54de
614ecade7decf30ef223d680fd0724c3c3852cb3
2130 F20101111_AAAKDU toska_g_Page_076.txt
506f0326768f68cff28b2580e1159b54
9c19b846a5ea050c7c2c29b19821e33dddd7b609
53659 F20101111_AAAJYO toska_g_Page_047.pro
144a6f5056c6be9a7abbfe04ec9a015b
12d81af89a733638f54b8987f06b0d2c7373dfcf
2052 F20101111_AAAKEJ toska_g_Page_094.txt
dca750bea50c5203ad809fee0e5ccf0b
75e7b721498c30cfab987110f292f196fd4c1b3f
53573 F20101111_AAAJZD toska_g_Page_064.pro
6646d325b971423834196bf4222620e7
d506805b104442bca1709bad4e5c3caa313f0f87
2162 F20101111_AAAKDV toska_g_Page_078.txt
b71f04a241e07389e249853c96deb146
f4526327e4568a8429c6fb26e8873bc01e1ad530
53187 F20101111_AAAJYP toska_g_Page_048.pro
14ff81830c543112e1e50ee4b016adb1
cf5f42dfa2a177fa094c5e962f884349ada6c21e
F20101111_AAAKEK toska_g_Page_095.txt
8ca08ab23aa7f10755b0b300c7c319d0
80fb976b8aa09c3f4f1c119658cba11d90879ac8
52426 F20101111_AAAJZE toska_g_Page_065.pro
5d795230e893aad3fc520c19e8f9a15b
cc0b7b8e0b7a01babbfce604d46915c77979a6e0
2256 F20101111_AAAKDW toska_g_Page_079.txt
4336d1f7f12e5897fc27be9b2f019a5e
2199b6c4814c608c673bccab15b86d28acd9f7e8
52277 F20101111_AAAJYQ toska_g_Page_050.pro
c4d38df11d38c07e1d1c5597880d608c
25b0c0eb63b58510cedd7f1f4326a4f6b9d7754e
2175 F20101111_AAAKEL toska_g_Page_096.txt
0e03d16169294386a7a54e6280cec579
2b530a7e23b998a4387ed821785999bce169edb4
50898 F20101111_AAAJZF toska_g_Page_067.pro
7b7079942d8d3305e78f0ff1dbd10fc6
b57c143e483a62c7f22a23b10e9f593e981e7e5b
2408 F20101111_AAAKDX toska_g_Page_080.txt
de6bbbe6bbe76e4f6a9168c433471401
24015591c9f7ac5f0f482092188ea01c05b50c7e
57710 F20101111_AAAJYR toska_g_Page_051.pro
c4d23e619860a00c58475466848da32b
e555d65798241671d54edb92b0eb0d5e393f6e6e
F20101111_AAAKEM toska_g_Page_097.txt
c7202ea62385bce57efb4b49b96da0af
da4cdde8b11586a48db67cb5db7b17eeacf2a3e4
57651 F20101111_AAAJZG toska_g_Page_068.pro
3129d7251c8ac6ab4aadba72e458bbe3
e75dd79e842d6a0c329546e457b6647b2c90e42d
2703 F20101111_AAAKDY toska_g_Page_081.txt
628d6aa33e9096f677b868f9c959d3f0
d37b40e205b038319c4d0b4eabc08e41c9b7a9fb
54706 F20101111_AAAJYS toska_g_Page_052.pro
d6a7f1bc34d1b91687b8900905f7230b
b09102cf8edc9206fafd24129755d5c32687cc4f
2084 F20101111_AAAKFA toska_g_Page_111.txt
9e9a37280c68b806f290695616feeafb
81c1ad84707def7eb58743de7bb7f01025d6a649
F20101111_AAAKEN toska_g_Page_098.txt
28f4354a87bd9900888fa963532303d0
759d8f7ffe82eb47f50cd5ca712724ec2d3a0ed7
51845 F20101111_AAAJZH toska_g_Page_070.pro
3634bdc1c3c53da6fd7e612ecbd88b9d
34f3d0161cc747c801a69d6ee69a7f0b4773ada9
2890 F20101111_AAAKDZ toska_g_Page_082.txt
39e42ca4767fde4835e4903783d07976
c9cdcd5de54cc775824282e2c11459d96ef94e13
2058 F20101111_AAAKFB toska_g_Page_112.txt
271256fe6b56cca4ffd2b972c7c03e15
94d3cce317fa2cdb30e146125c7861777eba5d51
2151 F20101111_AAAKEO toska_g_Page_099.txt
d538dfecb8cccf0a05a12720229e5cb7
cd36c6954cb71c6f2cd0d9f6f678398aaab6a948
54649 F20101111_AAAJZI toska_g_Page_071.pro
cbbd01519928cbeb31dfe88666d7347f
67ce789d2317533fe11bc86dfa64918e5607658a
52073 F20101111_AAAJYT toska_g_Page_053.pro
78f41294e09ac36781a097f5caf399b1
5e3213d36c1f4eadd5a6064bc1c52915d27996ed
2152 F20101111_AAAKFC toska_g_Page_113.txt
34b1e045760b14ab70479a7b8b4ec707
82baa02979dcc398d352003a9280d71ed5835cfb
F20101111_AAAKEP toska_g_Page_100.txt
9c0c043964bf447e4f4c02feef24861e
db4bd26eaf30aa31dbbc4c3cfe926ac165e57e86
51154 F20101111_AAAJZJ toska_g_Page_072.pro
8f5dcb108862365bcd47e35cb34694c4
1059f980c12581d02f7ad4fed9cc4d3945f216df
57374 F20101111_AAAJYU toska_g_Page_054.pro
8ceb396781f6d89f7be5881d316fd582
775088111ffc73f2fc8da06e71268346214571fa
1704 F20101111_AAAKFD toska_g_Page_114.txt
728aee190b0575d28fe26aa1b48c0b5b
9a95ef1256c2ad087262a0d66b50e01ff9fef5fc
F20101111_AAAKEQ toska_g_Page_101.txt
ba8834e745623c12d2e71d26fc4973d1
c427a0e47763d2b0a68fba4756a0a75e78f8134c
51411 F20101111_AAAJZK toska_g_Page_073.pro
cfd0e19e69320b700f76faacd15a6afc
5f9b1fc8d0959234412cc9001228ffa66f96e333
54456 F20101111_AAAJYV toska_g_Page_055.pro
543c0a09d45520adba42d33dc9303ce3
e95d5b78cd75c7479cd5d2c191aae579dafad37d
F20101111_AAAKFE toska_g_Page_115.txt
ca6833f7cfc56e4cf3d064282e92e977
9f3e67219282e3a57ce23b49a1d24e64f34098f9
2104 F20101111_AAAKER toska_g_Page_102.txt
e03f3a847fe1e4661ed17da619e065cf
b6555fff75551adfc396dccd1ec0fbdca29ae186
52344 F20101111_AAAJZL toska_g_Page_074.pro
feb0c24b3e19fd4b06433340b32000e2
bdbbc7b2ea39a757fa5b1770ce336ed7a7101611
54281 F20101111_AAAJYW toska_g_Page_056.pro
56c0439fb0a4126cb2b5e2c375a553b9
f7f25e13a9399a4a50306a472bfc0f344ed4556d
1395 F20101111_AAAKFF toska_g_Page_116.txt
1c7aedf7d13239d18f177daa94a376cc
9661c129045bc429f6a7702d23ed6542b4a419a9
2167 F20101111_AAAKES toska_g_Page_103.txt
e8a96e8324541f77b1fcaafe41be927f
58e829410ac0e17a03e979940e82089ad43282b8
53934 F20101111_AAAJZM toska_g_Page_076.pro
d388e795fa8be4494f7ae33af36d31db
fb92d0820d4420b79a9cd1892d4bd00c50c24234
26489 F20101111_AAAJYX toska_g_Page_057.pro
bf4aa5c2ec54c9ab89ac9d0b19022e86
a018a314ba03566b848d2b65f71091de0edc95c9
2653 F20101111_AAAKFG toska_g_Page_117.txt
72d3704636f2a86eb62c6e5ecd60802d
2d0d97eb62c7240cee7320dc4f07674bc992fadb
F20101111_AAAKET toska_g_Page_104.txt
520698e2b2f01e05c9edceaba782aa14
dd1829ad8bacd8fc4f8278c65e89f94f3c3bcf70
53521 F20101111_AAAJZN toska_g_Page_077.pro
7300a762bd482109a0e6d230f94fc01d
ab6687c704610f5e7aa68c647979db4a5427d3e9
44568 F20101111_AAAJYY toska_g_Page_058.pro
142ce61f9a18573a37fd5b3434d80812
4ba7168d0215d7ee8d8875d18cb9706b8d1a43e0
2605 F20101111_AAAKFH toska_g_Page_118.txt
17575a8fc218ee0c4f89cce4bcfe4201
5cbd094e250acaee03d1b781aa79cc2441793b5c
2139 F20101111_AAAKEU toska_g_Page_105.txt
54e16fe30685ed8eb24030f0cef90cbd
f7d0e5990d187daceeaf7fd608cde7a008241cca
54887 F20101111_AAAJZO toska_g_Page_078.pro
c1410065ffa6c234e2c680c6c832e09d
56fa7ae3374d78d759bc95dee798e1da6591f63b
50892 F20101111_AAAJYZ toska_g_Page_059.pro
03615ebbaccdd07bcd22d159062d32f1
779ddce4d69202daa351e2827cdea38f6c354629
2172 F20101111_AAAKFI toska_g_Page_119.txt
61255bbebdcf1ab8beec47e0b20d7e26
563f72ec030596b6d2397931a7434067a1efa830
F20101111_AAAKEV toska_g_Page_106.txt
9d144935772c6563156fa567ce141483
57bebb7f4e9aa4c691788a9d30a824fb7cc70c2a
57542 F20101111_AAAJZP toska_g_Page_079.pro
35e205cebfe5c88f1bbff57f6ea0bfbb
41fd44fc450ffed396e3969e33a27662164e0c1f
1434 F20101111_AAAKFJ toska_g_Page_120.txt
36a9d94f92a09c6c192446e9ec0683f9
a3a0b2d76fbe530c4b3a10ca0288a6f3dea26efa
2109 F20101111_AAAKEW toska_g_Page_107.txt
7e6b61763475ed8720f5f7eecd485d9b
076b2bf88cbe36f0bcd57d4fbbcb0bc5700800d3
48575 F20101111_AAAJZQ toska_g_Page_080.pro
5f2949bf0666b221466ebc6f95345111
3ca6f5575d5f248b3abd5c9507b527cfc2efc679
2552 F20101111_AAAKFK toska_g_Page_121.txt
0ddb3aa471f805d32e5f20803cf4fb54
b88ae519125702f12121f5312defc6f7a234f32d
F20101111_AAAKEX toska_g_Page_108.txt
5553583fca3fc997cb37101c0a30b3e0
65cd0d60df6fccf1c96082d7965c4bd51a0fab97
65566 F20101111_AAAJZR toska_g_Page_081.pro
4b2cd179d7674262c4c511e2e92c76cb
d9bb01c682b7910078ae68e91f062eae44f0e422
2686 F20101111_AAAKFL toska_g_Page_122.txt
64e60e33acee610c028eaa467bd108a2
3b1f02bb1983caed4af78cad93407299e34df3ce
2140 F20101111_AAAKEY toska_g_Page_109.txt
d430541214b36a7136d0b403cffd204a
95065708170ed4cd97bdf1f12b54dcfb832a86a6
54271 F20101111_AAAJZS toska_g_Page_082.pro
d56ee5c4c4416b0d83d6b46088e47d56
9597e9205c490ac46e69af0a973616f02201020f
34949 F20101111_AAAKGA toska_g_Page_109.QC.jpg
6fa4e77329212a5dd123fbef9c47c402
6329554e339ec0597b8690d98054c75ee57ae25c
2624 F20101111_AAAKFM toska_g_Page_123.txt
a0c21fe49a402fed2cc2140ebaca27d1
f31d9ca930ddd22778444201ed1d54eea53481aa
2294 F20101111_AAAKEZ toska_g_Page_110.txt
2e84b5a4d5aaa25c71c9f0b8368fe968
6eb45ff30c344e398219c3950484aaf0167da434
45021 F20101111_AAAJZT toska_g_Page_083.pro
9eff6684978575e092724273a3d60645
b1c1df59d1160e6b0114b13be604122530fff1f8
27806 F20101111_AAAKGB toska_g_Page_114.QC.jpg
d6d9a8811d78360657f97c21b83db568
b0c4eaf228dccf1d23f1f34a8a5d05ba16310c4c
2683 F20101111_AAAKFN toska_g_Page_124.txt
250b9dfbcc0b09043cf4543bb1a2f505
1b4b004a5c78498836461a387de846f1140e71ef
5949 F20101111_AAAKGC toska_g_Page_012.QC.jpg
b3af6c86397f6e2a2d8c7f2edc5d06a6
fb57107f95eaa0887581c490c8ca49162c6bc628
2484 F20101111_AAAKFO toska_g_Page_125.txt
810d7ec361248db09f027dd5524610f9
9a4ada94b337618f2e26c8ce2a515e5138715341
41904 F20101111_AAAJZU toska_g_Page_084.pro
8599393e41c7ae9ec6370704e921e9af
d726931e3d28b0201210d9ed5264ac5ebfd54654
9020 F20101111_AAAKGD toska_g_Page_075thm.jpg
f09c3d5cddd2b1e7c8f856c17db0fbd8
e60f0c446155be26257755eb95ec709fa6a4ebc5
2698 F20101111_AAAKFP toska_g_Page_126.txt
827073dcc0eba724cff784c66bcc9b2e
ef45f1e02ea96dd370267a2ae1cf7f2de3c3a552
51843 F20101111_AAAJZV toska_g_Page_087.pro
82d9102fa68ffe7c44f32da7288de5b9
737ef2cf126b46543c71976718100d7e031769a8
8195 F20101111_AAAKGE toska_g_Page_035thm.jpg
888ae1a693117ea33e71b94ec166d597
f00a35aa53df4e96441e1076c864eb04960f92e5
2438 F20101111_AAAKFQ toska_g_Page_127.txt
13637083068bd9f9f26a4071a488850e
12e4efe4f22a1562b034c26ee8b6ab1be8883d93
54961 F20101111_AAAJZW toska_g_Page_088.pro
53dd1f67f1aa0d0a81af2d6f1dfb6751
d0d4824f82f5983154fa8903250485431c981382
6180 F20101111_AAAKGF toska_g_Page_006thm.jpg
18dc547da576631c82587b09f9c44e73
a698de8009fff2bcbe6d0cd3d21d95560a77b86b
644 F20101111_AAAKFR toska_g_Page_129.txt
3a8a5bc019aaa61bc96e916880b4cc6e
9e86094f78deb278a17b381e79d40a211983a805
54749 F20101111_AAAJZX toska_g_Page_089.pro
e9391814188c616dcc5408b7c82c7ce3
9eb040b4ed2a1d40714c1afea822d0f6788f5e2f
35292 F20101111_AAAKGG toska_g_Page_125.QC.jpg
15f50e99a230dab18a0aa06495e83239
4ff5b1b1c3dca253999bf0be8e020c0a5a12408d
F20101111_AAAKFS toska_g_Page_001thm.jpg
b29ef335a24e1063d1ae872286c8a017
45f7e3b2a367d5b1e194df541c9dfce08e38d90c
55768 F20101111_AAAJZY toska_g_Page_090.pro
26c6d8b02936be2a71ea7f5c78a8fdda
52f439ce621d480c063d17ac4f9a41bb944a6727
37054 F20101111_AAAKGH toska_g_Page_016.QC.jpg
dc780143d61a54dded1ec5ea9a77a21a
fd4d26d685bfabaacdcc5f3427439ffd358039c7
440595 F20101111_AAAKFT toska_g.pdf
bceb162045f404e1a4f4f3b4cf35ed89
0c831a8fb83c90d0694545a6f3ba64e3b0d787aa
54067 F20101111_AAAJZZ toska_g_Page_091.pro
f167e33eba248e132bb7e5b95d22a436
7911103b8bd3fa3c9438145a73fb3258062695c0
34660 F20101111_AAAKGI toska_g_Page_112.QC.jpg
d6eb9e959d81404b7eac25c692bc2415
6fb5e3d2d894fd4fc5d90808c9437456d139d099
35396 F20101111_AAAKFU toska_g_Page_056.QC.jpg
af5f995b4178b255222c90b3799984b0
82026d686b2ef1c7e5847dbebaca557bc905352b
1335 F20101111_AAAKGJ toska_g_Page_002.QC.jpg
839a0bf8d2f3887f1cb395d52a5dcba1
3c08362cf6131971482b0437eda3b8d344417065
8843 F20101111_AAAKFV toska_g_Page_101thm.jpg
f24db4fc118621fde55a67e8e43a5748
3c9337189817bd58fe03ab21c771e05477bb9a12
35987 F20101111_AAAKGK toska_g_Page_020.QC.jpg
6f9a8f2b431f54e925d7006fab408c78
8afe0dd5a43ac5aecba618425b60b02d86316a2b
8304 F20101111_AAAKFW toska_g_Page_107thm.jpg
db526edd0e6ccd2422e2109803b39463
3e125cccadd8449cf72ac0383d8c8a8fc226851a
36410 F20101111_AAAKHA toska_g_Page_066.QC.jpg
8fa7ae913c83e33df82797b6f64bd624
596c63354dfedd4457ff1993fc2b6a5c0c19bcc0
8680 F20101111_AAAKGL toska_g_Page_065thm.jpg
c80e234bb89cb74714715476ce5a633d
b2c588bd6f5c49d2a34616ee0cc9533421858827
8367 F20101111_AAAKFX toska_g_Page_108thm.jpg
60a64e0bb4eec43e1e8edfbd7ad7646b
881cc3ee9a84165e4de160affadf13621b1ee656
33663 F20101111_AAAKGM toska_g_Page_022.QC.jpg
2adb54bbf1fa77ee9950c5c1db1d95bc
acf33353de51d78f11c90e1a5255157adef69bdb
8778 F20101111_AAAKFY toska_g_Page_060thm.jpg
a1452a6dd52c0eb0b500c97ea329c1dc
359d09c132f1b376a607e6e81c2412af3f0cd4b3
8192 F20101111_AAAKHB toska_g_Page_022thm.jpg
3012de62f16f27686893d08ee0609319
398f6fd5a5049856c9166a570711e403160d2471
33967 F20101111_AAAKGN toska_g_Page_011.QC.jpg
884930bb4b2c25b3d645c04ebb35744b
a2fa3abeb93c6b609d9a3fb1d2aae8c34ff0d68d
8212 F20101111_AAAKFZ toska_g_Page_086thm.jpg
2c7e544ee7a4ad635b615721d5becb87
687304ae2232a823a831cad5017f487f5c53edd2
35807 F20101111_AAAKHC toska_g_Page_093.QC.jpg
9c8df145400ca6f08ddbdca2d65ca0be
89879128f95b222289cc1bc890dcc3471c7fdd22
33908 F20101111_AAAKGO toska_g_Page_035.QC.jpg
a0cf99d4480fd79ce1ae693a4b2e10c3
a1c953d409a035ee3e71d9b3ec2851717a0607bd
34921 F20101111_AAAKHD toska_g_Page_078.QC.jpg
eb49eebf54c1005d566e2527f15a0963
21483f647e93ca7a9faedb98a8e02aff741ede6f
7034 F20101111_AAAKGP toska_g_Page_083thm.jpg
6ea8211abead3febbd486e4447f1e16c
4ffc4dfeaf34587dd9629950ba0eb86cff13fb4c
5411 F20101111_AAAKHE toska_g_Page_007thm.jpg
a8c6529d58afd6fc569e310d7d33902b
2a3a579c40a051cbc5d3ee174417ee51903bd71d
34586 F20101111_AAAKGQ toska_g_Page_077.QC.jpg
f15cd4fd2d3bca22379a2debc176fb2e
d363c7e2e1d284f91d591277148c93ba700ad44f
34942 F20101111_AAAKHF toska_g_Page_127.QC.jpg
d94e01e7e11a99c0b71fbf40adbaafdd
9fabd4eded5005b6ce85be64f09666b7d67dbd03
1659 F20101111_AAAKGR toska_g_Page_128thm.jpg
7217ea672f143235ab2db2c308a518f5
4ad10d985c7b8b085e756cd152d926355897c185
36677 F20101111_AAAKHG toska_g_Page_033.QC.jpg
45177406659fd2187ccf4834e7c324b8
83a08fc0e7ce536b1972a9119dac1cbf3ef55aaa
8397 F20101111_AAAKGS toska_g_Page_011thm.jpg
8dfc28a7636504f7f8dcd14b3c5cd341
54863117e380f981db119a203471c01f9344cdce
8780 F20101111_AAAKHH toska_g_Page_015thm.jpg
bea951dc7e1d98336839c422f091e5a6
8a44c52eefd6882297b38e536083d6c483b1c9cc
8849 F20101111_AAAKGT toska_g_Page_021thm.jpg
c25ddf12e0f736b0aca286a205af032e
ed6f4b87a84f6e8e8bc483bc7fe57f594d01cd49
32788 F20101111_AAAKHI toska_g_Page_067.QC.jpg
3d9ad1201b0af47584141e3978d55357
ff2807d61dfd6a653014035d73018ba64b495f91
33794 F20101111_AAAKGU toska_g_Page_026.QC.jpg
7126bfb9bb7b3e3965c8684cc74cbe21
d00a646c99985468a082f0a08a6016322b95aa77
3267 F20101111_AAAKHJ toska_g_Page_004thm.jpg
03caa4336376452e4760e06ad24f0d29
6fedb0bfb287e096fbfdf8a24cc0fae397f3164a
8713 F20101111_AAAKGV toska_g_Page_088thm.jpg
9a7334d382036e6ecd79ce6456396e81
d14b71fdb452dddf9eb6808d140059674e14205b
8928 F20101111_AAAKHK toska_g_Page_076thm.jpg
521e4f88bd982ff8cf4bacd16a386548
e64ee2b28c80f251d768a3810972a4ec7acf92cb
34407 F20101111_AAAKGW toska_g_Page_018.QC.jpg
44d63ef70ebc6e4b1bbab00f47515001
45d22f358b0bd4fa7fcd69d3ea7a6451c8ad35cb
34341 F20101111_AAAKHL toska_g_Page_102.QC.jpg
56662592c4dd347fc6c8ced17b70af15
7e1699f11786b6e8f7faebbbcabe83e1f112e9df
5937 F20101111_AAAKGX toska_g_Page_085thm.jpg
28ca0c385fdc8f8b2f6ab88d084fc20d
28e4d441b08bde86e6e70100dae3c027669c04dc
F20101111_AAAKIA toska_g_Page_037thm.jpg
b930202e083508e00522b194a0b4c0c6
b5e3ec695701d8d12e34a9ccca4f3963cae498e5
34775 F20101111_AAAKHM toska_g_Page_087.QC.jpg
e77c311b4dcbe3f8b1026ec614826ded
fabf3c38c5abdb2da028d1a7130c61581c7d965b
5120 F20101111_AAAKGY toska_g_Page_116thm.jpg
05c3254e69767651cf5ff97307c43efe
5066834b70a721100c554f1ecba2eef2ef664821
28500 F20101111_AAAKIB toska_g_Page_058.QC.jpg
3127185381ff4071f51110ba81eea050
1f8cbb32449bd4d0f1232065255bc5641f56a075
F20101111_AAAKHN toska_g_Page_054thm.jpg
840ece7aab067dee3009b84b69156023
d1b4e62d1eff072da434d7b8816b3ff127d19e65
8785 F20101111_AAAKGZ toska_g_Page_077thm.jpg
c59ecbf17aa4dc9ce0c50d83d9bec83f
97a74cd61e1a21a54318019fad144d4d5e478bdc
8428 F20101111_AAAKHO toska_g_Page_073thm.jpg
cd1302f3d11f4b4953ccd7048b05d7c1
973c703d6110b07ab65be093dfedbccf60dda60b
8538 F20101111_AAAKIC toska_g_Page_106thm.jpg
00bcceab08370bed67dbb73f49c60285
433aad05c164fcf2ab292d6b072879e6f2d56352
8684 F20101111_AAAKHP toska_g_Page_027thm.jpg
50b76b1e841f8dc927027b6ae36d086e
e56d9f866167fd674d57c5f19db07d15ac9d7a91
8225 F20101111_AAAKID toska_g_Page_118thm.jpg
648c61d02a8b3e6dd683bb43e3373606
380ec8c80c5450d415d5e6d14b77b695fd4b2ca9
34843 F20101111_AAAKHQ toska_g_Page_048.QC.jpg
c3c918efc31a630973d82a2daf41d40d
5420485729491921d692cc5e8cc1807f78f0da4e
34717 F20101111_AAAKIE toska_g_Page_052.QC.jpg
e216957a025599738b4e633cbf4b66f4
851ea1c6db8a600410423c3a2b573fe1dc37dba7
8471 F20101111_AAAKHR toska_g_Page_009thm.jpg
e84bcdb88afc268d856571b43b454a0e
27463ed9e4a53a05812cd7643d4cfa4ccb2a162a
2128 F20101111_AAAJFD toska_g_Page_027.txt
92dfaad458a7d1d5f1cb174c3e3c894b
b5c917b6f11dd806d4f7842971b65f121d73a2c3
7917 F20101111_AAAKIF toska_g_Page_028thm.jpg
89347e6068b98b8022e18ca68696b4d6
69607d4355cd01d4986b76735cc6581e676b3285
108889 F20101111_AAAJFE toska_g_Page_069.jpg
e7613b05719e15a4fb9b7a0bbfc75513
d7431688f84cb566900746e12519062f0788dc6e
F20101111_AAAKIG toska_g_Page_111thm.jpg
aec5dda4eeb419f9eb787baa244b97c2
2771fc7b8bae79f61e4ca9680f6e81bbc0cf8f5a
34746 F20101111_AAAKHS toska_g_Page_039.QC.jpg
ba5b9174ffd74c3934a2f96a31856046
d8c50a7441087b9b011ca21ecb5e3f32529e0f2a
107195 F20101111_AAAJFF toska_g_Page_015.jpg
a539d0697a9c261601fba93a0fbbadb2
c7174bba8c68d3101f68c2c1a4f6e22d5d8e2c78
5928 F20101111_AAAKIH toska_g_Page_120thm.jpg
da6aba58d0bf93c7f4bb3c91ed3e51f1
91df7914d28c65c96d44da848c66993f140e731f
1523 F20101111_AAAKHT toska_g_Page_003thm.jpg
78ec7bf6efe093794f628667282fb24d
718087341103834a62b1b8545ce80ed9d4139673
109576 F20101111_AAAJFG toska_g_Page_033.jpg
82d3e3012a7b5aa71223c85c68fdaf92
406983a10d3ebc77f54eb71b2cad6dde9a476d84
36977 F20101111_AAAKII toska_g_Page_110.QC.jpg
c6635125b988dd5c91d4dfc11feac4a1
b917388702d8f6258fdca8e2b23b316f490afbf3
7621 F20101111_AAAKHU toska_g_Page_058thm.jpg
67939082f10032a3d7df7e4f1cfc236f
26674a40ff7cb94ae196b80291e87a7b7bbd20e5
8542 F20101111_AAAJFH toska_g_Page_044thm.jpg
6c2a2e160810467cfba26c19d7cd4709
c47e5173d4a48a7f9ec20a2292ffc8e7bb819241
33829 F20101111_AAAKIJ toska_g_Page_074.QC.jpg
d3811f4c590f2abbf3e13bc878d2c537
69e6615fbe5c11e3c07435f2af8866008e06a8da
8609 F20101111_AAAKHV toska_g_Page_069thm.jpg
49c646d1317538f05c858a032bea4dfe
39291a8b7a290fcb0c96e3d9573eb9b45360fbf0
F20101111_AAAJFI toska_g_Page_016.tif
42619d73cb86bcaae909289b98e00af9
988e5d4d3f97931fcdafac0fa6ed824acd419376
F20101111_AAAKIK toska_g_Page_055thm.jpg
850a63673724e95405cbce0f0e818d83
7cc7b65e56a00b5214cc28a3e3e347aadea54fbd
33846 F20101111_AAAKHW toska_g_Page_097.QC.jpg
eaf87a758efb69ae38579f98e7c0476a
a4843cd14adff74011975e6e0225e017789caa07
33822 F20101111_AAAKJA toska_g_Page_111.QC.jpg
ac713792931c01aabece28f4fe71611b
f145d4526426ee34319ccb2879ad5f7f524f40c0
F20101111_AAAJFJ toska_g_Page_121.tif
2387f8760933526b765c9ac499b0ab8c
cc4adb678d3c81582d264823813cc70afcfb2063
8349 F20101111_AAAKIL toska_g_Page_115thm.jpg
337654ee989f2166194fbbbe4f684c98
5245e1e1a8b4d30c9476875bb0d2aa6c4a46c1db
37593 F20101111_AAAKHX toska_g_Page_122.QC.jpg
520f12c325edf47ed14802e8e685ca40
ef21e14a822d9c92d2992f74ee4f534d2d9dfef1
35682 F20101111_AAAKJB toska_g_Page_104.QC.jpg
f4999cfd071a56b4dea14eaebe6a1e4e
9fbf3f122ee242f71bd5651dd96d3dad7681f6a1
59446 F20101111_AAAJFK toska_g_Page_127.pro
321380e8686931209040f751be68b94e
925d3a2e44878dc570aa059790cc55dcab7e1d58
36645 F20101111_AAAKIM toska_g_Page_079.QC.jpg
21218ef7c62ded02b970382cf886303c
bfb60a6bdd0f379c2d329059669ba6d9b0bc8832
8232 F20101111_AAAKHY toska_g_Page_013thm.jpg
e7d3dccc66515801c43d1c046a7b0616
3a8708f90c1d483f1949f9e0e23d941491f4111a
35623 F20101111_AAAJGA toska_g_Page_060.QC.jpg
85a8bf021a3838e58f01814cacbaac57
428a6dc6fc921463fb896e59f312fb770396c7a0
8308 F20101111_AAAKJC toska_g_Page_036thm.jpg
bb527535e1083ea6e21f0f828367105b
ff182201a5edb2946c127fbed58073ce86b49121
1043076 F20101111_AAAJFL toska_g_Page_017.jp2
a214d56d0bd3d1a9acdc3c2beaf5d172
f5d41167e06f88a235b2c7452c212e8bfb03258d
6620 F20101111_AAAKIN toska_g_Page_084thm.jpg
1b23ea293d7e0418388f47a7f6864461
eca6e2757613be3bc757bcc37c78f06406cb0509
8560 F20101111_AAAKHZ toska_g_Page_103thm.jpg
3ebeb2cc7e895d96e27e7f286a09bedd
5853853c97134ace4712a36ca56a75f94283f955
F20101111_AAAJFM toska_g_Page_105.tif
9e081dc0782e2020ab0c1afebbf1bee8
67cd81749a6f2148c0bc15e6f1edf4959a5c7d1e
8177 F20101111_AAAKIO toska_g_Page_029thm.jpg
e0c5468a5f350a5d2d719a3206c4a48e
0526b957e37d4e78076904265ca84834577d2b39
F20101111_AAAJGB toska_g_Page_109.tif
eba28853ae5689cb2b7edcd1add1b077
4601fa47fc0f8e786f0270f4f18a0c93eecea6fc
34148 F20101111_AAAKJD toska_g_Page_091.QC.jpg
de9c493ed509132ba23993db57b531cb
f13d03878ea9ea9856f9f0c8ee6f2de91da53328
52915 F20101111_AAAJFN toska_g_Page_026.pro
a369bc2b69ed103fd322bc7050d16f5c
f02e4dd59079badeced3a0ef66fcd36b75ed8e61
34914 F20101111_AAAKIP toska_g_Page_106.QC.jpg
558972c4c4e7fd29f1898aaae1016944
4ac3e8fa81d641e6e30a2a0355274259d5b4d2e0
523 F20101111_AAAJGC toska_g_Page_002thm.jpg
4966fbb8c8e0ce0b13e1440795f09ca8
9ba258b62bd61c2f8348db5b9846ce6d90aae016
8892 F20101111_AAAKJE toska_g_Page_071thm.jpg
d723337d8011273a2815cded9dc0199d
aac1af6c5dc21b67a4ac6cfde8fa3fc60efaa4fb
116448 F20101111_AAAJFO toska_g_Page_051.jpg
a4857b0845d5a49b8fa779bae23f900d
04a83d9d88a54729f7d996b62bd33a02785d1df3
F20101111_AAAKIQ toska_g_Page_020thm.jpg
f157a99d91f3dbf83d449690e2da5cd7
a2a0ed3a17c48040bc38896152371b05e1241015
34280 F20101111_AAAJGD toska_g_Page_047.QC.jpg
a687078f0dba1f115f55cfa8894a084e
61f736deb1408228c5a99f208acbc4a32b25a997
F20101111_AAAKJF toska_g_Page_090thm.jpg
575f23e9add247d43c309ebab918634b
7f4a6c38a65b82c7a3da48d924f34817c1399dd6
127523 F20101111_AAAJFP toska_g_Page_124.jpg
153a2a02301322eb6cef8ebff45f1e39
cce5a9a7978511835ad65719a8109c8d7f663e35
8122 F20101111_AAAKIR toska_g_Page_072thm.jpg
da4fec1b0d36a9b29c92fae3b58242ec
c2cf18d9ca74c926cbc6bb3f22284b33b16fdab2







ME NOW, ME THEN: THERAPISTS AND CONSTRUCTIONS OF THEIR EPISTEMIC
JOURNEY



















By

GIZEM TOSKA


A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL
OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT
OF THE REQUIREMENTS FOR THE DEGREE OF
DOCTOR OF PHILOSOPHY

UNIVERSITY OF FLORIDA

2008































2008 Gizem Toska


































To Michael J. Mahoney, for inviting me to appreciate the complexity of life, and to my
academic and clinical supervisors, Drs. Greg Neimeyer, Michael Murphy, Roberta Seldman,
Elizabeth M. Koshy, Marshall L. Knudson, and Paul Schauble, for their everlasting impact on
my journey. I am grateful that my path crossed with the minds and hearts of these incredible
individuals.









ACKNOWLEDGMENTS

I would like to thank my advisor and committee chair Dr. Greg J. Neimeyer, and my

beloved husband Ferit Toska, for their extensive guidance, support, and encouragement. I thank

my dear friend Burhan Ouit for his guidance in the conduct of the statistical analyses of this

project. I thank to my dear father Yalcin Aksoy for his help in improving the quality of writing.

I am thankful for the assistance given to me by my committee members, Dr. Kenneth Rice, and

Dr. Michael Farrar. I am grateful to my family and my friends in Turkey and in Gainesville for

their love and support. I could not have done this project without their help.









TABLE OF CONTENTS

page

A C K N O W L E D G M E N T S ..............................................................................................................4

L IS T O F T A B L E S ................................. ............................................ ............... 7

ABSTRAC T ...........................................................................................

CHAPTER

1 INTRODUCTION ............... ............................ .................................9

2 REV IEW OF TH E LITERA TU RE .......................................................................... ....... 13

E p istem ic S ty le ...................................... ................................................... 13
Root-M metaphor Theory .................. ....................................... .. ............ 13
Theory of K now ledge .................. ................................. ....... .. .......... .. 16
Epistem ic Style and Psychotherapy.................................................................................. 18
Epistemic Style and Theories of Psychotherapy .................................. ...............18
Epistemic Style and Preferences for Psychotherapy ................................................. 21
Epistemic Style and Practices of Psychotherapy.........................................................22
Epistemic Style and Characteristics of Psychotherapists.........................................27
E p istem ic C h an g e ......................................................... .............. ................ 3 0
Epistem ic Change of the Field ............................... ............................... ...................30
Personal Examples of Epistem ic Change............................................... .................. 32
A lb e rt E llis ...............................................................................................................3 2
D onald M eichenbaum ........................................... .................. ............... 32
M ichael J. M ahoney .............. ... .................................. .. ... ..... ..... ..... ....... .... 33
Narrations of other psychotherapists including Aaron "Tim" Beck ......................34
Professional Change as a Counterpart of Epistemic Change............................................... 37
T heoretical O orientation C change ........................................................... .....................43
Therapy Style Change .................................... ..... .......... .............. .. 44
Epistem ic and Professional Change ........................................ .......................... 51
P u rp o se of Study ............................................................................... 55

3 METHODS .........................................58

P artic ip an ts .........................................................................5 8
P ro c e d u re .............. .... ...............................................................5 8
In stru m en ts .........................................................................5 9

4 R E SU L T S .............. ... ................................................................63

D em o g rap h ics .................. ................... ............................................................. ............... 6 3
Descriptives and Preliminary Analyses ............................................................. ............ 65
P rim ary A naly ses ................................................................................ 67









Research Question #1: How Do Therapists Change in Their Epistemic
Commitment and in Professional Characteristics across the Course of Their
Professional Practice? ................................................... .... ... .. .. ..... ......... .....68
Research Question #2: Do Cohort Effects Explain Changes in Therapists'
Epistemic Commitments? ......................... .. ....... ......................72
Research Question #3: What Is the Relationship between Therapists' Epistemic and
Professional Change Experiences? ........................................ ......................... 74

5 D ISCU SSION ..................................... .......................................86

Sum m ary of R esults................................ ...... ........................ .............. .. .............. 86
Epistemic Journey Constructions of Psychotherapists ..................................................... 87
Cohort Effect on Perceived Changes on Epistemic Leanings .........................................90
Theoretical and Stylistic Change Constructions of Psychotherapists...............................92
T heoretical C hange................. .... ................................ .. .. .............. ..... ...... .. 92
Stylistic C change ................................................................................................ .... 94
Association between Epistemic and Professional Change Constructions ............................101
Epistemic and Theoretical Change............... .............................. .................. 102
Epistem ic and Stylistic C change ............................ .............................. ............... 104
Limitations ............... ....... ......... .. ....... .......... ....... 107
Significance and Directions for Future Research................................................. ...........111
C o n clu sio n ...... ... ................... ......... .......................................................1 13

APPENDIX

A THERAPIST ATTITUDE QUESTIONNAIRE-SHORT FORM (TAQ-SF) ......................115

B THEORETICAL ORIENTATION RATINGS ......................................... ......................117

C DEM OGRAPHIC INFORM ATION ........................................................ .......... .....120

L IST O F R E F E R E N C E S ..................................................................................... ..................12 1

BIOGRAPHICAL SKETCH ............................................................. ...........129









LIST OF TABLES


Table page

3-1 Personal Style of the Therapist Questionnaire (PST-Q): Subscale directions .................62

4-1 Summary statistics of the variables of interest. ....................................... ............80

4-2 Intercorrelations among the variables of interesta .................. ............. ...............81

4-3 Repeated measures ANOVA summary table for perceived epistemic and stylistic
com m itm ent differences across tim e ........................................... .......................... 81

4-4 Repeated measures ANOVA summary table for perceived theoretical commitment
differences across time................................ ............ ........ ...... .. 82

4-5 Current and initial theoretical orientation endorsements............................................82

4-6 Post-hoc analyses examining the moderating effect of the theoretical commitment on
perceived engagem ent differences across tim e............................................................... 82

4-7 Hierarchical regression analyses showing amount of unique variance in therapists'
current professional standing accounted for by their initial standing and epistemic
com m itm ents ...................................... ......................................................83

4-8 Hierarchical regression beta coefficients for constructivism difference scores at steps
2 3 a n d 4 ............................................................................. 8 5









Abstract of Dissertation Presented to the Graduate School
of the University of Florida in Partial Fulfillment of the
Requirements for the Degree of Doctor of Philosophy

ME NOW, ME THEN: THERAPISTS AND CONSTRUCTIONS OF THEIR EPISTEMIC
JOURNEY

By

Gizem Toska

August 2008

Chair: Greg J. Neimeyer
Major: Counseling Psychology

Our study investigated the epistemic change processes of psychotherapists and attempted

to identify the nature of the epistemic journey of this group. We conducted a retrospective study

where therapists were asked to reflect on their current and past epistemic commitments as well as

theoretical orientations and therapeutic styles. This method provided us with a unique set of data

where we learned about the therapists' personal constructions of their epistemic journeys and

other professional change processes accompanying this journey.

Findings suggested that when reflected on their current experiences and their initial

experiences as blossoming practitioners, therapists perceived their commitment to constructivist

epistemology as amplified, and their commitment to rationalist epistemology as reduced over

their practice. The cohort effects failed to explain these changes or to differentiate therapists'

initial constructivist commitments. The obtained results also indicated that the perceived change

in epistemic commitments predicted therapists' theoretical and stylistic commitments.

Our study facilitated our understanding of the developmental trajectory of therapists'

epistemic commitments as they perceive it and it provided empirical data with respect to how

therapists construe the professional change processes that accompany their epistemic change.









CHAPTER 1
INTRODUCTION

Epistemic style refers to an individual's prevailing set of assumptions regarding the way in

which knowledge is acquired, organized, and developed and it can be summarized within the

dichotomy of rationalist and constructivist epistemologies that has become common within the

recent psychotherapy literatures (Mahoney, 1991).

On the one hand, rationalist epistemologies assume that human beings are passive

recipients of a reality external to themselves that is itself stable, universal, and potentially

knowable. They value the validity of knowledge and knowledge is considered valid to the extent

to which it matches external reality (Neimeyer, 1993). Rationalist epistemologies can include

those identified as a Mechanistic Worldview (Pepper, 1942), social-deterministic worldview

(Berzonsky, 1994), Objectivist Simple Worldview (Botella & Gallifa, 1995) or simply

Rationalism (Royce, 1964).

Constructivist epistemologies, on the other hand, assume that human beings actively

construe their own reality and that this reality is dynamic and contextual (Lyddon, 1988;

Mahoney & Lyddon, 1988). Individuals can only know reality indirectly and cannot be separated

from the reality that they perceive. Constructivists seek viable knowledge that is internally

consistent and consensually validated (Neimeyer, 1993). Constructivist epistemologies may

include Organicism (Pepper, 1942), Constructivist Complex Worldview (Botella & Gallifa,

1995), and Metaphorism (Royce, 1964).

Previous research has linked epistemology to psychotherapy and to psychotherapists.

Specifically, therapist's epistemic style was related to therapists' theoretical inclinations,

therapeutic behavior, and personal characteristics (e.g. Johnson Germer, Efran, & Overton, 1988;

Lyddon, 1989a; Lyddon & Adamson, 1992; Mahoney & Gabriel, 1987; Neimeyer & Aksoy,









2005; Neimeyer, Prichard, Lyddon, & Sherrard, 1993). However, the literature regarding the

nature of the epistemic development and change in therapists or in any other groups is scarce.

A brief overview of the topics, content, and framework of the published articles reveals

that the field of psychology and particularly psychotherapy became increasingly constructivist

over the course of the last 20 years (Mahoney, 1995a; 1995b). Such a change in the field's

understanding might be reflection of the infusion of a new generation of therapists who were

steeping in post-modern epistemologies and psychotherapies. Yet the personal writings of some

longstanding prominent psychotherapists also reflect this epistemic journey towards

constructivism, suggesting that this development may also be the result of a shift within the

current field of practitioners, in addition to the inclusion of a new generation of post-modern

therapists. Psychotherapists such as Ellis (1993; 1995), Meichenbaum (1993), and Mahoney

(1991; 2001) have repeatedly reported and described their epistemic journey where they have

become increasingly constructivist in their epistemic commitment. Goldfried's (2001a) work

where he collected personal change narrations of 15 seasoned psychotherapists also reveals a

similar journey where they pursued a path from relative certainty and simplicity to increasing

complexity in their worldview.

Nonetheless, research is scarce concerning epistemic shifts within the field and its

practitioners. Although substantial anecdotal, conceptual, and case-based information is on hand,

strikingly little empirical research is available that documents this shift in the field across time or

traces these changes over time in relation to particular practitioners. As a result, not only is the

field lacking empirical evidence of its putative epistemic shift, but it also remains unclear

whether this shift is due to the infusion of new, post-moder therapists or significant

developmental shifts among its current practitioners in the field. Thus; to explore any perceived









epistemic shifts in the field and examine the correlates of these shifts in relation to the years that

therapists have entered to the field was the focus of the current research project.

In our efforts to understand the nature of the epistemic change experienced by

psychotherapists, another interesting inquiry would be the investigation of the factors that

contributes to or accompany the epistemic change. Investigations of the personal reports of

above-mentioned psychologists offer some insight into the subject. For instance, these authors

comment on their change in theoretical orientation and therapeutic style that accompanied their

epistemic journey (see Goldfried, 2001a; 2001b).

Recent qualitative and quantitative studies focused on the career development of the

psychotherapists that they defined as the organized systemic change of psychotherapists that

involves succession over time (Ronnestad & Skovholt, 2003). These studies also revealed the

sources influencing therapists' organized change processes, i.e. their career development

(Orlinsky et al., 1999; Ronnestad & Skovholt, 2003). Moreover, Jennings and Skovholt (1999;

Skovholt & Jennings, 2004) collected further narrations from master therapists to explore their

developmental processes. These studies collectively suggested that practitioners do develop, as

documented in their successive changes in systemic ways across their professional lifetimes.

Professional development included, but was not limited to, change in therapists' theoretical

adherence and therapeutic style. Yet whether or to what extent psychologists' theoretical

orientation and their professional activities were related to their epistemic journey remained

unknown.

The current study aimed to investigate the epistemic change processes of the

psychotherapists as they perceive it. Specifically, we investigated (1) whether therapists

perceived their epistemic commitments as being shifted as they become more experienced; (2)









whether these perceived epistemic trends could be explained through cohort effects; (3) whether

therapists' perceived epistemic change was associated with their self-reported theoretical

orientations or therapeutic styles in coherent ways.









CHAPTER 2
REVIEW OF THE LITERATURE

This chapter provides a literature review that supports specific predictions regarding

psychotherapists' epistemic journeys and related professional change experiences. First, the

review introduces and explains the notion of epistemic style, which is followed by the

examination of the ways in which epistemic style is linked to psychotherapy-related attitudes and

practices. Next, the literature on the change of the field of psychotherapy is explored. Within this

section, the review first focuses on the epistemic journey of the field and of certain well-known

psychotherapists and then it explores psychotherapists' theoretical and stylistic change

experiences and why such professional change experiences might align with therapists'

epistemic journey. The literature review ends with an outline of the study's overarching

questions and specific predictions.

Epistemic Style

Personal epistemology is one's theory about knowing and knowledge. Epistemic style

refers to an individual's way of testing the validity of his or her knowledge. Pepper's (1942)

Root-Metaphor Theory and Royce's (1964) Theory of Knowledge have been the most

predominant ways of conceptualizing and studying the implications of epistemic style.

Root-Metaphor Theory

Pepper's (1942) Root-Metaphor Theory is composed of four root metaphors that are basic

analogies for the four distinct ways in which we see the world and organize experience. Pepper

(1967) suggested that individuals engage in analyses of their root metaphors to make sense of the

world and to solve problems. One's root metaphor implies certain ways of dealing with events

and generates possible solutions to existing problems. Categories of hypothesis that arise from

such analysis of root metaphors are unrestricted by the field of inquiry, and such a hypothesis "is









responsible for the interpretation of any item of criticism proffered" (Pepper, 1967, p. 3). In other

words, one's dominant root metaphor provides an intuitive sense of reality.

The first metaphor, form (or similarity), focuses on similarities among entities and it

reflects the formistic way of seeing the world and organizing experience. Formism perceives

reality within the set of predetermined universal forms and types. An object's essence can be

discovered via understanding its similarity to other objects through categorical analysis of

objects. Similarly, formistic individuals would make sense of an experience through

understanding its similarity to and differences from other experiences. In psychology, formistic

thinking underlies trait models of personality and psychiatric diagnostic practices (Lyddon,

1989b).

The second metaphor, machine, focuses on similarity between machines and world and it

reflects mechanistic way of seeing the world and organizing experience. Mechanism assumes a

machine-like deterministic universe in which observable effects are caused by natural factors,

and it focuses on this linear cause-effect relationship to understand the world and experiences. In

psychology, mechanistic thinking underlies behaviorism, rationalist cognitive therapies and

certain aspects of Freudian theory (Lyddon, 1989b).

The third metaphor, context, focuses on historic events and it reflects a contextualistic way

of seeing the world and organizing experience. Contextualism assumes that meaning is

embedded in the context and hence, context would determine the ways in which events would be

experienced. Like historic events make sense only when they are considered in their context, an

experience can be understood only in its context. While formism and mechanism focus on

analysis of parts, contextualism tends to focus on synthesis of wholes. In psychology,









contextualistic thinking underlies Bandura's revised social-learning perspective, Rice and

Greenberg's change process research program and existential theories (Lyddon, 1989b).

The fourth metaphor, organ, focuses on integration of experiences of living organisms and

it reflects organismic way of seeing the world and organizing experience. Organicism assumes

that reality is dialectically-constructed and that it evolves over time with increasing

differentiation and integration. In contrast to contextualism, organicism suggests universal and/or

teleological principles govern the functioning of the phenomena and it strives to understand these

principles (Lyddon, 1989b). Organic worldview seeks to understand integrative associations

among the various aspects of a phenomenon. In psychology, organicist thinking underlies

developmental, humanistic, and transpersonal movements as well as systems thinking and self-

organizational processes (Lyddon, 1989b).

Pepper (1942) suggested that contextualistic and organismic worldviews were very similar

to one another in nature while mechanistic worldview could be considered an opposing

worldview. While contextualism and organicism have been associated with the worldview of the

postmodern era, mechanism has represented the dominant worldview of the modern era. Pepper

(1942) claimed that each root metaphor and related worldview provides a different lens to

interpret the reality and he encouraged individuals to be able to employ a number of lenses to

understand a given phenomenon.

Different measures have been constructed to assess individual's worldviews as Pepper

defined them. The Organicism-Mechanism Paradigm Inventory (Germer, Efran, & Overton,

1982; OMPI) has been designed and employed to assess organismic and mechanistic worldviews

of the individuals. Pepper's four world hypotheses can also be measured through Kramer's

Worldview Beliefs Measure (Kramer, Kahlbaugh, & Goldston, 1992).









Researchers such as Berzonsky (1994) and Botella and Gallifa (1995) further studied

Pepper's (1942) root metaphors and consolidated our knowledge of personal worldviews. Their

studies introduced more condensed categorizations of epistemic style following Pepper's four

root metaphors and worldviews. In general, these studies reflected the dichotomous nature of

contextualism and organicism versus formism and mechanism.

Berzonsky (1994) conceptualized three core epistemological assumptions that were named

as formistic, social-deterministic, and constructivist worldviews. Formistic worldview is parallel

to Pepper's formistic view and social-deterministic worldview is congruent with Pepper's

mechanistic view. Constructivist worldview embodies Pepper's contextualist and organismic

views. Berzonsky's (1994) Constructivist Assumption Scale (CAS) measures the degree to

which one endorses constructivist epistemological assumptions as opposed to formistic and

social-deterministic worldviews.

As a part of a comprehensive study, Botella and Gallifa (1995) employed Berzonsky's

CAS as well as Germer et al.'s (1982) OMPI among other measures in a factor-analytic study

and revealed two main and opposing views underlying the above-mentioned worldviews and

epistemic assumptions: Constructivist Complex Worldview and Objectivist Simple Worldview.

The Constructivist Complex Worldview was related to the Pepper's organismic worldview that

characterized the world as a living organism and to Berzonsky's constructivist epistemic

assumptions that emphasized human beings' active construction of their own reality. Participants

operating from this worldview rejected formism and mechanism and rather they "construe

knowledge in a multidimensional way" (Botella & Gallifa, 1995, p. 15).

Theory of Knowledge

Royce's "Theory of Knowledge" (Royce, 1964; Royce & Powell, 1983) is another well-

known and valuable conceptualization of personal epistemologies. Royce (1964) identified three









fundamental ways of knowing, namely empiricism, rationalism, and metaphorism. Royce

derived these epistemologies from the dominant cognitive process that can be employed by

individuals. According to Royce (1964), people utilize perceptual, conceptual, and symbolic

processes during their daily pursuits and one of these three cognitive processes would be

dominantly employed over the others. This dominantly used cognitive process would indicate the

individuals' dominant way of knowing the world.

Empiricism reflects dominant use of perceptual cognitive processes. Empiricists seek out

sensory experience. They engage in induction and test reality in terms of reliability and validity

of their perceptions and sensory experiences. Rationalism reflects dominant use of conceptual

cognitive processes. Rationalists seek out rational analyses of ideas. They engage in deduction

and test reality by its logical consistency. Metaphorism reflects dominant use of symbolic

cognitive processes. Metaphorists emphasize the symbolizing nature of events arguing that

knowledge is constructed symbolically. Hence, they seek viability of knowledge rather than its

validity and they engage in information analysis through making use of analogies (Royce, 1964;

Royce & Mos, 1980; Royce & Powell, 1983). Empiricism and rationalism reflect the epistemic

style of the modem era, while metaphorism reflects the epistemic framework of the postmodern

era.

Individuals' commitment to Royce's (1964) three epistemologies can be measured by

Psycho-Epistemological Profile (Royce & Mos, 1980; PEP). PEP has been frequently employed

in investigating the ways in which epistemic style related to the theory and practice of

psychology.









Epistemic Style and Psychotherapy

Various studies demonstrated that epistemic style is related to theories, practice and

practitioners of psychotherapy. Understanding the relationship between epistemology and

psychotherapy provides the groundwork of the present study. This section illustrates the ways in

which epistemic style is linked to these psychotherapy variables.

Studying epistemic commitments has enhanced our understanding of psychotherapy

practice and practitioners. The psychotherapy variables that relate to epistemic style can be

studied under four categories: Theories of psychotherapy (Lyddon, 1989b; 1991), preferences for

psychotherapy (Lyddon, 1989a; Neimeyer et al., 1993; Neimeyer & Morton, 1997; Schacht &

Black, 1985), practices of psychotherapy (Lyddon, 1988; Mahoney & Gabriel, 1987; Mahoney &

Lyddon, 1988; Neimeyer & Saferstein, 2006, and personal characteristics of psychotherapists

(Neimeyer & Aksoy, 2005).

Epistemic Style and Theories of Psychotherapy

Theories of psychotherapy reflect a certain way of understanding the world and they can be

conceptually tied to epistemic worldviews that had been identified in the literature. Lyddon

(1989b, 1991) identified epistemological framework of the various therapy approaches

suggesting that psychotherapy theories were related to the epistemologies in systematic ways.

Lyddon employed both Pepper's (1946) Root-Metaphor Theory and Royce's (1964; Royce &

Powell, 1983) Theory of Knowledge to identify these relationships.

Lyddon (1989b) suggested that trait models of personality and psychiatric diagnostic

practices were supported byformistic worldviews because they both utilized the matters'

similarity to establish their reality. Both trait taxonomies and psychiatric diagnostic systems

classify traits or disorders based on the presence and absence of certain characteristics or









symptoms. They ignore temporal and contextual factors and assume stability of the nature of

their subject matter as well as of their similarities to others.

Behavioral, rationalist cognitive and psychodynamic approaches to psychotherapy have

been linked to Pepper's mechanistic worldview because they assumed a machine-like

deterministic view of human psyche. Behavioral approach assumes that behaviors of human

beings are determined by antecedent conditions and they objectively study these behaviors to

understand human psychology. Rationalist cognitive therapies suggest that human emotions are

determined by antecedent beliefs and thoughts and they focus on such linear relationships

between thoughts and feelings to understand human psychology. Psychodynamic therapies

regard mind in mechanistic terms and they focus on the linear interactions among psychological

forces to understand human mental processes (Grof, 1985, as cited in Lyddon, 1989b). All of

these three approaches to psychotherapy analyze parts of human psychology and assume that an

observer, a psychologist, can objectively identify these causal linear interactions among aspects

of human experiences and processes.

Bandura's revised social-learning theory, Rice and Greenberg's change processes and

existential theories have been identified as reflecting the contextualist worldview since these

theories seek to understand human experience in its context and focus on the synthesis of wholes

rather than analysis of parts. Bandura's social learning theory highlights the importance of

context in learning. Rice and Greenberg focus on context of client-therapist interaction to

understand and facilitate clients' change processes. Existential theories study human experience

through individuals' "being-in-the-world" where they act on the world as the world acts on them.

Developmental theories, humanistic and transpersonal movements, and systems thinking

were linked to the organicist worldview. They all focus on universal principles that govern the









functioning of human psychology, namely the processes of self-evolution, self-actualization,

self-transcendence, and self-organization. They define these processes as organs: They evolve

over time with increasing differentiation and integration and they study these dialectically

constructed processes to understand our psychological functioning.

Royce's theory of knowledge (Royce, 1964) was also associated with the psychotherapy

theories. Royce's (1964; Royce & Powell, 1983) empirical, rational, and metaphorical epistemic

styles were associated with behavioral, rationalist and constructivist approaches respectively.

Lyddon (1989a) suggested that behavioral approaches to psychotherapy were founded on

empiricism considering behaviorist therapists' emphasis on sensory experiences. Behaviorists

assume that the true nature of the human psychology can be understood from our objective

observations of human beings and they engage in induction to reach the truth. Rationalist

cognitive psychotherapies were tied to rational epistemic styles evident in rationalist therapists'

emphasis on conceptual cognitive abilities (Lyddon, 1991). Rationalist therapists tend to analyze

their clients' logical consistency, challenge their clients' irrational thinking and invite their

clients to a reality that is defined by logical consistency. Constructivist psychotherapies were

associated with metaphorical epistemic style considering that constructivist therapists tend to

construct client experiences symbolically. Constructivist psychologists try to understand their

clients' experiences through making use of analogies and they explore and facilitate clients'

developmental processes (Lyddon, 1991).

After arguing the ways in which psychotherapy theories are systematically tied to

epistemic styles, it remains important to understand the implications of these ties on our attitudes

and experiences of psychotherapy. Given that theories on which psychotherapies are built are

tied to certain epistemologies, would individuals' epistemic style guide them to seek a form of









psychotherapy that shares similar assumptions? Next, we will investigate the literature

supporting this link between individuals' epistemic style and psychotherapy preferences.

Epistemic Style and Preferences for Psychotherapy

Following the idea that psychotherapy theories are systematically related to certain

epistemic viewpoints, researchers explored the impact of epistemic style on preferences of

psychotherapy approach. The results suggested that individuals' epistemic framework play at

least a moderate role in guiding their psychotherapy preferences (Lyddon, 1989a; Neimeyer et

al., 1993; Neimeyer & Morton, 1997; Schacht & Black, 1985).

Lyddon (1989a) measured epistemic styles of potential clients and asked them to evaluate

audiotaped presentations of behavioral, rationalist, and constructivist approaches to

psychotherapy. Results suggested that participants with empirical, rational, and metaphorical

epistemic styles preferred behaviorist, rationalist, and constructivist therapy approaches

respectively. Lyddon and Adamson (1992) extended the findings of Lyddon (1989a) to Pepper's

root-metaphor theory. Participants with an organismic worldview indicated preference for the

constructivist approach, while participants with a mechanistic worldview preferred the

behavioral approach. Overall, lay people reported preference for the therapy approaches that

were congruent with their own epistemological framework suggesting that individuals' dominant

epistemological commitments had an impact on their therapy preferences.

These findings were extended for counselor trainees and mental health practitioners

(Arthur, 2000; Neimeyer et al., 1993; Neimeyer & Morton, 1997; Schacht & Black, 1985).

Despite the differences among various studies, the overall findings confirmed a moderate

relationship between epistemological commitments and psychotherapy preferences for therapists.

Organismic worldview and metaphorical epistemic style predicted a preference for constructivist

therapies. The empirical epistemic style was linked to a preference for a behavioral approach.









Rationalistic epistemic style was linked to the preference for rationalist therapies (Neimeyer et

al., 1993; Neimeyer & Morton, 1997). Psychoanalysts tended towards organicism and

metaphorical orientation, whereas cognitive-behavioral therapists tended towards mechanism

and empiricism in their dominant worldviews (Arthur, 2000; Schacht & Black, 1985).

Taken together, empirical evidence strengthened the link between epistemic style and

preference for different psychotherapeutic approaches for future clients, future therapists and

seasoned practitioners.

Epistemic Style and Practices of Psychotherapy

Epistemic commitments underlie theories of psychotherapy and at least moderately

account for therapists' psychotherapy preferences. Epistemology was also linked to

psychotherapy practices. The mindset underlying psychotherapy practices was studied to

understand the practical differences among different forms of therapy, especially among different

forms of cognitive therapies (Lyddon, 1988; Mahoney & Gabriel, 1987; Mahoney & Lyddon,

1988).

Cognitive therapy is an umbrella term covering a variety of approaches to psychotherapy.

Lyddon (1988) and Mahoney (1991) suggested that we could differentiate cognitive therapies

from one another through studying the epistemic assumptions underlying these approaches. A

continuum of epistemic worldviews have been employed in this purpose where cognitive

approaches fall along the continuum of rationalism and constructivism (DiGiuseppe & Linscott,

1993). Differences between rationalist and constructivist epistemologies in their understanding

of reality and knowledge reflect upon the ways in which cognitive therapies are conceptualized

and conducted. Hence, understanding how epistemologies underlying cognitive therapies impact

psychotherapy practices help differentiating different cognitive approaches to therapy.









Rationalist epistemologies reflect belief in a-priori truths and in a singular, universal, and

historical reality (Mahoney & Gabriel, 1987). This reality can be passively and objectively

perceived through thought processes (Mahoney, Lyddon, & Alford, 1989). Modern cognitive

therapies show commitment to rational theories of knowledge and assume reasoning and logical-

analytic processes are fundamental means of validating knowledge (Lyddon, 1988; Mahoney &

Gabriel, 1987; Mahoney & Lyddon, 1988). Modern cognitive therapies such as Ellis' Rational

Emotive Therapy (RET) seek to replace clients' irrational thoughts with rational ones to set them

free from their negative experiences (DiGiuseppe & Linscott, 1993; Lyddon, 1990).

Constructivist epistemologies challenge the basic assumptions of rationalistic

epistemologies suggesting that knowing is a much more complex process than rationalist

epistemology sustained (Mahoney & Gabriel, 1987). Constructivist epistemologies assume that

individuals actively construct their realities and hence, reality is multiple, contextual, historical,

and paradigmatic. Postmodern cognitive therapies show commitment to constructivist

epistemology (Mahoney & Gabriel, 1987). Constructivist cognitive therapies such as Kelly's

Personal Construct Therapy (Neimeyer, 1995) seek viability of knowledge over validity and they

explore the ways in which clients' organizations of personal knowing systems (Lyddon, 1988;

Neimeyer, 1993).

The ways in which epistemology reflected on practice and differentiated rationalist and

constructivist therapies were identified conceptually and sustained empirically. Conceptually,

rationalist and constructivist therapies were differentiated in numerous aspects, such as

therapists' thinking style, focus and direction of therapy, conceptualization of therapeutic

concepts such as therapeutic relationship, client problems, resistance, emotional distress, relapse

and regression (Mahoney & Gabriel, 1987) and level of intervention (Lyddon, 1990).









First, rationalist and constructivist therapies were differentiated in therapists' thinking

style. Rationalist cognitive therapies tend to utilize a basic thinking style and to follow a simple

format with clear-cut methods, while constructivist cognitive therapies tend to have a

complicated thinking style and to follow a complex format with unclear methods (Mahoney &

Gabriel, 1987).

Second, rationalist and constructivist therapies were differentiated in therapy focus.

Rationalist cognitive therapies tend to focus on the clients' present problem as it roots from

clients' irrational thoughts. Constructivist cognitive therapies, on the other hand, tend to shift the

focus from presenting problems to clients' way of processing life within their given history

(Mahoney & Gabriel, 1987; Mahoney et al., 1989).

Third, rationalist and constructivist therapies were differentiated in the direction of the

therapy. Rationalist cognitive therapies tend to follow a set specific client goals determined at the

very beginning of the therapy, while constructivist cognitive therapies refrain from following a

pre-determined route and conceptualize therapy as a journey without a set itinerary (Mahoney &

Gabriel, 1987).

Fourth, rationalist and constructivist therapies were differentiated in the kind of the client-

therapist relationship that they value and seek. Rationalist therapies tend to value objective

relationships where therapists maintain an analytical stance, while constructivist therapies tend to

seek personal and emotionally intense relationships between therapists and clients (Mahoney &

Gabriel, 1987).

Fifth, rationalist and constructivist therapies were differentiated in their conceptualization

of certain therapeutic concepts. Rationalist cognitive therapies tend to conceptualize client

problems as cognitive dysfunctions, view negative emotions as a problematic outcome of such









thought errors and perceive client resistance, relapse and regression as indicators of client failure

in maintenance and generalization of therapy outcomes. Constructivist therapies, on the other

hand, tend to define client problems as indicators of the discrepancies between external

challenges and internal capacities, view negative emotions as an indicator of clients' current

functioning, perceive client resistance, relapse and regression as indicators of clients' self-

preservation efforts (Mahoney & Gabriel, 1987; Mahoney & Lyddon, 1988). Frankel and Levitt

(2006) recently detailed the postmodern strategies for working with resistance, demonstrating the

similarities across the rich ways that constructivist therapies conceptualize and work with client

resistance.

Sixth, rationalist and constructivist therapies were differentiated in their conceptualization

of change. Rationalist approaches to therapy tend to seek first-order change that is defined as

surface-level change achieved without disturbing the existing systems. Therapies with

constructivist commitments, on the other hand, tend to facilitate change entailing fundamental

restructuring of the existing systems that is recognized as second-order change (Lyddon, 1990).

Empirical studies supported that rationalist and constructivist cognitive therapies differed

in direction of the therapy, relationship with client, conceptualization of clients' emotional

distress, relapse, and regression and approaching such client variables in the context of therapy

(Nagae & Nedate, 2001; Vasco, 1994; Viney, 1994; Winter & Watson, 1999).

The empirical evidence supporting the link between epistemology and practice were

mainly in-depth studies of therapy transcripts (Nagae & Nedate, 2001; Vasco, 1994; Viney,

1994; Winter & Watson, 1999) with a recent addition of a self-report study of psychotherapists

(Neimeyer & Saferstein, 2006). These studies supported the assumptions that rationalist and

constructivist cognitive therapies differed in direction of the therapy, relationship with client,









conceptualization of clients' emotional distress, relapse and regression, and approaching such

client variables in the context of therapy.

Vasco (1994) observed therapy sessions of Portuguese therapists with constructivist

commitments. The results of his study suggested that therapists conducting constructivist

therapies tended to reject therapeutic structure and directive helping styles yet they were

technically eclectic compared to rationalistic cognitive therapists. Constructivist commitment

was negatively associated with therapists' focus on clients' problems.

Viney (1994) sampled and content analyzed therapy transcripts of five therapists with five

different orientations including personal construct, client centered, and rational emotive

therapies. Therapist conducting constructivist cognitive therapy, i.e. personal construct therapy

acknowledged the negative emotions of their clients more compared to therapists conducting

rationalist cognitive therapy, i.e. rational-emotive therapy.

Winter and Watson (1999) studied the therapy session transcripts of the two therapists, one

adhered to personal construct therapy that is identified as a constructivist cognitive therapy, and

the other adhered to rationalist cognitive therapy. Their in-depth analyses revealed that

constructivist therapist was more empathic of clients, more communicative of unconditional

positive regard towards the client and more engaging in complex levels of processing during

therapy. Rationalist therapist, on the other hand, was more directive in therapy. Moreover, in

dealing with client's failure to complete a given assignment, rationalist therapists were more

likely to encourage clients to go through with it, while constructivist therapists strived to

understand the dynamics of client's resistance.

Nagae and Nedate (2001) extended these results to Japanese therapists. Therapists engaged

in rationalist cognitive therapies were more likely to engage in psycho-educational instruction,









while therapists conducting constructivist cognitive therapies were more successful in

establishing rapport with their clients (Nagae & Nedate, 2001).

Studies of Vasco (1994), Viney (1994), Winter and Watson (1999), and Nagae and Nedate

(2001) inferred the impact of epistemology on practice through investigating practice of

therapists conducting constructivist or rationalist cognitive therapies. Neimeyer and Saferstein

(2007), on the other hand, conducted a self-report study that measured psychotherapists'

epistemic commitments. This methodology provided the authors with an opportunity to study the

relationship between epistemology and practice independent of the name of the conducted

therapy.

Neimeyer and Saferstein (2007) focused on therapists' emphasis on therapy style and

working alliance. Their results were consistent with the assumptions of Mahoney and Gabriel

(1987) and the findings of the preceding studies. Therapists with higher levels of constructivist

epistemology were more likely to pursue closeness, broad focus, engagement, and spontaneity in

therapy. Commitment to constructivist epistemology was also positively associated with

therapists' emphasis on the personal bond in the therapeutic relationship. Overall, their results

supported the assumptions that commitment to constructivist epistemology may influence the

ways in which therapy is conducted and therapeutic relationship is built and maintained.

Altogether, these conceptual and empirical studies suggested that epistemologies influence

how therapists construct therapy variables, how they conduct therapy, how they relate to their

clients and what kind of results they pursue. Next, we clarify the ways in which epistemology

relates to personal characteristics of psychotherapists.

Epistemic Style and Characteristics of Psychotherapists

Mahoney (1995c) had suggested that basic tenets of constructivist therapies may reinforce

therapists to value and pursue self-awareness, to be more attuned to personal feelings, to be more









tolerant of ambiguous circumstances, to be more socially tolerant of diversity and to be more

open to new experiences.

Constructivist worldview assumed that individuals' understandings are limited by their

perceptions, emotions are primitive knowing systems, the direction and outcome of therapy

gradually emerge from the context and individuals' experiences are informed by the social,

historical and cultural contexts. Hence, therapists holding these assumptions were expected to

seek self-awareness to understand the ways in which their constructs shape their perceptions.

Therapists with constructivist commitment would attend to emotions to learn from them. The

complex way that they construe therapy and clients' reality would ask for tolerating ambiguity as

well as social differences and being open to experience and learning (Mahoney, 1995c;

Neimeyer & Aksoy, 2005).

Rationalist approaches, on the other hand, present as largely complementary views and the

differences between the two epistemic commitments reflect upon the conceptualization and

practice of psychotherapy (Lyddon, 1988; Mahoney & Gabriel, 1987; Mahoney & Lyddon,

1988). Rationalist therapists tend to operate assuming that they are objective observers of the

stable and single reality and they can correct their clients' faulty cognitions of reality and hence

their clients' negative emotions through change processes that are presumed to be uniform and

universal. The processes and direction involved in rationalist therapy would be clear and

straightforward. Hence, therapists with rationalist commitments were expected to have lower

levels of self-awareness, personal attending to emotions, ambiguity tolerance, social tolerance

and openness to experience given that these characteristics would not be necessitated by their

epistemic commitment.









Moreover, the literature on the association between epistemology and personality provides

additional support for the above-mentioned conceptualizations. For instance, social tolerance and

openness to experience were found to be positively related to organismic worldview and

negatively related to the mechanistic worldview (Babbage & Ronan, 2000; Johnson et al., 1988)

supporting the expectation that therapists with constructivist standpoints would be more likely to

have higher levels of social tolerance and openness. Organismically-oriented individuals were

more likely to be empathic (Johnson et al., 1988) and cognitively flexible (Botella & Gallifa,

1995) supporting the proposition that therapists with constructivist standpoints would be more

likely to have higher levels attendance to emotions and ambiguity tolerance that increase the

ability to deal with complexity (Beitel, Ferrer, & Cecero, 2004).

Neimeyer and Aksoy (2005) provided empirical evidence supporting the theoretical

conceptualization of Mahoney (1995c) and others (Lyddon, 1988; Mahoney & Gabriel, 1987;

Mahoney & Lyddon, 1988). Their findings suggested that commitment to constructivist

epistemology predicted higher levels of pursuit of self-awareness, attending to emotions,

ambiguity tolerance, social tolerance for individual diversity and openness to experience,

whereas commitment to rationalist epistemology predicted lower levels of these characteristics.

The developing literature on epistemology confirms that therapists' epistemic standpoint relates

to their personal characteristics.

Overall, the literature suggests that epistemology has been conceptually and empirically

related to the theories of psychotherapy, to therapy preferences of prospective clients and

prospective and practicing psychotherapists, to the forms of intervention and to the personal

qualities of psychotherapists.









Epistemic Change

Epistemic change experiences of the field of psychotherapy can be studied by examining

the general directions the field has undertaken as well as by studying specific examples of

psychotherapists who had experienced an epistemic shift. This section highlights the literature

that indicated how the field of psychotherapy is changing with respect to its epistemic

commitment in general and it provides specific examples from seasoned psychotherapists where

these experts convey their own epistemic journey that parallels the journey of the field.

Epistemic Change of the Field

The world of psychotherapy has faced multiple changes such as increase in the number of

distinguishable psychotherapies, increase in integration and collaboration and expanse of

information (Mahoney, 1995a). Farber and his colleagues (2005) also noted the dramatic change

the field of psychotherapy endured over the past three or four decades, suggesting that

"psychotherapy now tends to be short-term, problem-focused, cognitively oriented and

psychopharmacologically influenced" (p. 1018). Ellis (1992b) noted the change as well in his

writings: "When I started RET in 1955, psychologists were mainly split into conflicting

psychotherapy camps, most of which violently fought each other. Those who followed the

theories and practices of Freud, Jung, Adler, Rogers, Perls, and Skinner were dogmatically tied

to their own schools and only rare eclectics, such as Frederick Thorne, were multimodal and

integrated." (p. 9).

The field was increasingly interested in the integration of diverse forms of psychotherapy.

Cognitive and constructivist therapies assumed an active role in psychotherapy integration

movement providing a rich avenue for integration (Mahoney, 1995b). Cognitive therapies

mushroomed to more than 20 different types in a period of 40 years and through its development

and growth, cognitive therapies encouraged productive exchanges with behavioral, humanistic,









and psychodynamic traditions (Mahoney, 1995b). Cognitive therapies have been found to be the

most frequent theoretical contributor to integrative practice at least among clinical psychologists

(Norcross, Karpiak, & Lister, 2005).

Mahoney (1995b) pointed out to the dialectical interaction between the field and its

practitioners and he suggested that such changes in the field impact the way psychotherapists'

practice. That, in return, further facilitate the conceptual developments within the cognitive

psychotherapies, and hence, within the field. One of the major conceptual developments was

recognized as the differentiation of rationalist and constructivist approaches to cognition

(Mahoney, 1995b).

Development of constructivism or constructive metatheory has been recognized as a

revolution within the cognitive revolution (Mahoney, 1995a; 1995b). Constructivist metatheory

has developed rapidly; it continues to expand and today it is international in scope (Mahoney,

1995b). The field experiences a shift towards increasingly embracing constructivist metatheory

and epistemologies. Moreover, practitioners expect the field to change further in this direction.

According to the Delhi Poll that Norcross and his colleagues conducted at 2002, 62 experts

"predicted growth of culturally sensitive and multicultural therapies which rely more on

constructivist principles and cultural values that seek to protect the experiences of minority

groups from being dominated by the worldviews of powerful groups that dominate the discourse

of mental health." (Norcross, Hedges, & Prochaska, 2002, p. 321).

And this ongoing shift is further evident in and could be the partially attributed to the

individual work of prominent cognitive psychologists (Mahoney, 1995b).









Personal Examples of Epistemic Change

Albert Ellis

Albert Ellis (1990; 1995), the founder of rational emotive behavior therapy (REBT) clearly

projects a personal and professional pathway where his theory and practice moved to become

more constructivist and humanistic in nature. Ellis (1995) distinguished between general RET

and preferential REBT where the former stands for general cognitive-behavioral therapy and the

latter stands for what Ellis has practiced for past 15 years. Ellis clarified that both his practice

and the empirical work of the fellow psychologists such as Beck and Meichenbaum made an

impact on his conceptualization of REBT and pushed him in more constructivist directions. Ellis

(1990; 1993) strongly suggested that not only the theory of REBT, but also the practice of REBT

is constructivist.

Ellis has used various publications to draw attention to the fact that the term rational had

been misunderstood by the field. He suggested that in REBT, rational referred to effective

cognitions rather than empirically and logically valid cognition (Ellis, 1999). Ellis (1999)

emphasized that "What is deemed rational by one person, group, or community can easily be

considered irrational by others" (p. 154) suggesting his commitment to constructivist metatheory.

Ellis (1992a) even claimed that his therapy "is probably the most constructivist of all cognitive

behavioral therapies" (p. 122).

Donald Meichenbaum

Donald Meichenbaum has been considered among the fathers of cognitive therapy and he

is among the leaders of cognitive revolution. Meichenbaum (1990; 1993) advocated for

constructivist perspective encouraging fellow practitioners to help their clients in their

identifying the ways in which they construe reality and then affected by their constructions and

in developing coherent and adaptive narrations that would enable change and growth.









Meichenbaum's analysis of the past and future of cognitive behavior modification shed

further light onto the epistemic change cognitive-behavior practitioners had experienced.

Meichenbaum (1993) noted that psychotherapists adhered to cognitive-behaviorist theory has

been going through a change process where the way they conceptualize the role of cognition in

behavior change has shifted. He utilized three guiding metaphors, namely, conditioning,

information processing and constructive narratives to illuminate the shift experienced by

cognitive-behaviorists practitioners including himself.

At first, client cognitions were viewed as conditioned responses, covert behaviors that

control overt behavior and hence, treatment focused on deconditioning and reconditioning.

Subsequently, human mind was equated to computers where the individuals were the architects

of their experiences through the way they collected and processed data and treatment focused on

helping clients to learn the way their mind process and the ways of interrupting cognitive-

behavioral-affective chains. Meichenbaum (1993) suggested that the idea that clients are

architects of their mind led to the use of constructivist metaphor where cognitions are believed to

be active constructions of individuals. He identified that cognitive-behaviorist practitioners are

increasingly committed to constructivist worldview where therapists function "as a co-

constructivist helping clients to alter their stories" (p. 24).

Meichenbaum (1993) expected the change to continue for cognitive-behaviorist

practitioners. He suggested that not only himself but also the "...field of CBM has come a long

way since its inception. The story continues to unfold and to change as new metaphors are

adopted and new narratives constructed." (Meichenbaum, 1993, p. 204).

Michael J. Mahoney

Mahoney (1991) is also among the prominent psychologists who had taken a journey

headed towards constructivism even tough he started his practice as a committed behaviorist.









Mahoney (2001) described his intellectual and emotional journey as a therapist where he

identified his starting point as a behaviorist psychologist. Mahoney noted that as he faced the

limitations of this approach in dealing with the complexity introduced by his clients and as he

was involved in the quest of human change processes, he was immersed in the function of

cognitions and he eventually participated in the cognitive revolution and identified himself as a

cognitivist. His involvement in the depth of human cognition, his personal therapy as a client and

his interactions with his colleagues and with different cultures opened up novel ways of thinking

and practicing and Mahoney (2001) had developed an increasing interest in constructivism and

has contributed to our understanding of constructivist metatheory through his intensive work as a

researcher, practitioner, and editor.

Narrations of other psychotherapists including Aaron "Tim" Beck

Interested in the change that psychotherapists' themselves had gone through, Goldfried

(2001a) asked 15 seasoned psychotherapists to narrate their personal change and growth

experiences as a result of their personal and professional interactions. In their personal accounts,

various contributors mentioned their path where they had started their practice being adhered to

one camp of theoretical orientation and moved towards more eclectic and complex ways of

approaching their clients as their learning experiences challenged their limited ways of looking at

the world of psychotherapy. One of the contributors, Greenberg (2001), summarized a shared

process in the title of his narration as he named his story as "My change process: From certainty

through chaos to complexity".

A related example comes from the communications provided by Aaron "Tim" Beck and

his colleagues that highlighted his increasing appreciation and pursuit of complexity in his work.

Beck's professional journey towards complexity could have started through his "rebellion"

against the autocratic nature of psychoanalysis (Bloch, 2004). Instead of following that "faith-









based" approach to therapy, Beck developed an empirically-driven practice that aimed to explore

the cognitive processes underlying human suffering, namely Cognitive Therapy (Bloch, 2004).

His approach was criticized for its mechanical, over-simplified nature yet in his recent

arguments, Beck claimed that the change processes facilitated by the cognitive therapy can be

complex (Bloch, 2004), while cognitive therapy is much richer than mechanical treatment

(Bloch, 2004) and individually designed considering the client and presenting concern at the

hand (Beck, n.d.).

Beck (Bloch, 2004) also questioned if applying certain techniques would ever be enough to

conduct effective therapy. He suggested that treating a presenting concern in a mechanical way

would not work especially with complex cases. "Therapists who are good at the technical end of

cognitive therapy fall flat on their faces when it comes to the more complex cases. Empathy,

sensitivity, considerateness together with the ability to put them together with technical aspects

is the combination needed." (para. 107).

Moreover, Beck demonstrated constructivist commitment through his conceptualization

and utilization of emotions, personally and professionally. In a paper written in his honor, Beck

was praised for his attention to his emotional processes and his willingness to learn from them in

his personal and professional life (Padesky, 2002). Beck (2002) himself suggested that emotional

arousal and expression were essential parts of cognitive therapy since he assumed that the

expression of emotion would have certain meaning to client and "the interaction taking place can

provide an experiential for of reframing (similar to what Franz Alexander terms "The Corrective

Emotional Experience")" (para. 2). Beck (n.d.) also referred to other strategies that parallel

constructivist therapy strategies such as guided discovery and he encouraged collaboration









between therapist and the client to understand the cognitive and emotional processes of his

clients.

The appreciation of complexity is among the basic tenets of constructivist epistemologies.

Constructive metatheory "promotes a complex systems model in which thought, feeling, and

behavior are interdependent expressions of a life span developmental unfolding of interactions

between self and (primarily social) systems" (Mahoney, 1995b, p. 8). Similarly, paying attention

to complex affective experiences that are present in the therapy room and inviting clients to

"actively experience, explore and express a much broader range" of emotions are central to

constructivist therapies (Mahoney, 1995b, p. 9). Practitioners' increasing appreciation of

complexity as well as increasing emphasis on emotionality and experiential processes may

reflect a change in their epistemic style where they have become increasingly more committed to

constructivist epistemology.

Moreover, Ronnestad and Skovholt (2003) suggested that therapists' career development

involved increased understanding of knowledge as a construction. Experienced practitioners

were more likely to reject "precisely defined realities in understanding matter of human

interaction" (p. 31). The authors' focus was on themes concerning therapists' career development

and yet their findings provided implicit support for the proposition that therapists engage in

increasingly more constructivist processing of the therapy room and of the world as they

seasoned. Therapists' increasing commitment to constructivist epistemology may be a related

theme of their career development.

All in all, individual narrations of certain psychotherapists directly and indirectly speak to

an ongoing epistemic shift in the field and imply the epistemic shift was a result of personal

change processes, at least to some degree. Nonetheless, the field is lacking empirical evidence of









its claimed epistemic shift and it is unclear to what extent this shift can be attributed to the

individual change processes of psychotherapists in time and/or to cohort effect facilitated by the

inclusion of post-modern therapists to the field. The current study aims to explore any perceived

epistemic shifts in the field and its underlying dynamics.

Professional Change as a Counterpart of Epistemic Change

Change concerning therapists is not limited to their personal epistemologies.

Psychotherapists change professionally as they conduct therapy. This section highlights

psychotherapists' change processes and then focuses on two professional variables that may

complement therapists' epistemic journey: Theoretical orientation and therapeutic style.

Psychotherapists do change as they practice; at least, they report they do. The scarce

literature on therapist change is built on psychotherapists' self-report collected in various forms.

Interviews, questionnaires, as well as personal narrations were employed to understand their

personal and professional journey as psychotherapists (Farber, 1983; Goldfried, 2001a; Radeke

& Mahoney, 2000).

First, Farber (1983) conducted one-hour semi-structured interviews with 60

psychotherapists and pooled their answers together in order to understand the effects of

psychotherapy practice on psychotherapists. Their results suggested that psychotherapists

believed their personal characteristics as well as social relations had changed since they have

began conducting therapy and they attributed some of this change experience into the their

therapeutic work as therapists. Overall, Farber (1983) suggested that "the effects of therapeutic

work is not confined within the office, but rather have a substantial impact on therapists' outside

behavior and self-identity" (p. 180).









Second, Radeke and Mahoney (2000) compared the impact of their work for psychologists

who were primarily involved with research and psychologists who were primarily identified as

practitioners. This study revealed that compared to researchers, therapists experienced a stronger

impact of their work on their personal problems as well as their personal life. Practitioner

therapists were more likely to acknowledge feeling emotionally exhausted, anxious, and

depressed. Impact of work on personal life included reports of becoming a better and wiser

person with increased self-awareness, increased appreciation for relationships and increased

ambiguity tolerance. In general, psychotherapists reported more change experiences in various

forms than researchers did.

These studies focused on or provided answers for how psychotherapists' personal lives and

experiences changes through their lives as professional practitioners. Goldfried (2001a)'s edited

work, on the other hand, provided information on the therapists' professional change

experiences.

In Goldfried (2001a)'s work, a group of seasoned practitioners individually reflected on

their professional change processes. These narrations revealed intricate yet shared ways in which

practitioners change as they conducted therapy. Summarizing the common points of the

narrations of 16 seasoned psychotherapists, Goldfried (200 b) concluded that conducting

psychotherapy with a mindset of being helpful to clients often demanded therapists to change the

ways in which they understand and approach certain conditions and that impacted the way they

approached to their clients and the way they conducted therapy.

Sporadic interviews with established psychotherapists (such as DeAngelis, 2006) and

infrequent publications where psychologists told their personal stories (such as Hoyt, 2005 and

Brown, 2005) make the last group of resources that can shed light into the process of change









experienced by therapists although they do not include a comparison among one another nor they

provide a tentative conclusion.

For instance, DeAngelis' (2006) interviews with psychotherapists as well as a series of

articles published in the Journal of Clinical Psychology under the title of 'Why I became a

psychotherapist' tapped on the transformations that practitioners have undergone. Some

conceptualized their growth and change not only as an outcome of conducting therapy but also as

a requirement of it and at least some conceptualized the change as a source of motivation to

become and remain as a therapist (see Brown, 2005). Similarly, a group of practitioners that

participated in a study investigating occupational hazards and rewards facing psychotherapists

cited their opportunity to learn and grow as well as their increased self understanding among the

rewards of their work (Kramen-Kahn & Hansen, 1998) suggesting that they have changed

throughout their career and that change process was rewarding for them.

Overall, the results implied that psychotherapists go through a complex change process and

at least some aspects of their change were tied to their work. Different groups of

psychotherapists already reported that personal change (Farber, 1983; Radeke & Mahoney,

2000) and a smaller group implied that their professional attitudes and experiences were not

spared from the process of change (Goldfried, 2001 a).

Recently there has been an increased attention on the change experiences of practitioners

from the developmental perspective. A group of researchers such as Orlinsky, Ronnestad,

Skovholt and Jennings started to study the career trajectories of mental health practitioners from

various parts of the world. They maintained that therapists not just change; their change

processes are systematically organized and they involve progression over time (Ronnestad &

Skovholt, 2003). Combined with the studies on expertise in counseling and psychotherapy









(Jennings & Skovholt, 1999; Kivlighan & Quigley, 1991; Martin, Slemon, Hiebert, Hallberg, &

Cummings, 1989; Skovholt & Jennings, 2004), these studies provided an alternative, systemic

way of conceptualizing change experiences of therapists.

Qualitative studies on master, expert, and/or experienced therapists (Jennings & Skovholt,

1999; Kivlighan & Quigley, 1991; Martin et al., 1989; Skovholt & Jennings, 2004) and on

American practitioners at different experience levels (Ronnestad & Skovholt, 2001; Skovholt &

Ronnestad, 1992; Ronnestad & Skovholt, 2003), as well as an international quantitative study of

development of 5000 psychotherapists from different countries (Orlinsky et al., 1999) revealed

insight into the career paths that psychotherapists pursue.

Martin et al. (1989) studied the differences between novice and experienced counselors by

studying the counselors' conceptual associations regarding the therapy process. Their study

included 23 counselors. Experienced counselors had at least 4 years of experience in university

counseling centers and novice counselors were interns in the 2nd year of a counseling master's

program. Their findings differentiated novices from experienced practitioners in their

conceptualizations of client issues as well as their ways of proceeding. They established that

novice counselors were more likely to pay attention to procedural, "how to", aspects of

counseling; whereas experienced counselors tend to conceptualize their clients at a broader level

in a more inclusive manner.

Kivlighan and Quigley (1991) further supported such cognitive differences between novice

and experienced group counselors. They identified novice counselors as graduate students and

expert counselors were professional counselors with more than 1,000 hours of active group

leadership. In that study, 30 group counselors, half novice and half expert, were asked to

differentiate between the members of a counseling group after watching a session of the group









and experienced counselors engaged in more complex and richer cognitive conceptualizations in

their distinctions.

Jennings and Skovholt (1999; Skovholt & Jennings, 2004) studied not only cognitive, but

also emotional and relational characteristics of master therapists. They have conducted

interviews with 10 therapists who were nominated by their peers as "masters" of their work.

Jennings and Skovholt identified significant personality characteristics shared by master

therapists and proposed a CER model of master therapist that referred to the triad of cognitive,

emotional and relations expertise on the part of master therapists. Master therapists demonstrated

cognitive complexity, openness and desire for continuous learning, emotional receptivity and

maturity, and interpersonal skillfulness. This work was criticized for its lack of a comparison

group that would allow the reader to infer the distinctive characteristics of master therapists

(Orlinsky, 1999). Moreover, the authors did not provide an initial definition of "master

therapist". That combined with their attention to uniformities and neglecting the individual

differences across therapists might create a fictional ideal with little understanding of what being

a master therapist really entails (Orlinsky, 1999). Still, this study provided a sense of what

experience could promote in therapists and stimulated research on full spectrum of therapist

development.

Ronnestad and Skovholt carried out a qualitative study where they have conducted cross-

sectional as well as longitudinal interviews with 100 American psychotherapists at different

experience levels. Their findings were placed in the literature at different instances (Ronnestad &

Skovholt, 1991; Ronnestad & Skovholt, 2001; Skovholt & Ronnestad, 1992). Recently, they

have provided a "reformulation" of the main conclusions (Ronnestad & Skovholt, 2003). They

structured their findings into a phase model of therapist career development that were identified









as the phases of the lay helper, the beginning student, the advanced student, the novice

professional, the experienced professional and the senior professional. They have also

established 14 themes of therapist development describing central processes of therapist

development. The themes addressed various issues such as processes of personal and profession

integration and shifts in attentional focus and emotional functioning. A more detailed account of

these themes will be provided across this literature review in relation with the professional

variables of interest, namely theoretical orientation and therapeutic style.

Ronnestad and Skovholt (2003) have also highlighted certain constants that emerged

across the therapists' professional developmental span. Most importantly, interpersonal

interactions in both personal and professional realms of life have been found as a consistent

contributor to therapists' professional development. Moreover, commitment to learn as well as

the experience of professional growth was invariable for therapists of all experience levels.

Personal and professional growth never ceased for practitioners regardless of the length of their

journey.

Orlinsky and his colleagues' (1999) findings from 5,000 international psychotherapists

confirmed the constancy of growth experience. Although therapist reports of perceived mastery

increased as therapists' years in practice increase, the experience of professional growth was

independent of years spent in practice. Novice and veteran therapists did not differ in the amount

of perceived growth. Even after two decades of practice, therapists reported improvement in their

skills as well as growth in their enthusiasm. The authors suggested that the very experience of

growth provided therapists with the motivation to continue their work.

In this section, we have introduced the literature suggesting that therapists do change

personally and professionally. We have also established that therapists' change processes are not









haphazard. On the contrary, processes of change reflect a certain career trajectory where the

experiences of therapists are defined by the stage of their developmental stage. The current study

focuses on the systemic change of two professional therapist variables, namely theoretical

orientation and therapy style. Following sections will clarify the existing literature on

psychotherapists' change experiences in their theoretical orientation and therapy style.

Theoretical Orientation Change

As we noted above, change is a constant in the field of psychotherapy. The field has been

changing, practitioners have been changing and the change in practitioners' theoretical

orientation is among the most noticeable and cited changes. Today it is suggested that "the

average practitioner changes theoretical orientations 2 or 3 times during his or her career"

(DeAngelis, 2006, p. 59). Mahoney (2001), for instance, has described how he transformed from

a behaviorist, to a cognitivist and then to a constructivist in his theoretical adherence, as

mentioned above.

Various theoretical orientations such as cognitive and constructive theories are gaining

more popularity over others such as psychoanalytic theories. Reports of the 62 psychotherapy

experts who participated at the Delphi Poll at 2002 suggested that this shift was expected to carry

on (Norcross et al., 2002). Specifically, experts anticipated that cognitive-behavior, culture-

sensitive, cognitive and eclectic/integrative theories to become more frequent, whereas classical

psychoanalysis, solution focused theories and transactional analysis would become less frequent

(Norcross et al., 2002).

Moreover, the field is increasingly open to theoretical integration and technical

eclecticism. As much as the idea of integration has been rejected by certain groups of people

who were strictly adhered to their theoretical orientation (see Goldfried, 2001a and Mahoney,

2001 for striking instances of opposing psychotherapy integration), increasing number of









practitioners move away from their original theoretical orientation towards utilizing various

perspectives (Goldfried, 2001a). Today, eclecticism is the modal theoretical orientation for

American psychotherapists (Norcross, 2005).

Ronnestad and Skovholt (2003) observed therapist integration of personal self and

professional self among the 14 themes of therapist development. As therapists seasoned, they

reported increasing consistency between who they were personally (e.g. their values, belief

systems and such) and the ways in which they have conducted therapy. Eagle (2001) provided an

example to this theme from his personal experiences suggesting that he had become more

authentic and genuine as a person and this personal development reflected on his professional

work:

"Comparing my early way of practicing with my current ways brings to mind the
awkwardness I felt when I first began doing therapy. I felt that I was role-playing and the
person I was when I was doing therapy was radically different from the person I was when
I was not doing therapy. I would say that washing away that marked discrepancy between
person as therapist and just person and the accompanying reduction in my awkwardness -
replaced by a greater sense of ease and naturalness- are the most important ways in which I
have changed as a therapist. I think I have become more so with the years" (p. 49).

Ronnestad and Skovholt (2003) conceptualized therapists' changing their theoretical

orientation as an indicator of such an increased integration and congruency. They further

suggested that as their theoretical adherence shifted, the ways in which they connect with their

clients and assign responsibilities within the therapeutic relationship have changed.

Next, we investigate the nature and development of psychotherapists' therapy style that

includes the way therapists related to their clients.

Therapy Style Change

Knowing that therapist variables account for a significant portion of therapy outcome,

research in therapist variables gained momentum. Fernandez-Alvarez, Garcia, Lo Bianco, and

Corbella (2003) suggested that therapy style could be among the therapist variables influencing









the process of change and recovery for the clients. They have contributed to the literature by

conceiving the Personal Style of the Therapist (PST) construct and providing a detailed

description this understudied variable.

Fernandez-Alvarez et al. (2003) defined PST as "the set of characteristics that each

therapist applies in every psychotherapeutic situation, shaping its basic attributes" (p. 117). In

other words, PST is the collection of conditions that guide the therapist's therapeutic behavior.

They conceptualized style of the therapist as composed of five bipolar dimensions of

instructional, expressive, engagement, attentional, and operative, and this conceptualization was

validated empirically (Fernandez-Alvarez et al., 2003).

First dimension was identified as instructional, and it referred to therapists' ways of

establishing and regulating the rules of therapy such as scheduling and ways of negotiating

change. It was defined within the bipolarity of flexibility-rigidity. Second dimension was

identified as expressive, and it referred to therapists' level of expressing emotions to their clients.

It was defined within the bipolarity of distance-closeness. Third dimension was identified as

engagement, and it referred to therapists' level of commitment to therapy and clients. It was

defined within the bipolarity of lesser degree-greater degree. Fourth dimension was identified as

attentional, and it referred to therapists' range of attention when gathering information from

clients, and associated level of activity in the search of certain client information. It was defined

within the bipolarity of broad focused-narrow focused. Broad focus accompanied therapist

receptiveness as well as lacking preconceived expectation of what client may bring to session,

while narrow focus accompanied therapists' active pursuit of certain realms of knowledge. Fifth

dimension was identified as operative, and it referred to therapists' way of implementing

intervention. It was defined within the bipolarity of spontaneous-planned.









Fernindez-Alvarez et al. (2003) suggested that these dimensions appear in an integrated

manner through therapists' work. They also suggested that all combinations in personal style

were valuable, and some combinations would be more convenient or beneficial than others for

specific clinical situations. In order to investigate the nature of this construct further, Fernandez-

Alvarez et al. (2003) developed a self-administered questionnaire measuring these five

dimensions of the therapist style, called the Personal Style of the Therapist Questionnaire (PST-

Q). They have further employed this questionnaire to study the relationships between personal

style of the therapist, theoretical orientation, years of professional experience and length of

treatment for a group of Argentinian psychotherapists (Castafieiras, Garcia, Lo Bianco &

Fernindez-Alvarez, 2006). The findings of this study informed the aims of the current study and

we will explore these findings in depth. In general, the findings suggested that therapy style was

associated with these identified therapist variables in complex and dynamic ways. Most

importantly, preliminary evidence suggested the stable yet flexible nature of the PST construct.

The therapy style was conceptualized as a stable variable over the time, yet Fernindez-Alvarez et

al. (2003) had also claimed that PST could withstand minor or major changes as therapists

endure significant changes in their life or work circumstances. Castafieiras et al. (2006)

supported this assumption by showing significant PST differences for therapists with different

levels of experience.

Castafieiras et al. (2006) first assigned therapists into three different theoretical adherence

categories based on participants' self-descriptions, and therapists were classified into the groups

of psychoanalytic therapy, cognitive therapy, and integrative therapy with respect to their

theoretical orientation. They identified beginner level therapists as the therapists with up to 5

years of experience and expert therapists as the therapists who had 15 years of experience or









more. Then, they analyzed how PST, experience and theoretical orientation relate to one another

by slicing their findings in different ways. First, we will present the findings that focused on PST

differences across theoretical orientations. Then we will present the comparisons between

beginner and expert therapists on their PST scores for each theoretical orientation group

separately.

Castafieiras et al. (2006) found significant PST differences between therapists with

different theoretical orientations. They studied the association between style and theoretical

orientation separately for beginners and experts since level of experience was found to be a

modulating factor. For beginners, there were no difference in therapists' level of expressiveness

and engagement across three orientation groups; participated beginners were fairly committed to

and emotionally expressive with their clients regardless of their theoretical orientation.

Instructional rigidity separated beginner cognitive therapists from beginner integrative

therapists: Cognitive therapists were more rigid in their establishing and maintaining the rules

and regulations relating to therapy than integrative therapists.

At the both levels of experience, cognitive and integrative therapists were similar in the

dimensions of attentional and operative, and scored significantly higher than the psychoanalytic

therapists. Compared to psychoanalytical therapists, cognitive and integrative therapists were

significantly more active in eliciting information and narrower in their focus and they were more

planned in the implementation of therapeutic interventions.

For experts, the cognitive and integrative therapists also score significantly higher on

expressive dimension of style than psychoanalytical therapists; expert cognitive and integrative

therapists reported more emotional presence and communication with their clients compared to

expert psychoanalytical therapists. And for the expertise level, integrative therapists scored









significantly higher on engagement dimension than the psychoanalytical therapists; expert

integrationists reported higher levels of commitment to the act of therapy and to their actual

clients.

Overall, the findings indicated that adherence to cognitive and integrative theories was

associated with similar levels of attentional, operative, and expressive, and psychoanalytical

therapists had a broader focus, more spontaneity and more distance than cognitive and

integrative therapists. The findings indicated that the therapy style is associated with theoretical

orientation in different ways depending on therapists' experience level (Castafieiras et al., 2006).

Then, Castafieiras et al. (2006) compared beginner level therapists to expert therapists on

their PST scores for each theoretical orientation group separately. Among cognitive therapists,

differences between beginners and experts emerged for the domains of instructional and

expressive: Beginner level cognitive therapists were more rigid in setting and maintaining rules

regarding therapy (instructional) and more emotionally distant towards clients (expressive)

compared to experts. Among integrative therapists, differences across experience level emerged

for the dimensions of attentional, operative, and engagement. Beginner level integrative

therapists were more narrowly focused, actively searching for a specific realm of knowledge

(attentional), more planned in implementing interventions (operative), and yet less committed to

therapy and client (engagement) as compared to expert integrationist. Among psychoanalytic

therapists, differences between beginners and experts emerged for the dimension of attentional:

Beginner level psychoanalytic therapists endorsed significantly narrower focus (attentional) than

their expert counterparts.

The authors concluded that years of experience partially modulated the evolution of

therapist style in each specific theoretical orientation (Castafieiras et al., 2006). These findings









implied that therapy style is related to years of experience and that therapy style could change

over the course of professional development. Recognizing the cross-sectional nature of this

study, one might speculate that the obtained differences between beginner and expert therapists

could indicate a cohort effect where the field and/or contemporary training models locate

distinctive demands on recently graduated therapists. Yet, the findings on therapist professional

development (Jennings & Skovholt, 1999; Martin et al., 1989; Ronnestad & Skovholt, 2003;

Skovholt & Jennings, 2004) support the conclusion that the stylistic differences between

beginner and expert therapists was a reflection of professional change experiences. The therapist

career development studies and Castafieiras et al.'s (2006) study concur that therapists relax in

their style, broaden their attentional perspective, and become skillful in communicating their

emotions as they season in the profession and gain expertise.

Specifically, Martin et al. (1989) differentiated novice practitioners from experienced

practitioners in their conceptualizations of client issues. Novice counselors were more likely to

present a preoccupation with procedural concepts. On the other hand, experienced counselors

tended to conceptualize their clients at a broader level and in a more inclusive manner. These

findings can be translated to the PST terminology employed by Castafieiras et al. (2006) where

novice counselors had narrow attentional focus and planned way of conducting therapy

interventions guided by their "how to" knowledge, while experienced counselors had broader

focus, openness to wide-range of client material and willing to incorporate spontaneous

interventions. Martin et al. (1989) provided an early evidence for the assumption that therapy

style, in particular with the dimensions of attentional and operative, differ with respect to

therapists' level of experience. The more recent research on master therapists and professional









development provided more compelling evidence supporting stylistic change of therapists with

experience.

Likewise, Ronnestad and Skovholt (2003) suggested that therapists reported increased

professional flexibility throughout their career development. As therapists seasoned, they have

confronted various challenges that facilitated a gradual disillusionment with training. With this

disillusionment, the practitioners' attention gradually shifted from what their training solicited to

an internally-based flexible professional functioning. This inferred flexibility across professional

development was aligned with the findings that expert therapists were significantly more flexible

in setting and maintaining rules regarding therapy (instructional), more broadly focused and

open-minded while listening to client material (attentional) and more spontaneous in

implementing interventions (operative), at least for the expert therapists with certain theoretical

commitments (Castafieiras et al., 2006).

Additionally, Jennings and Skovholt (1999; Skovholt & Jennings, 2004) found that master

therapists were strong in their emotional and relational skills Specifically, among other qualities,

emotional receptiveness, ability to attend to self and other's emotions, recognition of the ways in

which their own emotions impact their work, relational skillfulness, strong adherence to working

alliance and exceptional use of relational skills in therapy were among the qualities shared by

and hence define the master therapists. These findings were supportive of the findings that expert

therapists had higher scores on the dimensions of engagement and expressive compared to

beginner therapists, at least for master therapists with certain theoretical commitments

(Castafieiras et al., 2006).

The narrations of 16 seasoned psychotherapists further confirmed these findings

(Goldfried, 2001 a). These practitioners that reflected on their professional change processes









reported increased flexibility, broadened understanding and appreciation of client concerns and

enriched ways of reaching out to their clients. Most importantly, each narrative described ways

of breaking free from original teachings and developing integrative, expansive, pliable ways of

being and doing in their therapeutic work. Even though these practitioners did not employ the

PST framework or language, they were clearly providing further evidence from their own

perspective on how they have changed in their therapy style as they seasoned as therapists.

Castafieiras et al.'s (2006) study was significant as it provided empirical support for the

usefulness of the PST construct, for the sensitivity and specificity of the PST-Q, and most

importantly, for the change processes of dimensions of therapy style. Combined with the

therapist development studies (Jennings & Skovholt, 1999; Ronnestad & Skovholt, 2003;

Skovholt & Jennings, 2004) and personal narratives of seasoned therapists (Goldfried, 2001a),

the findings of Castafieiras et al. (2006) suggest that therapists' style in which they engage with

therapy might change with experience. The current study aims to clarify whether therapists

perceive stylistic change as a part of their professional development and growth experiences, and

if so what the direction of change would be for the participating therapists. In line with the

above-mentioned findings, we expect to find increase in therapists' emotional expressiveness,

engagement, attentional focus and spontaneity. This clarification would be a significant edition

to the limited literature on psychotherapists' change experienced in therapy style.

Epistemic and Professional Change

Our literature review studied two change processes regarding psychotherapists, namely

epistemic change and professional change. We agree with Stricker (2001) who conceptualized

change as a "synergist" and suggested that "change of any sort can facilitate other changes" (p.

79). Hence, once we have accumulated information with respect to therapists' change

experiences in epistemology, theoretical orientation and therapy style, then we shall investigate









the ways in which these change processes facilitate one another. The existing literature suggests

that these two processes are associated; yet this interaction remains to be studied.

As we have clarified above, certain schools of thought and theoretical orientations have

been associated with certain epistemic styles. Conceptually, rational epistemic style was linked

to rationalistic cognitive therapies whereas metaphorical epistemic style was linked to

constructivist cognitive therapies (Lyddon, 1991). Consistent with these conceptual links,

epistemic style moderately accounted for individuals' attitudes and preferences for theories of

psychotherapy (Lyddon, 1989a; Lyddon & Adamson, 1992; Neimeyer et al., 1993; Neimeyer &

Morton, 1997; Schacht & Black, 1985): Participants preferred theoretical orientations that were

consistent with their own epistemic view.

Considering that the epistemic style of a therapist accounts for his or her theoretical

orientation preferences, it is reasonable to expect that a change in a therapist's epistemic

commitment would reflect on the therapist's choice of theoretical orientation. It can be argued

that therapists' epistemic change experiences would be related to the quantitative and qualitative

changes in their theoretical orientation. In other words, as the psychotherapists see the world

differently, they may adhere to new theories that capture their most recent worldview. We

assume that psychotherapists' change in the epistemic commitment can predict the change in

their theoretical orientation. The more psychotherapists experience an epistemic shift, the more

likely they may be to report a change in their theoretical orientation.

As constructivist metatheory reflects recognition of complexity in human processes,

epistemic shift of practitioners towards constructivism may further encourage practitioners to

integrate various forms of therapy. Alternatively (and additionally), the ongoing integrationist

movement might have endorsed a more constructivist framework on its members. In other









words, it is likely that the field's increasing commitment to constructivism and the increasing

theoretical integration on the part of psychotherapists may be related to and promoting one

another. Hence, we expect that increase in therapists' commitment to constructivist

epistemologies might correlate with their engagement in more integrated ways of conducting

therapy.

Epistemic style has also been employed to understand the differences among

psychotherapy practices. Therapists conducting rationalist and constructivist therapies differed in

the way they set the direction of the therapy, related to client, and conceptualized and worked

through clients' emotional distress, relapse, and regression (Nagae & Nedate, 2001; Vasco, 1994;

Viney, 1994; Winter & Watson, 1999). Therapists with different epistemic commitments

appeared to have different styles in their therapeutic closeness, focus, engagement, and

spontaneity as well as different emphasis on bonding with their clients (Neimeyer & Saferstein,

2006).

Moreover, Castafieiras et al. (2006) demonstrated the complex ways in which therapy

style, experience, and theoretical orientation interacted. Their findings indicated that the ways in

which therapy style related to theoretical orientations (psychoanalytic, cognitive, and integrative)

was different across the two levels of experience (beginners with less than five years of

experience and experts with 15 years of experience or more). Overall, the findings indicated that

adherence to cognitive and integrative theories was associated with similar levels of attentional,

operative and expressive, and psychoanalytical therapists had lower scores on each of these three

dimensions of therapy style compared to cognitive and integrative therapists.

Castafieiras et al.'s (2006) findings indicated that the therapy style was associated with

theoretical orientation in different ways depending on therapists' experience level. Given that









theoretical orientations reflected an underlying epistemic commitment (Lyddon, 1989b) and

certain dimensions of therapy style have already linked to epistemic commitments of therapists

(Neimeyer & Saferstein, 2006), it is reasonable to expect therapist epistemic change to account

for or to align with therapists' stylistic change experiences. Hence, any increase in therapists'

commitment to constructivist epistemologies might correlate with increase in certain dimensions

of therapeutic style, specifically therapeutic closeness, engagement, spontaneity, and focus.

Castafieiras et al. (2006) did not include epistemology as a variable, nor did they group

their participants into groups of epistemically divergent categories of theoretical orientation.

Rather it is safe to assume that these categories were fairly generic, each involving a wide range

of theories and practices. As this literature review suggested, cognitive therapy is an umbrella

term combining a variety of approaches (Lyddon, 1988; Mahoney, 1991). The current study

aimed to further our understanding between the therapy style and theoretical orientation by

separating how epistemic commitments underlying theoretical orientations related to levels of

and changes in therapy style. Recognizing the ways in which epistemology is linked to therapy

style could improve our understanding of these significant therapist variables.

Overall, the existing literature provides a cogent rationale to pursue and expect

association between therapists' epistemic and professional journeys. This relationship would be a

complex one, impacting one another at different levels through different dynamics. Uncovering

this multifaceted association starts with simply establishing that therapists perceive their

epistemic and professional change processes to correlate. This basic question of whether and if

so, to what extent psychotherapists' perceived epistemic change accounts for where therapists

stand in their theoretical stylistic journey has remained to be answered, and was identified among

the inquiries of the present study. The purpose of the present work was to help lay the foundation









for developing an increased understanding of therapists' developmental processes and the place

of epistemic commitment within that framework, as construed by therapists' themselves.

Taken as a whole, the literature indicates psychotherapist theory preferences as well as

therapeutic conceptualizations and behavior are colored by their epistemic commitments. Yet

such professional attitudes and behaviors as well as the epistemic commitments are subject to

development and growth. Moreover, these change processes are likely to interact with one

another: Any change experienced in the way we perceive the world and test the validity of

knowledge as psychotherapists are likely to mark the growth and change in our therapy-related

attitudes and behaviors. Overall, the complex associations between epistemic worldview and

psychotherapy preferences and behaviors have been yet to be clarified within a developmental

framework that supposes change and growth in both aspects.

Purpose of Study

As the literature review points out, the psychotherapy literature suggests that the field has

experienced an epistemic shift where its members have become increasingly more constructivist,

and numerous seasoned psychotherapists endorsed this shift through narrating their own

epistemic change. However, despite the general acceptance of the notion in the current literature,

there is no empirical evidence documenting that today's practitioners have in fact experienced an

epistemic shift in their perspective and practice, apart from the anecdotal evidence of selected

prominent practitioners in the field. The "increasingly constructivist" landscape of contemporary

psychotherapy could be an indicator of a cohort effect rather than an indicator of therapists'

developmental changes across time. For instance, early-career therapists might have stronger

commitments to constructivism than therapists of the previous generations, and/or therapists who

entered the field at different times have different epistemic trajectories. The dynamics underlying









the field's and its practitioners' increasing commitment to constructivism have yet to be

empirically investigated. The literature also indicates that therapists change in their theoretical

orientation and therapy style in somewhat consistent ways and that therapists' epistemic journeys

might relate to these professional change experiences. Yet, these interactions have also remained

to be investigated empirically.

The present work was an exploratory study investigating the epistemic change experiences

of practitioners, as therapists perceived them. This study attempted to answer three umbrella

questions including specific hypotheses following two of the questions. The main questions and

accompanying hypotheses are specified as followed.

Question 1. How do therapists perceive themselves to change in their (a) epistemic

worldview, (b) theoretical orientation characteristics, and (c) therapeutic style across their

professional lifetime? Specifically we expected that (1) when compared to their initial epistemic

commitments, therapists would report having increasingly higher levels of commitment to

constructivist epistemologies; (2) when compared to the plurality, i.e. eclecticism of their initial

commitments, therapists would report having increasingly higher levels of plurality in their

therapeutic orientation; and (3) when compared to their initial levels, therapists would indicate

increasingly higher levels of (a) expressiveness, (b) engagement, (c) attentional focus, and (d)

operative spontaneity in their therapeutic styles across the course of their practice.

Question 2. What are the reasons behind the field's increasing commitment to

constructivist epistemology? More specifically, to what extent do cohort effects account for the

epistemic shift in the field of psychotherapy? As an exploratory analysis, we attempted to clarify

how much of the variance in therapists' initial epistemic commitments as well as their epistemic

trajectories can be explained by the time in which they have entered the field.









Question 3. What is the relationship between therapists' epistemic and professional

change experiences? In other words, to what extent can therapists' epistemic journeys account

for their current standing with their therapeutic orientation and style after accounting for their

initial standing with these variables? We hypothesized that increases in therapists' constructivist

commitments would predict (1) greater changes in their theoretical orientation throughout their

professional lifetime; (2) greater levels of theoretical plurality, indicating greater adherence to

theoretical integration and eclecticism; (3) greater levels of expressive and engagement

dimensions of therapy style, indicating greater adherence to emotional expressiveness with and

engagement to clients; and (4) lower levels of operative and attentional dimensions of therapy

style, indicating greater levels of spontaneity in implementing interventions and wider range of

attention in collecting information from the clients.









CHAPTER 3
METHODS

Participants

Participants were professional psychologists and they were recruited online from the

American Psychological Association (APA) Practice Organization (www.apapractice.org)

online practitioner directory (approximately 13,000 members). The solicitation email also

encouraged participants to forward the survey invitation on to other eligible practitioners.

Procedure

An Internet survey was conducted where participants were invited to complete a set of

questionnaires online that required approximately 25 minutes to complete on average.

Participants were informed that the study aims to understand their descriptions of themselves as

therapists at different stages of their career. We refrained from using the word 'change' to limit

the potential bias that might be introduced by the nature of this word. Informed consent was

required before the survey appeared on the screen. The survey was anonymous and the

confidentiality of completed surveys was insured.

In the survey, participants were asked to answer some sets of questions twice with different

directions. Participants rated certain items once reflecting on their current experiences and once

reflecting on their past, specifically on the time where they had started post-graduate practice of

psychotherapy.

The order of these two sets of directions were alternated, half of the participants reflecting

on their past first, and their current selves later, and the other half of the participants reflecting on

their today first and their past later. This enabled us to test and if necessary control the possible

operation of any order effects as we detailed in the results section.









To avoid a likely frustration on the part of participants that may stem from answering

several questions twice, the study was set-up such that the items would appear only one time

asking therapist to respond to the given item once from their current standing point and once

from their initial standing point. We anticipated that this set-up would shorten the time spent on

reading and answering the questions twice and lessen the likely frustration. Yet, attending to

same item considering "now" and "then" side by side would provide participants' with an

immediate opportunity to compare their ratings for their past and present, and hence, might

artificially stretch the gap between two ratings.

A pilot study conducted with 34 professional practitioners and practitioners in training

failed to support such possibility. When half of the participants responded to ratings of past and

present side by side, the other half responded to such items separately. The obtained findings

failed to indicate a significant difference between the two groups' ratings; hence encouraged us

to believe that reflecting on items side by side had minimum or no considerable impact on the

participants' ratings.

Participants were also debriefed at the end of the study and they were provided with the

contact information of the primary investigator for further inquiries.

Instruments

Epistemic commitments: Therapists' epistemic commitments were measured with the

Therapist Attitude Questionnaire .- h,, t Form (TAQ-SF). This scale assesses the degree of

participants' commitments to rationalist and constructivist epistemologies. DiGiuseppe and

Linscott (1993) developed the Therapist Attitude Questionnaire (TAQ) to measure the

philosophical, theoretical, and technical dimensions of the rationalist and constructivist positions.

Neimeyer and Morton (1997) developed the short version of the TAQ, named Therapist Attitude









Questionnaire Short Form (TAQ-SF). The TAQ-SF measures the same constructs the TAQ

measures using a total of 16 items. Eight items represents rationalist positions and the other 8

items represents constructivist positions. As in the TAQ, the respondents determine the degree to

which they endorse the statements on a five-point scale ranging from 1 (strongly disagree) to 5

(strongly agree). Sample items include "Reality is singular, stable and external to human

experience" and "Reality is relative. Realities reflect individual or collective constructions of

order to one's experiences". Higher rationalism and constructivism scores reflect higher

commitments to rationalist and constructivist epistemologies. The TAQ-SF was found to

reproduce the basic factor structure of the TAQ. Predictive validity of the measure was

established as it predicted the therapeutic identifications and descriptions of a group of practicing

professionals (Neimeyer & Morton, 1997).

Theoretical orientation: Theoretical orientation was measured by asking therapists to rate

their orientation on a list of seven categories of analytic-psychodynamic-neo-analytic,

behavioral, cognitive, humanistic-existential, systemic, constructivist-narrative, and feminist-

multicultural. The respondents were asked to rate each orientation on a five-point scale ranging

from 1 (not a part of my practice) to 5 (a very significant part of my practice). Then, the

respondents were asked to identify their main theoretical orientation from a menu that included

the above-mentioned orientations and integrationist orientation. At last, the respondents were

asked to rate the extent to which they perceive their theoretical orientation has remained the

same, or changed on a five-point scale ranging from 1 (same) to 5 (changed).

The plurality, i.e. eclecticism, of theoretical orientation was defined based on the

cumulative number endorsed on the theoretical orientation ratings. Higher numbers indicated

higher plurality. Therapists' indication of their main theoretical base was used as an anchor.









Therapist style: Therapist style was measured with the Personal Style of the Therapist

Questionnaire (PST-Q). This questionnaire assesses therapists' characteristics ways of

conducting psychotherapy. Fernandez-Alvarez et al. (2003) developed the questionnaire to

measure the ways in which therapists engage in therapy and shape the conduct of their

therapeutic work. The questionnaire is composed of five subscales that were designed to assess

five different dimensions of therapist style. (1) Instructional subscale assesses flexibility in

establishing and regulating the therapy setting; higher scores represent greater rigidity vs.

flexibility. (2) Expressive subscale assesses emotional communication; higher scores represent

greater closeness vs. distance. (3) Engagement subscale assesses level of commitment to therapy

and client, higher scores represent greater degree vs. lesser degree. (4) Attentional subscale

assesses therapists' range of attention and activity level in gathering information; higher scores

represent narrower focus vs. broad focus. (5) Operative subscale assesses spontaneity in

implementing interventions; higher scores represent more planned vs. spontaneous. See Table 3-

1. PST-Q is a 36-item self-report measure. The respondents rate how accurately each statement

described their practice on a seven-point scale ranging from 1 (total disagreement) to 7 (total

agreement). The questionnaire have yielded the following Cronbach's alpha scores for each

subscale: Instructional, .69; expressive, .75; engagement, .78; attentional, .80; operative, .78. The

measure has shown adequate 4-month test-retest reliability (instructional, r = .82; expressive, r =

.76; engagement, r = .78; attentional, r = .81; and operative, r = .78). Theoretical validity is

established through obtained factorial composition, and further supported by the work of

Castafieiras et al. (2006).

Demographics: Participants were asked to give information about their demographic

information. These included gender, age, ethnic background, name of their highest degree, the









year they obtained their highest degree, total number of years they have spent in clinical practice,

specialty area, primary employment setting, primary job responsibility, average number of

clients seen weekly and the country they live in.

Table 3-1. Personal Style of the Therapist Questionnaire (PST-Q): Subscale directions
Subscales Low High
1. Instructional Flexibility Rigidity
2. Expressive Distance Closeness
3. Engagement Lesser degree Greater degree
4. Attentional Broad focus Narrow focus
5. Operative Spontaneous Planned









CHAPTER 4
RESULTS

The results section is composed of three sections. First, the sample characteristics of the

participants are provided. Second, the descriptive information concerning the overall scores,

psychometrics and relationships among the primary variables of interest are presented. And last,

the three primary analyses are reported. A series of repeated measures ANOVA first address the

primary questions regarding the ways in which therapists regard themselves as changing in

relation to their theoretical orientations and therapy styles (expressive, engagement, operative,

and attentional) across the course of their practice. Next, multiple regression analyses are

reported to address the question regarding whether cohort effects (i.e. the year of entry to the

profession) accounted for therapists' perceptions regarding their initial epistemic commitments

and epistemic shifts. And third, a series of multiple regression analyses are reported to address

the question regarding whether change in therapists' epistemic leanings predict levels of

therapists' current theoretical and stylistic commitments, above and beyond their initial

commitments.

Demographics

The sample consisted of 702 participants of which 94.2% designated their demographic

information. Among those who responded, 59.5% women and 40.5% men, with a mean age of

50.36 (SD = 11.7, age range = 25-84 years). The majority of the participants were Caucasian,

88.6% (N= 584), followed by Hispanic, 3.6% (N= 24), African-American/Black, 2.4% (N= 16),

Asian-American, 1.2% (N= 8), multiracial, 1.2% (N= 8), and Other, 2.9% (N= 19). The

majority of the participants reported to be from the U.S., 96% (N = 630), whereas 4% (N = 26) of

the participants were from other countries.









The majority of the participants had a Ph.D. degree, 68.9% (N = 449), followed by a

Psy.D., 16% (N = 104), M.A. or M.S., 8.4% (N = 55), Ed.D., 1.8% (N= 12), M.S.W., 1.5% (N=

10), or other degrees, 3.4% (N= 22), as their highest degree. The majority of the participants

were self-identified as psychologist, 87.4% (N= 577), followed by mental health counselor,

4.2% (N= 28), marriage and family therapist, 2.4% (N= 16), and social worker, 1.2% (N= 8).

The remaining participants designated themselves as Other, 4.7% (N = 31).

The majority of the participants defined their primary responsibility as practice/clinical

work, 80.2% (N= 528), followed by academic, 8.2% (N= 54), administrative, 4.1% (N= 27),

research, 1.2% (N= 8) and other, 2.7% (N= 18). The remaining 23 participants designated

themselves as being equally involved in multiple responsibilities, 3.5%. The majority of the

participants indicated their primary employment setting as private practice, 47.0% (N= 309),

followed by hospital, 10.8% (N= 71), mental health care, 10.2% (N= 67), university academic

department, 8.5% (N= 56), university service delivery department, 6.1% (N= 40), community

center, 3.8% (N= 25), school, 2.7% (N= 18), correctional facility, 1.7% (N = 11), and other,

9.1% (N = 60). Mean number of years spent in clinical practice was 18.66, and ranged between 1

and 52 (SD = 10.94). The mean number of clients seen weekly was 17.38, and ranged between 1

and 61 (SD = 10.69).

The majority of the participants identified integrative as their primary theoretical

orientation at the present time, 32.2% (N = 213), followed by cognitive, 27% (N = 179),

psychodynamic, 17.1% (N= 113), humanistic-existential-gestalt, 8% (N= 53), systemic-family,

4.7% (N= 31), behavioral, 4.7% (N= 31), narrative/constructivist, 4.2% (N= 28), and feminist-

multicultural, 2.1% (N= 14). Psychodynamic theory was the most common primary theoretical

orientation designated by therapists at the time that they started practice after graduation, 26.5%









(N= 175), followed by cognitive, 23.9% (N= 158), humanistic-existential-gestalt, 16.9% (N=

112), behavioral, 12.4% (N= 82), integrative, 11.3% (N= 75), systemic-family, 6.4% (N= 42),

narrative/constructivist, 1.5% (N= 10), and feminist-multicultural, 1.1% (N= 7).

Descriptives and Preliminary Analyses

In order to assess the potential impact associated with the various orderings of the

questionnaires used in this study, one-way ANOVAs were conducted along the six different

orderings, using each of the questionnaire scores as dependent variables in the analysis. These

analyses suggested that there were no difference in the mean scores of the variables of interest

among the six types of questionnaire forms (all ps > .01). Thus for all analyses, the data from six

different forms were combined.

Table 4-1 depicts summary statistics of the primary variables used in this study. This

includes the measures of rationalism and constructivism derived from the Therapist Attitudes

Questionnaire (TAQ), the therapeutic change index, the measure of therapeutic plurality, and the

measures of therapy styles of (a) expressive, (b) engagement, (c) attentional, and (d) operative,

scores indicated separately according to their current (now) and initial (then) ratings from the

practitioners. All scores were normally distributed. Skewness and kurtosis values were in the

acceptable range for appropriate distribution. The epistemology scores obtained from TAQ were

consistent with the scores reported by Neimeyer and Morton (1997). Overall, the scales yielded

low to moderate reliability coefficients.

Table 4-2 depicts the Pearson Product-Moment correlation coefficients among the

variables of interest. Consistent with previous distinctions outlined in the literature, a number of

therapist qualities were associated with epistemic leanings in theoretically consistent ways.

Levels of constructivism, for example, were generally positively related to greater levels of









therapist expressive, and theoretical plurality, while rationalist leanings were negatively

associated with these variables. Levels of constructivism were generally negatively related to

narrower levels of attentional focus, and operative spontaneity (reflecting higher levels of plan-

induced approach to therapy), while rationalist leanings were positively associated with these

variables. Similarly, conceptually linked variables showed low to moderate associations. For

example, attentional and operative dimensions were positively associated with one another, as

were levels of expressive and engagement factors, and these two groups of variables were

negatively associated with one another.

Preliminary analyses investigating whether the scores on the dependent variables were

different across demographic variables revealed that certain variables of interest were different

across the levels of gender, age, and average number of clients seen weekly. T-test analyses

revealed gender differences in constructivism-now (t = -3.98, p < .001), constructivism-then (t =

-2.98, p < .003), and rationalism-now (t = 3.61, p < .001) scores. Males scored significantly

higher than females in their current commitment to rationalist epistemology (males, M = 23.41,

SD = 5.71, females, M= 21.84, SD = 4.90); whereas females scored significantly higher than

males in their current (males, M= 32.83, SD = 3.95, females, M= 33.99, SD = 3.17); and past

commitment to constructivist epistemology (males, M= 30.62, SD = 4.25, females, M= 31.57,

SD = 3.52). Regression analyses revealed that age significantly accounted for variance in

engagement-now (F(1, 492) = 9.51, p = .002; f = -.14), and attentional-then (F(1, 494) = 11.41,

p = .001; f = -.15) scores, and theoretical orientation change index (F(1, 504) = 13.01, p = .000;

f =. 16). The average number of clients seen weekly accounted for significant variance in

attentional-now scores (F(1, 630) = 11.20, p = .001; f = -.13). Hence, these three demographic

variables (i.e., gender, age, and average number of clients seen weekly) were entered into the









primary analyses as covariates when subsequent analyses involved the above-mentioned

variables.

Primary Analyses

The final set of analyses utilized three sets of analyses. First, repeated ANOVA analyses

were conducted to examine whether there was a perceived change in therapists' epistemic

leanings, theoretical orientation, and therapy styles of expressive, engagement, operative, and

attentional across the course of their practice. It was hypothesized that compared to their initial

levels, therapists would report increasingly higher levels of commitment to constructivist

epistemologies, plurality in their therapeutic orientation. In addition, they were expected to have

higher levels of expressive and engagement dimensions in the therapeutic styles and lower levels

of operative and attentional dimensions. Second, regression analyses were conducted to

investigate whether the participants' cohort of graduation would account for some of the

variance in the epistemic shift in the field of psychotherapy. In other words, we wanted to

determine whether the shifts towards greater constructivism were the result of the influx of new

constructivist therapists trained in recent years, versus perceived developmental changes

occurring within longstanding psychotherapists. No predictions were specified for this research

question. Third, regression analyses were conducted to examine whether change in

epistemological commitments predicted the therapists' current levels of theoretical orientation,

adherence to theoretical integration, and therapy styles of expressive, engagement, operative, and

attentional dimensions, above and beyond what their initial standing was. Increasing

commitment to constructivist epistemologies was expected to predict higher levels of theoretical

change and plurality, higher levels of expressive and engagement styles, and lower levels of

operative and attentional styles.









Research Question #1: How Do Therapists Change in Their Epistemic Commitment and in
Professional Characteristics across the Course of Their Professional Practice?

Within this broad research question, we have specifically hypothesized that when

compared to their initial standing, therapists would have (1) increasingly higher levels of

commitment to constructivist epistemologies; (2) increasingly higher levels of plurality in their

therapeutic orientation; and (3) increasingly higher levels of expressive and engagement

subscales, and lower levels of attentional and operative subscale. We conducted a series of

repeated measures ANOVA, with now-versus-then (i.e. time factor) as the within-subjects factor,

and epistemology, theoretical orientation, and therapeutic style scores as the dependent variables,

to investigate whether there were significant reported changes in the therapists' epistemic

commitments and identified professional variables over the course of their practice.

Gender was entered as a covariate to the analyses involving the variables of constructivism

and rationalism. Age was entered as a covariate in the analyses regarding engagement, attention,

and theoretical orientation change. In addition to age, the average number of clients seen weekly

was entered into the analysis involving the attention variable. A Bonferroni adjustment was

employed within the analyses to guard against the Type I error, and alpha level was established

at .007 (.05/7), which is the original alpha level (.05) divided by the number of statistical tests.

Obtained partial eta-squared scores were reported as effect size indices. Table 4-3 summarizes

the obtained coefficients.

Findings indicated statistically significant changes in therapists' epistemic leanings,

therapy styles and theoretical plurality. Consistent with our hypotheses, analyses revealed an

increase in therapists' perceived commitment to constructivist epistemology. This finding was

not only statistically significant, but also modestly robust, as indicated by a partial-eta squared of

.21. Another statistically and clinically significant finding was therapists' perceived change in









theoretical plurality. Data indicated a significant increase in therapists employing a greater

variety of theoretical orientations in their practice with a partial-eta squared of .38. Hence,

therapists' reported increase not only in their constructivist leanings but also in their theoretical

eclecticism i.e. plurality. Data also indicated a significant reduction in therapists' perceived

commitment to rationalist epistemology across their practice.

Therapists' change in their theoretical orientation can be understood further by comparing

individual theoretical orientation ratings for now and then. We conducted a series of repeated

measures ANOVA, with now-versus-then (i.e. time factor) as the within-subjects factor and

seven theoretical orientations as the dependent variables, to investigate whether there were

significant reported changes in the therapists' commitment to these specific theoretical

orientations over the course of their practice. Bonferroni adjustment was employed within the

analyses to guard against the Type I error, and alpha level was established at .007 (.05/7), which

is the original alpha level (.05) divided by the number of statistical tests. Table 4-4 summarizes

the obtained coefficients.

With respect to theoretical orientation changes within therapists, data indicated statistically

and clinically significant increase in therapists' commitment to cognitive, constructivist and

feminist-multicultural therapies. There was also a significant increase in behavioral therapy, and

systemic-family therapies although these changes were failed to be clinically meaningful

suggested by their low effect size indices. Data failed to indicate change for therapists'

commitment to psychodynamic and humanistic-existential-gestalt orientations.

An overall change in therapists' theoretical perspectives is also evident when we compare

their initial and current theoretical base. When therapists were asked to choose one theoretical

orientation as their main base among the eight options (cognitive, behavioral, humanistic -









existential gestalt, narrative/constructivist, systemic family, psychodynamic, feminist -

multicultural, and integrationist), the cumulative picture of primary commitments showed

perceived differences over time (See Table 4-5). Cochran-Mantel-Haenszel statistics were used

to test the significance of the observed differences. The results suggested that the now and then

percentages were statistically different from one another for this cross-tabulation (y2 = 124.56, p

< .001).

These percentages are consistent with the previous findings concerning theoretical shifts.

Commitments to cognitive, narrative-constructivist, feminist-multicultural, and integrationist

perspectives as primary theoretical bases have strengthened, while commitment to behavioral,

humanistic-existential-gestalt, systemic-family, and psychodynamic perspectives as therapists'

primary theoretical bases have weakened.

Results of the analyses for therapy style variables are depicted in Table 4-3. Data indicated

a statistically and clinically significant increase in the expressive subscale that assesses emotional

communication, where higher scores represent greater emotional closeness. Data supported our

hypothesis that therapists would perceive increased closeness and emotional expressive in their

therapy styles across time. There was a statistically significant decrease in operative subscale

that assesses spontaneity in implementing interventions, where lower scores represent more

spontaneity in conducting therapy. Hence, the results supported our prediction of perceived

decrease in operative style, indicating that therapists perceived themselves as increasing in

spontaneity across time. There was also a decrease in attentional scores that assesses therapists'

range of attention and activity in gathering information, where lower scores represent broader

focus. Data supported our prediction that therapists perceived themselves as having increasingly









broader focus in the way they have collected data during therapy. But the low partial eta squared

for the change in operative and attentional raised question into the magnitude of these findings.

The data failed to support our hypothesis of increased engagement across years. Higher

levels of engagement represent higher degrees of engagement with clients. We expected

therapists to report increased commitment to therapy and their clients across their practice. The

obtained results, on the other hand, suggested therapists viewed their engagement level as

remained stable across time. Due to these findings, engagement as a therapy style variable was

excluded from the analyses investigating the relationship between therapists' epistemic and

professional change experiences.

In order to understand the data's failure to support our hypothesis regarding increased

therapist engagement across practice, we conducted exploratory post-hoc analyses. Specifically

we investigated if differences across experience levels emerge for the dimension of engagement

only for those therapists with certain theoretical orientation and we engaged in the post-hoc

analysis by entering therapists' current and initial theoretical orientations into the model. In the

post-hoc analysis, we used a repeated measures ANOVA, with now-versus-then as the within-

subjects factor, theoretical orientation as the between-subjects factor, age as the covariate and the

engagement scores as the dependent variable to examine whether there was significant increase

in the engagement scores over the course of therapists' practice. We conducted this analysis

twice, once current theoretical orientation as the between-subjects factor and once initial

theoretical orientation as the between-subjects factor.

A total of 488 therapists were included in both of the analyses, with engagement-then

scores (M= 28.4, SD = 5.34) higher than engagement-now scores (M= 27.5, SD = 5.70). This

less than 1-point score difference failed to represent a significant change in both of the analyses,









for the analysis including therapists' current theoretical orientation, one-tailedF(1, 479) = 0.06,

p = .405, and for the analysis including therapists' initial theoretical orientation, one-tailedF(1,

479) = 0.00, p = .496. Thus, there was no substantial mean change in engagement scores over

therapists' practice. Yet, the analyses revealed a significant interaction between engagement

now-versus-then scores and theoretical orientation, for therapists' current theoretical orientation,

F(7,479) = 3.30, p = .002, partial eta squared= .046, for therapists' initial theoretical

orientation, F(7,479) = 2.35, p = .023, partial eta squared = .033. Table 4-6 depicts the post-hoc

results locating the interaction for both of the analyses.

Data indicated that engagement levels have declined across the practice of therapists that

identified their current theoretical commitment as cognitive and integrative, while no significant

changes appear for therapists with other theoretical commitments. Data also suggested a decline

for therapists that identified their initial theoretical orientation as behavioral, humanistic-

existentialist-gestalt, and integrative. The engagement levels seemed to increase across the

practice only for therapists that identified their initial theoretical orientation as

narrative/constructivist.

Research Question #2: Do Cohort Effects Explain Changes in Therapists' Epistemic
Commitments?

As a part of this study we wanted to provide a tentative answer to the question regarding

whether cohort effects may have accounted for the epistemic shift in the field of psychotherapy.

Answering this question in a satisfactory manner is beyond the scope of this project, yet we

attempted to provide a preliminary answer to this question through conducting hierarchical

regression analyses where the number of years that therapists' had been in the field was utilized

as a continuous indicator of the cohort.









To conduct this set of analyses, we first computed change scores for the epistemic

variables where the THEN scores were subtracted from the NOW scores. Specifically, a

constructivist-change score was computed such that we subtracted participants' original

constructivist commitment score from their current constructivist commitment score. This

computation provided us with an index of change, with higher scores indicating therapists'

increasing commitment to constructivist epistemologies.

To investigate if the entry-year to the field, numerated by the years that therapists had been

in the field, account for their epistemic change, we conducted a series of hierarchical regression

analyses where the independent variable was number of years therapists had after their entry to

the field following as graduates and the dependent variable was the therapists' epistemic change

score. Gender (dummy coded: 1 = male, and 0 = female) was entered into the analyses in Step 1

and years after graduation was entered in Step 2 to examine whether the year entry to the field

explains variance on therapists' epistemic changes when the effect of gender was controlled for.

To guard against alpha inflation, a Bonferroni correction was employed to establish the alpha

level at .025 (.05/2), which is the original alpha level (.05) divided by the number of statistical

tests.

In these regression equations, VIF statistics ranged from 1.00 to 1.08, suggesting that

multicollinearity was not present in the analyses (Myers, 1990). Examination of residual plots

indicated normality, linearity, and homoscedasticity of residuals in the model. Durbin-Watson

coefficient was 1.97 indicating independence of observations. The model failed to account for

therapists' changing epistemic commitments; for constructivism change score, F(2,634) = 2.19, p

> .05, R2 = 0.01; for rationalism change score, F(2,627) = 2.44, p > .05, R2 = 0.01. No significant









levels of the variance in the dependent variables, constructivism and rationalism difference

scores, was explained by the years that therapists had entered the profession.

Our data also allowed us to investigate whether the epistemic shift in the field is the result

of the infusion of new therapists who were more committed to the constructivist epistemology to

begin with than the seasoned therapists. To investigate this question, we compared therapists'

initial constructivist commitments in five cohorts (1954 to 1969, N= 21; 1970 to 1979, N= 94;

1980-1989, N= 150; 1990-1999, N= 197; 2000-2008, N= 191). We conducted a one-factor

ANOVA, with cohort groups as the between-subjects factor and therapists' initial constructivism

scores as the dependent variable. There was no significant main effect of cohort, F(4,638) = 1.55,

p = .185, partial eta squared= .01. The data failed to show any significant differences in

therapists' initial constructivist commitments across cohort groups, again suggesting that cohort

effects did not account for the epistemic shifts observed in our sample across time.

Research Question #3: What is the Relationship between Therapists' Epistemic and
Professional Change Experiences?

We conducted a series of regression analyses to examine whether changes in therapists'

epistemological commitments were related to the levels of change in their theoretical orientation,

the plurality of their theoretical orientations, or therapy styles (expressive, operative, and

attentional dimensions). In other words, we investigated to what extent therapists' perceived

epistemic shifts would explain their current theoretical and stylistic commitments above and

beyond their initial standing.

To conduct this set of analyses, we first computed change scores for the epistemic

variables where the THEN scores were subtracted from the NOW scores. This index was

computed for the commitment to constructivist and rationalist epistemology variables.









We then conducted a series of hierarchical multiple regression analyses to study the main

effects of the two independent variables on each of the four dependent variables while

controlling for gender (dummy coded: 1 = male, and 0 = female), age, and average number of

clients seen weekly. The independent variables were the initial scores for the theoretical and

stylistic commitment variables, constructivism difference score, and the rationalism difference

score. The dependent variables were five professional variables: theoretical change index,

current theoretical plurality score, and current expressive, operative, and attentional scores. For

each regression analysis, gender, age, and average number of clients were entered in Step 1,

initial scores for the dependent variable for that particular analysis was entered in Step 2,

constructivism difference score was entered in Step 3, and rationalism difference score was

entered in Step 4. In the analysis where theoretical change index was the dependent variable, the

independent variables were entered in the same order but without the initial score, given that

theoretical change index has been rated only once from current perspective. Hence, only this

analysis was composed of 3 steps while the other analyses were composed of 4 steps.

Gender, age, and average number of clients were entered in the first step as covariates.

When it was applicable, the initial scores for the independent variable were entered in the second

step. Constructivism difference scores were entered in the next step to reveal whether change in

therapists' constructivist epistemology explains the variance on the select current professional

commitments over and beyond what initial commitments explain; and this would be the focal

point answering our research question #2. Rationalism difference scores were entered in the last

step to examine whether change in therapists' rationalist epistemology explains variance on the

select professional variables over and beyond that of their initial commitments and change in

constructivist epistemology. A Bonferroni adjustment was employed to protect against the Type









I error, and the alpha level for the overall regression analyses for each dependent variable was set

at .01 (.05/5), which is the original alpha level (.05) divided by the number of statistical tests.

Effect size indices for multiple regression analyses was defined as the R2 divided by one

minus R2. The obtained/s were evaluated according to the Cohen's (1992) operational definition

of small (.02), medium (.15) and large (.35) effects.

To assess for the presence of multicollinearity, the variation inflation factor (VIF) statistics

across the independent variables were examined. Myers (1990) pointed out that a VIF value

above 10 indicates concern for the presence of multicollinearity. In our regression equation, VIF

statistics ranged from 1.00 to 1.01, suggesting that multicollinearity was not present.

Examination of residual plots indicated normality, linearity, and homoscedasticity of residuals in

the models. Durbin-Watson coefficient ranged from 2.01 to 2.17 suggesting the independence of

observations.

The results of the hierarchical multiple regression analysis for the four dependent variables

are presented in Table 4-7. The results indicated significant regression equations (i.e.,p < .01 for

the overall F ratio at the last step) for all of the dependent variables: theoretical change,

theoretical plurality, expressive, operative and attentional scores.

In the first step of the models, covariates age and number of clients seen weekly were

significantly related to four different variables of interest. Age accounted for 3% of variance in

both theoretical change index and expressive score, while number of clients seen weekly

accounted for 2% of variance in operative score and for 4% of variance in attentional score.

Where the theoretical change was the dependent variable, the model at Step 2 explained

5% of the variance and the inclusion of rationalist commitment change into the model at the Step

3 improved the model by 2%. Overall, the model explained %7 of the variance in the dependent









variable. Only for this model, constructivism difference score failed to account for significant

levels of variance after the rationalism difference score was entered into the analysis. At the third

step of this model, the F value for constructivism difference score could no longer meet the alpha

of.01.

For the other dependent variables of theoretical plurality, expressive, operative, and

attentional, the models at the Step 2, at which the initial standings were entered into the model,

accounted for a significant amount of variance in the dependent variables after controlling for the

variance explained by gender, age, and average number of clients. The models accounted for

variances in four dependent variables between 27% and 36%. At Step 3, the model accounted for

a significant amount of variance in all of the four dependent variables after controlling for the

variance explained by gender, age, average number of clients, and initial standings. The

inclusion of constructivism difference scores into the model at Step 3 increased the accounted

variances between 3% and 7%. The model at Step 4 accounted for a significant amount of

variance only in three therapy style variables after controlling the variance explained by gender,

age, average number of clients, initial standings, and constructivism difference scores. For the

theoretical plurality, inclusion of rationalism difference scores failed to improve the variance

explained in the dependent variable. For the three therapy style variables, the inclusion of

rationalism difference into the model at Step 4 increased the accounted variances between 4%

and 9%. The overall models accounted for variances in four dependent variables between 37%

and 50%.

To identify the location and direction of the effects on each of these dependent variables,

we examined a standardized beta coefficient for each predictor. At the first step, the results

indicated that age was positively related to participants' ratings of their theoretical change across









the years of practice (f = 0.15), and negatively related to participants expressive scores (f = -

0.13). The standardized beta coefficients suggested that with increased age, participants tended

to rate their theoretical change higher, and rate their expressive lower. Average number of clients

seen weekly was negatively related to both operative and attentional scores (f = -0.13; f = -

0.15), suggesting that as participants' caseload increased, they tended to rate their operative and

attentional dimensions lower.

The second step of the models for the current theoretical plurality, expressive, operative,

and attentional variables, revealed that participants' initial standing with these variables were

positively related to the dependent variables. Initial ratings were positively related to current

ratings of the variables; for theoretical plurality, f = 0.57, for expressive, f = 0.49, for operative,

f = 0.60, and for attentional, f = 0.53. Higher initial ratings for the variables predicted higher

scores for the current ratings of the variables.

The next step of the models revealed that participants' increasing adherence to

constructivist epistemology were positively related to three of the dependent variables and

negatively related to the other two. Increasingly higher constructivism scores were positively

related to theoretical change index (f = 0.14), theoretical plurality (f = 0.21), and expressive (f =

0.27), and negatively related to operative (f = -0.12) and attentional dimensions (f = -0.17).

Consistent with our expectations, therapists' increasing commitment to constructivist

epistemology predicted increasing change in their theoretical orientation, as well as higher levels

of theoretical plurality, emotional expressive, spontaneity in conducting therapy and broadened

focus in gathering information in therapy in their current practice.

The last step of the models revealed that therapists' increasing adherence to rationalist

epistemology was positively related to operative (f = 0.32) and attentional (f = 0.21) scores and









negatively related to the theoretical change index (f = -0.14), and to expressive scores (f = -

0.21). Therapists increasing commitment to rationalism predicted higher scores on operative (i.e.

less spontaneous) and attentional (i.e. narrower focus), and lower scores on expressive and

theoretical change index. As therapists' commitments to rationalist epistemology increased, they

tended to rate their current practice as low on theoretical orientation change, emotionally

expressive, spontaneity and range of focus in information gathering. Therapists' increasing

commitment to rationalist epistemology failed to relate to their theoretical plurality scores.

The addition of the rationalism difference score to the models revealed certain changes in

the variance accounted by the constructivism difference scores for four dependent variables. Beta

coefficients for constructivism difference score decreased for the variables of theoretical change,

expressive, operative, and attentional once the rationalism difference scores were entered to the

model. These changes are summarized at Table 4-8. For the theoretical change index, the decline

in the beta coefficient resulted in failure for constructivism difference scores to significantly

account for the variance on this dependent variable. The results indicated that the inclusion of

both spectrums of epistemic commitment, constructivism as well as rationalism, strengthened

our understanding of the complex interaction between therapists' epistemic and professional

change experiences. Moreover, the results suggested that change in therapists' commitment to

rationalist epistemology was a better predictor of operative and attentional scores compared to

change in participants' commitment to constructivist epistemology.

The magnitudes of the effect sizes of the main analyses, between 0.07 and 0.98, correspond

to small to large effects (Cohen, 1992). Obtained effect sizes suggested that results have some

practical significance in addition to statistical significance for the variables of theoretical

plurality and therapy style. Effect sizes suggested that constructivism and rationalism difference









scores accounted for 9% to 41% of the variability in the theoretical plurality and therapy style

scores. On the other hand, effects sizes suggested limited practical significance for the theoretical

change index. Constructivism and rationalism difference scores accounted for 4% of the

variability in this variable.

Table 4-1. Summary statistics of variables of interest.
Possible Sample n of
Variable N M SD S Skewness Kurtosis n of
Range Range items
Now 675 22.43 5.30 8-40 8-38 -0.05 -0.12 8 0.69
1. TAQ-R
Then 673 24.46 5.25 8-40 8-39 -0.33 0.11 8 0.70
Now 683 33.51 3.55 8-40 19-40 -0.53 0.46 8 0.58
2. TAQ-C
Then 680 31.20 3.82 8-40 16-40 -0.32 0.49 8 0.64
3. TCI 663 3.05 1.12 1-5 1-5 -0.20 -0.95 1
Now 653 22.61 3.72 7-35 12-34 0.05 -0.00 7
4. TP
Then 650 19.92 3.94 7-35 9-33 0.15 -0.22 7
Now 630 41.26 6.41 9-63 22-60 0.02 -0.01 9 0.59
5. EX
Then 628 36.61 6.43 9-63 15-59 0.12 0.40 9 0.57
Now 659 27.49 5.78 6-42 8-42 -0.30 -0.15 6 0.66
6. EN
Then 656 28.43 5.31 6-42 12-42 -0.30 0.19 6 0.61
Now 660 21.64 4.20 6-42 7-35 -0.16 0.33 6 0.35
7. AT
Then 659 24.16 4.60 6-42 10-37 -0.10 0.13 6 0.45
Now 646 21.87 6.37 7-49 7-45 0.41 0.14 7 0.74
8. OP
Then 646 23.57 6.97 7-49 7-47 0.400 0.000 7 0.75
Note. TAQ-R = Therapist Assumption Scale Rationalism; TAQ-C = Therapist Assumption
Scale Constructivism; TCI = Theoretical Change Index; TP = Theoretical plurality; EX =
Expressive; EN = Engagement; AT = Attentional; OP = Operative; Now = Therapists' current
view of themselves today; Then = Therapists' view of themselves when they first started
practicing following the completion of their graduate training.









Table 4-2. Intercorrelations among the variables of interest.
Variable 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1. TAQ-R-Now -
2. TAQ-R-Then 0.7** -
3. TAQ-C-Now -0.2** -0.1**-
4. TAQ-C-Then -0.1* -0.3** 0.5** -
5. TCI -0.1 0.1 0.1* -0.1* -
6. TP-Now -0.1* -0.1* 0.3** 0.2** 0.1 -
7. TP-Then -0.1* -0.1** 0.1* 0.3**-0.2** 0.6** -
8. EX-Now -0.3**-0.2**. 03** 0.2** 0.1* 0.2** 0.1 -
9. EX-Then -0.2**-0.3** 0.1** 0.4**-0.1** 0.1 0.2** 0.5** -
10. EN-Now -0.2**-0.1** 0.1 0.0 0.0 0.1* 0.0 0.4** 0.2** -
11. EN-Then -0.2**-0.1** 0.1* 0.1 0.0 0.0 0.1 0.2** 0.3** 0.6** -
12. AT-Now 0.3** 0.3**-0.3**-0.2** 0.0 -0.2**-0.1* -0.3**-0.1** 0.0 0.0 -
13. AT-Then 0.2** 0.4** 0.0 -0.2** 0.2** 0.0 -0.1**-0.1 -0.3** 0.0 0.0 0.5** -
14. OP-Now 0.5** 0.3**-0.3**-0.2** 0.1 -0.1** 0.0 -0.3**-0.2**-0.2**-0.1** 0.5** 0.3** -
15. OP-Then 0.3** 0.5**-0.1**-0.3** 0.1 -0.1 -0.1 -0.2** -0.3** -0. -0.1* 0.3** 0.5** 0.6** -
Note. TAQ-R = Therapist Assumption Scale Rationalism; TAQ-C = Therapist Assumption
Scale Constructivism; TCI = Theoretical Change Index; TP = Theoretical plurality; EX =
Expressive; EN = Engagement; AT = Attentional; OP = Operative; Now = Therapists' current
view of themselves today; Then = Therapists' view of themselves when they first started
practicing following the completion of their graduate training.
aListwise N =537;
*p <.05 **p < .01

Table 4-3. Repeated measures ANOVA summary table for perceived epistemic and stylistic
commitment differences across time.
Variable N M SD Df F Partial eta-squared
Now Then Now Then
1. TAQ-C 642 33.51 31.18 3.55 3.86 1,640 173.90** 0.22
2. TAQ-R 636 22.47 24.47 5.30 5.29 1,634 107.78** 0.15
3. EX 625 41.24 36.62 6.41 6.44 1,624 327.83** 0.34
4. EN 491 27.49 28.40 5.80 5.32 1,489 0.25 0.00
5. AT 482 21.61 24.06 4.19 4.53 1,479 12.09** 0.03
6. OP 641 21.89 23.58 6.36 6.98 1,640 48.68** 0.07
7. TP 649 22.60 19.91 3.72 3.94 1,648 395.92** 0.38
Note. TAQ-R = Therapist Assumption Scale Rationalism; TAQ-C = Therapist Assumption
Scale Constructivism; EX = Expressive; EN = Engagement; AT= Attentional; OP = Operative;
TP = Theoretical plurality; Now = Therapists' current view of themselves today; Then =
Therapists' view of themselves when they first started practicing following the completion of
their graduate training.
**p <.001









Table 4-4. Repeated measures ANOVA summary table for perceived theoretical commitment
differences across time.
partial
N M SD Df F eta-
Variable squared
Now Then Now Then
1. Cognitive 661 4.08 3.34 1.00 1.31 1,660 202.06** 0.23
2. Behavioral 661 3.48 3.10 1.19 1.41 1,660 5,718.19** 0.07
3. Humanistic Existential Gestalt 658 3.35 3.22 1.19 1.34 1,657 9.11 0.01
4. Narrative/constructivist 652 2.44 1.92 1.32 1.15 1,651 163.32** 0.20
5. Systemic- Family 659 3.13 2.82 1.21 1.30 1,658 43.89** 0.06
6. Psychodynamic 660 3.05 2.98 1.38 1.50 1,659 2.46 0.00
7. Feminist Multicultural 659 3.10 2.54 1.29 1.33 1,658 169.24** 0.21
**p <.001


Table 4-5. Current and initial theoretical orientation endorsements.
Variable Valid Percentage
Now Then
1. Cognitive 27.0 23.9
2. Behavioral 4.7 12.4
3. Humanistic Existential Gestalt 8.0 16.9
4. Narrative/constructivist 4.2 1.5
5. Systemic Family 4.7 6.4
6. Psychodynamic 17.1 26.5
7. Feminist Multicultural 2.1 1.1
8. Integrationist 32.2 11.3


Table 4-6. Post-hoc analyses examining the moderating effect of the theoretical commitment on
perceived engagement differences across time.
Main theoretical orientation Current Initial


M F M F
Now Then Now Then
Cognitive 25.76 27.31 13.70** 26.57 27.20 2.12
Behavioral 29.00 28.86 0.02 27.68 29.22 6.36*
Humanistic Existential Gestalt 28.49 28.88 0.28 27.24 28.81 9.72*
Narrative/Constructivist 29.01 27.61 2.11 32.06 26.63 6.87*
Systemic Family 26.62 25.47 1.31 25.76 27.17 2.59
Psychodynamic 28.83 29.34 1.08 29.18 29.47 0.51
Feminist- Multicultural 30.73 28.40 1.87 27.15 29.44 0.98
Integrationist 27.32 29.01 21.71** 26.25 27.70 5.63*
*p <.01, **p <.001









Table 4-7. Hierarchical regression analyses showing amount of unique variance in therapists'
current professional standing accounted for by their initial standing and epistemic
commitments.
Variable / T R F df D2 AR2 R /
Dependent Variable: Theoretical Change Index
Step 1
Gender 0.03 0.64
Age 0.15 3.27*
Weekly clients 0.04 0.87 0.03 4.49* 3 468 0.03 0.03
Step 2
Gender 0.04 0.80
Age 0.15 3.23*
Weekly clients 0.04 0.80
Constructivism difference 0.14 3.17* 0.05 5.95** 4 467 0.02 0.05
Step 3
Gender 0.04 0.91
Age 0.15 3.29*
Weekly clients 0.04 0.77
Constructivism difference 0.10 2.05
Rationalism difference -0.14 -2.86* 0.07 6.47** 5 466 0.02 0.07
Dependent Variable: Theoretical Plurality Now
Step 1
Gender -0.07 -1.44
Age 0.00 0.07
Weekly clients 0.07 1.50 0.01 1.34 3 461 0.01 0.01
Step 2
Gender -0.01 -0.12
Age -0.01 -0.14
Weekly clients 0.01 0.34
Theoretical plurality Then 0.57 14.82** 0.33 56.35** 4 460 0.32 0.49
Step 3
Gender 0.01 0.25
Age -0.01 -0.25
Weekly clients 0.00 0.09
Theoretical Plurality Then 0.61 16.03**
Constructivism difference 0.21 5.61** 0.37 54.37** 5 459 0.04 0.59
Step 4
Gender 0.01 0.20
Age -0.01 -0.26
Weekly clients 0.00 0.12
Theoretical Plurality Then 0.61 16.04**
Constructivism difference 0.23 5.84**
Rationalism difference 0.06 1.60 0.37 45.89** 6 458 0.00 0.58
Dependent Variable: Expressive Now
Step 1
Gender -.040 -0.84









Table 4-7. Continued.
Variable 8/ T R F Df df AR2 F2
Age -0.13 -2.75*
Weekly clients 0.10 2.04 0.03 4.24* 3 438 0.03 0.03
Step 2
Gender -0.01 -0.30
Age -0.10 -2.31
Weekly clients 0.06 1.34
Expressive Then 0.49 11.90** 0.27 39.60** 4 437 0.24 0.36
Step 3
Gender 0.01 0.17
Age -0.10 -2.49*
Weekly clients 0.04 1.13
Expressive Then 0.56 13.77**
Constructivism difference 0.27 6.74** 0.34 43.98** 5 436 0.07 0.50
Step 4
Gender 0.02 0.37
Age -0.10 -2.50*
Weekly clients 0.04 1.02
Expressive Then 0.60 14.87**
Constructivism difference 0.22 5.26**
Rationalism difference -0.21 -5.01** 0.37 42.85** 6 435 0.04 0.59
Dependent Variable: Operative Now
Step 1
Gender 0.05 1.09
Age -0.06 -1.16
Weekly clients -0.13 -2.65* 0.02 2.99 3 447 0.02 0.02
Step 2
Gender 0.03 0.84
Age 0.01 0.35
Weekly clients -0.06 -1.47
Operative Then 0.60 15.54** 0.36 63.82** 4 446 0.34 0.57
Step 3
Gender 0.02 0.55
Age 0.03 0.68
Weekly clients -0.05 -1.25
Operative Then 0.64 16.98**
Constructivism difference -0.22 -5.81** 0.41 61.55** 5 445 0.05 0.69
Step 4
Gender 0.01 0.39
Age 0.03 0.87
Weekly clients -0.03 -0.96
Operative Then 0.70 19.65**
Constructivism difference -0.12 -3.30*
Rationalism difference 0.32 8.71** 0.50 72.54** 6 444 0.09 0.98









Table 4.7. Continued.
Variable 8 T R2 F Df df2 AR2 F2
Dependent Variable: Attentional Now
Step 1
Gender 0.09 1.87
Age -0.11 -2.32
Weekly clients -0.15 -3.21** 0.04 5.88** 3 456 0.04 0.04
Step 2
Gender 0.10 2.50
Age -0.03 -0.71
Weekly clients -0.12 -3.08*
Attentional Then 0.53 13.48** 0.31 51.59** 4 455 0.28 0.45
Step 3
Gender 0.09 2.31
Age -0.02 -0.46
Weekly clients -0.12 -3.02*
Attentional Then 0.57 14.39**
Constructivism difference -0.17 -4.40** 0.34 46.80** 5 454 0.03 0.52
Step 4
Gender 0.08 2.19
Age -0.01 -0.33
Weekly clients -0.11 -2.95*
Attentional Then 0.62 15.64**
Constructivism difference -0.11 -2.86*
Rationalism difference 0.21 5.24** 0.38 45.84** 6 453 0.04 0.61
*p <.01 **p<.001


Table 4-8. Hierarchical regression beta coefficients
2, 3, and 4.


for constructivism difference scores at steps


Step 2/3 Step 3/4
Dependent Variable P T P T
Theoretical Change Index 0.14 3.17* 0.10 2.05
Theoretical Plurality Now 0.21 5.61** 0.23 5.84**
Expressive Now 0.27 6.74** 0.22 5.26**
Operative Now -0.22 -5.81** -0.12 -3.30*
Attentional Now -0.17 -4.40** -0.11 -2.86*
*p<.01 **p<.001









CHAPTER 5
DISCUSSION

The discussion section is composed of three sub-sections. First, the hypotheses and

findings of the study are summarized. Second, a detailed interpretation of the findings in the light

of literature on epistemology and therapists' professional experiences is provided. And last,

limitations as well as implications of the present study and suggestions for future studies are

presented.

Summary of Results

Overall, the results of the present study supported the primary hypotheses regarding the

change processes of therapists' epistemic commitment. Therapists' ratings of their epistemic

commitments reflected a greater current commitment to constructivism (Now) than when they

began their careers (Then). Conversely, they perceived themselves as having become less

committed to rationalist epistemology across the course of their practice. The data failed to find

significant cohort effects for therapists' initial epistemic commitments and their epistemic

change scores. In other words, the data suggested that therapists' perceived epistemic

commitments, shifting towards greater constructivism (and less rationalism) across time, were

not a function of when they entered the field, but rather reflected perceived changes across the

course of their careers, regardless of the nature of their initial epistemic leanings.

The results also supported the hypotheses regarding the therapists' change processes in

selected professional characteristics. These professional characteristics included their theoretical

orientation, theoretical plurality, and expressive, operative and attentional dimensions of therapy

styles. Therapists' ratings of these characteristics indicated that they perceived themselves as

becoming more pluralistic, i.e. integrationist, in their theoretical orientation, and more

emotionally expressive, more operatively spontaneous, and broader in attention in their









therapeutic styles. The data failed to indicate an overall change in therapists' perceived

engagement style in therapy; post-hoc analyses (see below) extended our understanding of this

finding.

The results also suggested that perceived change in epistemology predicted therapists'

current professional standings after accounting for their initial standings. After accounting for

therapists' initial standings and rationalist-change scores, increase in therapists' constructivist

commitments predicted increased levels of adherence to theoretical integration and increased

levels of emotional expressiveness, operative spontaneity, and attentional range of therapists.

After accounting for therapists' initial standings and constructivism-change scores, decrease in

their rationalist commitments predicted increased change in theoretical commitments as well as

increasing levels of emotional expressiveness, operative spontaneity, and attentional range of

therapists.

Epistemic Journey Constructions of Psychotherapists

The field of psychology and particularly psychotherapy has changed dramatically over

years (Farber, 2005). Mahoney (1995a, 1995b) considered epistemic change among the

experiences of change that the field has experienced. Substantial anecdotal, conceptual, and case-

based information (such as Ellis, 1993, 1995; Goldfried, 2001a) supported Mahoney's suggestion

that the field of psychotherapy has become increasingly constructivist over the course of the last

20 years. Mahoney (1995b) also noted that given the dialectical interaction between the field and

its practitioners, changes in the field would impact the way psychotherapists' practice and also

perceive their practice, while their practice would impact the field, in return.

The primary aim of the present study was to investigate whether psychotherapists perceive

such an epistemic shift within themselves as a reflection of the epistemic shift in the field. We









specifically hypothesized increasing levels of perceived commitment to constructivist

epistemology as therapists continued to develop across time. Results were consistent with this

hypothesis. Therapists perceived an increase in their commitment to constructivist epistemology

when they reflected on their initial and current perspectives. Their perceived change experiences

also entailed a reduction in their commitment to rationalist epistemology across their practice.

These findings can be interpreted analyzing Mahoney's (1995a, 1995b) assumptions, as

well as the available literature supporting Mahoney. The constructivist worldview assumes

complexity and interdependency of human experiences and social systems. Therapies guided by

constructivist epistemology are committed to appreciation of complexity, and in-depth

processing of client emotions and experiences (Nagae & Nedate, 2001; Vasco, 1994; Viney,

1994; Winter & Watson, 1999), and they tend to have higher levels of self-exploration,

attendance to emotions, openness and tolerance in therapists (Neimeyer & Aksoy, 2005).

Various prominent psychotherapists, such as Albert Ellis (1992a, 1999), Donald

Meichenbaum (1993), Aaron Tim Back (2002; Bloch, 2004), and Michael Mahoney (1991), had

suggested their increasing levels of constructivism implicitly in their descriptions of their own

professional development across time, with practices becoming more eclectic and complex in

relation to their work with their clients. At certain times, they explicitly identified their change

processes as reflecting an epistemic shift and an increasing commitment to constructivist

epistemology (Ellis, 1990, 1995; Meichenbaum, 1990; Mahoney, 2001).

Studies conducted on therapists' career developments also have recounted change

processes that indicated the development of characteristics across years that might parallel

increasing commitment to constructivist epistemology (Ronnestad & Skovholt, 2003). Increased

practice and experience in the field translated to therapists' increasing likelihood to reject









precisely defined realities and embrace complexity and flexibility in the ways they understood

and reached out to their clients. The current study indicates that psychotherapists also perceive

this trend of increasing commitment to constructivist epistemology within themselves.

Rationalist and constructivist epistemologies are largely complementary and their

differences reflect upon the way therapy is conceived and conducted (Lyddon, 1988; Mahoney &

Gabriel, 1987; Mahoney & Lyddon, 1988). Rationalist epistemologies tend to assume a stable,

single, universal reality and therapists' commitment to rationalist epistemology translates into

their practice with an aim to correct the client's faulty cognitions of reality through a relatively

straightforward approach (Nagae & Nedate, 2001; Vasco, 1994; Viney, 1994; Winter & Watson,

1999). Higher levels of rationalist commitments were also linked to lower levels of self-

exploration, openness, and tolerance in therapists (Neimeyer & Aksoy, 2005).

Career development studies have indicated that therapists tend to reject precisely defined

realities, and embrace complexity and flexibility in the ways they conceptualized and conducted

therapy over the course of their development as professional practitioners (Ronnestad &

Skovholt, 2003). These changes are consistent with a greater alignment with constructivist

commitments. We might expect that therapists' increasing commitment to constructivist

epistemologies across the course of their development would be associated with corresponding

decreases in complementary epistemologies such as rationalism. Hence, the finding of perceived

weakening in therapists' rationalist commitments is consistent with overall increase in

constructivist leanings in the current study.

The current study reveals that lay psychotherapists also perceive this trend of increasing

commitment to constructivist epistemology within themselves. When therapists reflected on their

current and initial experiences, they observed an increase in their constructivist commitments









and a decrease in their rationalist commitments. Next, we investigated the degree to which cohort

effects underlie epistemic changes of the therapists and the field.

Cohort Effect on Perceived Changes on Epistemic Leanings

Existing literature agrees that the field is shifting in its epistemic commitments (Mahoney,

1995a, 1995b) and the current study provides support for this claim from the perspective of

practicing psychotherapists. Changes in the field and the changes of its members are reciprocal.

The change in the field impacts its existing members as well as those who enter the field

recently, while the existing members' change processes further impacts the field. As Farber et al.

(2005) noted, the changes in the field impacts therapists such that those who enter the field at a

certain time might be different than others who have entered the field at an earlier era. Therapists

entering the field recently might differ from seasoned therapists in their motivations or

aspirations (Farber et al., 2005). Similarly the epistemic commitments of those therapists who

entered the field recently might be different than their seasoned colleagues as a part of the

epistemic change of the field of psychotherapy. In fact, it can be suggested that the epistemic

journey of the field with its increasingly post-modernist perspective can be a reflection of the

recent cohorts' greater commitment to constructivism and postmodernism.

At the same time, a review of studies on career development of practitioners suggested that

individual change processes of the members of the field are systematic in nature, are independent

from the cohort to which practitioners belong to or their experience level (R0nnestad &

Skovholt, 2003), and include themes of increasing commitment to constructivist epistemology.

In other words, from the perspective of career development theories, the field's epistemic

journey might be a reflection of the therapists' individual change processes. It is also possible

that such individual change processes are subject to cohort effects such that certain groups of









practitioners who entered the field at a certain era might have a different epistemic journey due

to the nature of the field at that time.

Given the lack of empirical literature on this topic, the current study aimed to provide an

initial understanding of the complex dynamics underlying the field's and therapists' epistemic

shift. The current study explored to what extent the perceived epistemic shifts can be attributed

to cohort effect facilitated by the more recent infusion of post-modem therapists to the field

versus the perceived individual change processes of psychotherapists across time. Within the

limits of the current study, we focused our attention to two specific areas that might shed light on

the proposed question. First, we examined whether or not different cohort groups predicted

differences in the levels of therapists' initial levels of constructivist commitments. If cohort

effects were strong, this might suggest that the overall shift in the field towards greater

constructivism was due to the more infusion of new therapists into the field, who carried with

them greater constructivist commitments. Relatedly, we examined the data to see whether the

different cohort groups predicted the ways in which therapists changed in their epistemic shifts,

in order to understand the degree to which the entry year to profession colors the epistemic

change processes of therapists (did older, or younger therapists change more, for example?).

The results failed to suggest significant cohort effects either for therapists' initial epistemic

commitments or for their epistemology change scores. Therapists' initial commitment to

constructivism, as they construed it, has been similar across the years of entry to the field. Hence

our data indicates that the field's increasing commitment to constructivist epistemology cannot

be explained via the influx of those therapists with post-modern tendencies and/or training.

Therapists' initial commitment to rationalism has also been similar across years suggesting that









therapists' epistemic commitments at the time that they have entered the field cannot be

differentiated by the time in which they have entered the field.

Data also failed to support if therapists' year of entry to the field colored their epistemic

journey. For the group of therapists in this study, therapists' change in their epistemic

commitments was independent from the era in which they have been trained and entered the

profession. The results failed to support the notion that cohort effects might underlie epistemic

change processes of therapists and of the field.

Overall the obtained results may imply that therapists' individual processes play a

dominant role in therapists' epistemic journey rather than the cohort effects. This is consistent

with our review of the career development literature, where greater constructivist commitment

appeared to be a part of practitioners' professional change processes. For instance, Ronnestad

and Skovholt (2003) suggested that therapists' career development involved increased

conceptualization of knowledge as a construction and decreased use of precisely defined realities

in understanding clients, which are not only consistent with constructivist perspective, but also

indicative of increasing commitment to constructivist epistemology across the therapists' course

of practice.

Theoretical and Stylistic Change Constructions of Psychotherapists

Change concerning therapists is not limited to their personal epistemologies but includes

professional attributes as well. When they reflected on their initial and current experiences,

therapists revealed change in certain professional aspects such as theoretical plurality and

therapy style.

Theoretical Change

Theoretical change across practice is considered a widespread experience for contemporary

psychotherapists (DeAngelis, 2006, p. 59). This trend was also evident in the current study.









Overall, therapists perceived statistically significant and modestly robust increases in their

commitments to cognitive, constructivist, and feminist-multicultural therapies. There were also

significant increases in behavioral, and decreases in commitment to systemic-family therapies,

although these changes were failed to be robust, as suggested by their low effect size indices.

When therapists were asked to identify one theoretical orientation as their primary orientation, a

similar trend has emerged where commitments to cognitive, narrative-constructivist, feminist-

multicultural and integrationist perspectives strengthened over time. These results are consistent

with the current trends where cognitive, constructivist, multicultural, and integrationist theories

are more prevalent for therapists as their main base (Norcross et al., 2002).

The most notable change in the realm of theoretical orientation is the field's increasing

openness to theoretical integration and technical eclecticism (Goldfried, 2001a; Norcross et al.,

2002; Norcross, 2005). One of the aims of the present study was to investigate whether

psychotherapists perceive such a theoretical shift within themselves. We specifically

hypothesized increasing levels of perceived theoretical plurality as therapists developed across

time. Results consistently supported this hypothesis. Therapists reported statistically and

clinically significant increases in the variety of theoretical orientations that they employed in

their practice.

Ronnestad and Skovholt (2003) provided an explanation for therapists' theoretical shift

that mostly entails integration of a number of theoretical orientations. Increasing practice in

psychotherapy enhances the congruity between therapists' personality and their the ways in

which they conduct therapy. Therapists' changing their theoretical orientation can be an indicator

of such an increased integration and congruency. Ronnestad and Skovholt (2003) further

suggested that as therapists' theoretical adherence shifted, their therapy style may shift in certain









ways. Next, we summarize what the current study revealed about therapists' perceived change

experiences in the ways in which they conduct therapy.

Stylistic Change

Preliminary evidence suggesting the change in therapy style across the years of practice

was provided by Castafieiras et al.'s (2006) study where expert and beginner therapists showed

differences in certain aspects of their therapy styles. Therapist professional development studies

(Jennings & Skovholt, 1999; Martin et al., 1989; Rannestad & Skovholt, 2003; Skovholt &

Jennings, 2004) and personal narratives of seasoned therapists (Goldfried, 2001a) also supported

the assumption that therapists' styles might change with experience.

The aim of the present study was to investigate whether psychotherapists perceive such

stylistic shifts within themselves and to provide further support for the existing literature. We

specifically hypothesized increasingly higher levels of perceived expressive and engagement

scores, and lower levels of perceived operative and attentional scores as therapists became more

experienced. In other words, we expected therapists to perceive themselves to have increased in

their (a) expressing emotions to their clients, (b) commitment to therapy and clients, (c)

spontaneity in the way of implementing intervention, and (d) range of attention when gathering

information from clients.

Results supported three of the four hypotheses. Therapists reported increases in their

expressive and decreases in their operative and attentional dimensions of therapy styles. In other

words, across the course of their practice therapists perceived statistically significant and robust

increases in their emotional closeness and expressiveness to their clients, increases in the

spontaneity with which they conducted therapy and increases in the range of attention and

activity in gathering information. Results failed to indicate any change in therapists' degree of









commitment to therapy and engagement with clients, i.e. engagement dimension of therapy

styles.

The obtained results were mostly consistent with the literature. Castafieiras et al.'s (2006)

study on differences between expert and beginner therapists in therapy style, therapist

professional development studies (Jennings & Skovholt, 1999; Martin et al., 1989; Ronnestad &

Skovholt, 2003; Skovholt & Jennings, 2004), and personal narratives of seasoned therapists

(Goldfried, 2001a) concluded that therapists become more emotionally expressive, operatively

spontaneous, and broader in their therapeutic attention across the course of their practice.

Castafieiras et al. (2006) found that expert therapists who were identified with cognitive

orientation were more emotionally closed towards their clients compared to beginners.

Additionally, Jennings & Skovholt (1999; Skovholt & Jennings, 2004) described master

therapists as having strong emotional skills such as emotional receptiveness, ability to attend to

self and other's emotions and recognition of the ways in which their own emotions impact their

work. These findings supported the findings noting that therapists perceived their emotional

expressiveness to strengthen over the course of their practice.

Castafieiras et al. (2006) found that expert integrative therapists were more spontaneous

in implementing interventions compared to beginners. Likewise, Ronnestad and Skovholt (2003)

suggested that as therapists matured, they gradually developed an internally-based flexible

professional functioning. This inferred flexibility across professional development was aligned

with the findings that expert therapists were more spontaneous in implementing interventions.

The narrations of 16 experienced psychotherapists also described their process of breaking free

from their original teachings and developing integrative, expansive, pliable ways of being and

doing in their therapeutic work (Goldfried, 200 la). Overall, the results of our study support the









broader literature regarding therapists' increasing spontaneity over the course of their

professional development and practice.

Castafieiras et al. (2006) found that beginning integrative and psychoanalytic therapists

endorsed a significantly narrower focus and search for a specific realm of knowledge than their

expert counterparts. Experienced therapists tended to conceptualize their clients at a broader

level and in a more inclusive manner (Martin et al., 1989). The internally-based flexible

professional functioning of expert therapists was also aligned with therapists' being more

broadly focused and open-minded while listening to client material. In their narrations,

practitioners also reflected on their professional change processes where they have increased in

flexibility, and broadened their understanding and appreciation of client concerns (Goldfried,

2001 a). Overall, the finding of therapists' increasing range of attention in information gathering

across their practice is consistent with the literature. Yet, it is important to note the low reliability

rates obtained for the current and initial attentiveness scores since these rates raise questions

regarding the validity and interpretation of the obtained findings.

We expected therapists to report increased commitment to therapy and to their clients

across their practice, yet the data failed to support our expectations of increased engagement

scores across years. One plausible explanation may be the relatively high initial ratings of

engagement dimension of therapy style. Within the possible range of 6 to 42, participants'

average engagement-now score was 27.49 and engagement-then score was 28.40. Although there

was potential for them to score higher, no other dimensions of therapy style in the study has

passed the 65 to 67 % rating figure that was achieved by the engagement scores. In other words,

the data's failure to indicate any increase in engagement dimension of therapy style might stem

from the fact that therapists perceived themselves highly committed to therapy and engaged with









their clients starting the beginning of their careers, leaving less of a room for growth or increase

on this domain. The ceiling effect may also explain the reduction on the average of the

engagement score from then to now, although this difference failed to be clinically significant. If

therapists had hit the maximum of their care and concern for their clients starting their careers,

they might experience a slight decline in their engagement level across the course of their

practice.

Castafieiras et al.'s (2006) study may also aid our understanding of the data's failure to

support our hypothesis regarding increased therapist engagement across practice. Specifically,

Castafieiras et al.'s (2006) study indicated that differences across experience levels emerged for

the dimension of engagement only for those therapists who were identified as integrationist, but

not for psychoanalytic or cognitive therapists. In our analyses, we investigated the change

experiences of all participated therapists without controlling for their theoretical commitment,

and that might have masked the therapy style changes for therapists with specific theoretical

commitments.

Post-hoc analyses were utilized to investigate if differences across experience levels

emerge for the dimension of engagement only for those therapists with certain theoretical

orientation. Data confirmed the interaction between theoretical commitments and time on

therapists' levels of engagement. For therapists that identify their current theoretical commitment

as cognitive and integrative, engagement levels have declined across their practice while no

significant changes appear for therapists with other theoretical commitments. For therapists that

identified their initial theoretical orientation as behavioral, humanistic-existentialist-gestalt, and

integrative, engagement levels have declined across their practice. For therapists that identified

their initial theoretical orientation as narrative/constructivist, their engagement levels seemed to









increase across their practice. Possible explanations of these effects were drawn from the

literature.

Overall, findings supported the explanation that therapists' stylistic changes may be

moderated by their theoretical commitments (Castafieiras et al., 2006), masking the engagement

changes when combining responses of therapists with different theoretical commitments. The

obtained results revealed that the therapy style changes happen in a complicated fashion, where

different theoretical orientations, currently held or held in the past, may impact perceived

changes in therapy styles in different ways.

While Castafieiras et al. found that expert level integrationist therapists had higher levels of

engagement scores than beginners, our findings indicate that therapists who were initially or

currently identified their theoretical orientation as integrative perceived themselves to have

decreasing levels of engagement across years. The difference might be a result of the

methodological differences between the two studies. First, the two studies differ in the ways in

which therapists' theoretical commitments were determined. Castafieiras et al. assigned

theoretical orientation to the therapists who participated based on their descriptions of how they

conduct therapy; on the other hand, in the current study, it was the participants themselves

(rather than the researchers) who identified their main theoretical commitments with no

descriptions of how they conduct therapy or what these orientations that they selected

particularly mean to them. Second, the two studies differed in the number of theoretical

orientations that were included in the analyses. Castafieiras et al. grouped theoretical orientation

into 3 orientations; on the other hand, the current study expanded the options to 7 orientations

that might have captured the complexity of the interaction in-depth. Third, the two studies differ

in their comparison groups and conducted analyses. Castafieiras et al. compared expert









therapists' therapy style to beginner level therapists' therapy style, where beginner was defined

as therapists with up to 5 years of experience and experts as therapists with 15 years of

experience or more. However, the current study compared the same therapists' ratings of their

initial and current therapy style that included an average of 20 years of experience (ranging from

1 year to 52 years).

Decreasing levels of engagement that were found for therapists who were initially

committed to behavioral, humanistic, integrative and currently committed to cognitive and

integrative therapies was mostly inconsistent with the literature. But this finding may be

explained with the literature of therapist distress and burnout. Conducting psychotherapy can be

a distressing endeavor due to various sources of distress ranging from economic uncertainty to

working with complex issues where it is difficult to define success (Kramen-Kahn & Hansen,

1998). Conducting therapy has been recognized among factors contributing to the burnout

(Kestnbaum, 1984; Grosch & Olsen, 1994) that has been defined as "to fail, wear out, or become

exhausted by making excessive demands on energy, strength or resources" (Freudenberger,

1974, p. 159). Depersonalization that refers to uncaring and unfeeling attitudes towards others,

especially clients was identified among the central features of burnout (Maslach, Jackson, &

Leiter, 1996). The reduced commitment to therapy and clients may be related to an increase in

therapists' depersonalization experience that may follow the taxing years of practice.

It is important to note that previous research on burnout has failed to demonstrate a direct

relation between burnout experience and theoretical orientation (Raquepaw & Miller, 1989). Yet

researchers argue that certain therapeutic approaches can be contributing to the therapists' levels

of stress through their demands and effectiveness (Horner, 1993). Similarly, our findings of

decreased levels of engagement for therapists with initial commitments to behavioral,









humanistic, integrative therapy, and current commitments to cognitive and integrative therapy

might be a result of the distress and minor experiences of burnout for participated therapists.

The hypothesis of the study that predicted increasing levels of engagement across practice

was supported only for the therapists who were identified their initial theoretical orientation as

narrative/constructivist. Those therapists were the only group of therapists in the study that

perceived their commitment to therapy and clients increasing across the years of their practice.

The nature of narrative-constructivist therapies can be explored to understand this outcome.

Constructivist therapies refrain from one-way construction of the etiology and cure of the client

concerns, they promote experiential as well as cognitive growth, and they value a highly

humanized relationship with clients that is subjective, personal and emotional (Mahoney &

Gabriel, 1987; Mahoney, Lyddon & Alford, 1989). These qualities can buffer against the distress

of conducting therapy and can facilitate therapists' commitment to therapy and their levels of

engagement with their clients as they have been seasoned in their practice (Freudenberger, 1974;

Norcross, 2000).

Overall, our results concur with Castafieiras et al.'s (2006) study and therapist career

development studies that therapists become skillful in communicating their emotions, relax in

their style and become more spontaneous in the way they operate as therapists and broaden their

attentional focus in collecting data as they season in the profession and gain expertise. Change in

therapists' levels of engagement was more complex for therapists such that their theoretical

orientations colored their change experiences. For therapists currently identified with cognitive

and integrative orientations, and initially identified with behavioral, humanistic-existentialist-

gestalt and integrative orientations, engagement levels reportedly declined across their practice.









Our initial hypothesis of increasing engagement across practice held true only for those

therapists who were initially identified with narrative/constructivist orientation.

Association between Epistemic and Professional Change Constructions

Epistemology has been associated with certain schools of thought and theoretical

orientations (Lyddon, 1989a; Lyddon & Adamson, 1992; Neimeyer et al., 1993; Neimeyer &

Morton, 1997; Schacht & Black, 1985). Epistemology has also been associated with the ways in

which therapists conducted therapy (Nagae & Nedate, 2001; Vasco, 1994; Viney, 1994; Winter

& Watson, 1999), including the therapy style dimensions of expressive, engagement, operative,

and attentional (Neimeyer & Saferstein, 2006).

The literature indicated that epistemic, theoretical and stylistic commitments were

associated. The current study indicated that therapists' epistemic, theoretical, and stylistic

commitments were perceived to change across the course of their practice. Given that "change of

any sort can facilitate other changes" (Stricker, 2001, p. 79), we intended to explore if epistemic

change accounts for or aligns with therapists' theoretical and stylistic change experiences.

We hypothesized that increases in therapists' constructivist commitments would predict (1)

greater changes in their theoretical orientation throughout their career; (2) greater adherence to

theoretical integration and eclecticism; and (3) therapy styles marked by higher levels of

expressiveness, client engagement, attentional focus and operative spontaneity. Since the data

failed to indicate engagement differences across the years of practice, we excluded this variable

from the analyses. Results were mostly consistent with our expectations. After accounting for

demographic variables and initial standings, therapists' increasing commitment to constructivist

epistemology predicted high ratings for theoretical orientation change scale, as well as higher

levels of theoretical plurality, higher levels of emotional expressiveness and operative









spontaneity in conducting therapy and broader focus in gathering information in therapy in their

current practice.

Although no specific predictions were made, the ways in which changes in rationalist

commitments predict therapists' professional standings were also investigated. Results suggested

that therapists' increasing commitment to rationalist epistemology predicted lower ratings on

theoretical orientation change scale, lower levels of emotional expressiveness and operative

spontaneity and narrower focus in information gathering. Rationalist change scores accounted for

the variance in these variables even after the constructivist change scores were entered into

analyses, suggesting that, taken together, therapists' epistemic journeys better explained the ways

in which therapists ended up on their theoretical and stylistic dimensions than did either

epistemic orientation alone.

Overall, epistemological change processes predicted where therapists have reached in their

theoretical and stylistic commitments even after accounting for their initial commitments. These

results are consistent with the literature. The findings are explored in depth, first for theoretical

and next for stylistic commitments of therapists.

Epistemic and Theoretical Change

Epistemology has been associated with theoretical orientation. Not only certain epistemic

commitments were conceptually tied to certain theoretical orientations (Lyddon, 1991), but also

epistemic commitments accounted for therapists' theoretical orientation preferences (Lyddon,

1989a; Lyddon & Adamson, 1992; Neimeyer et al., 1993; Neimeyer & Morton, 1997; Schacht &

Black, 1985). The results of the current study supported and extended the relationship between

theoretical orientation and epistemology by indicating that as therapists have perceived greater

commitment to constructivism across the course of their practice, they indicated higher levels of

theoretical orientation change and higher levels of theoretical plurality.









Those therapists, who shift in their epistemic journey towards increased constructivism

tended to experience more change in their theoretical commitments and they were more likely to

integrate a variety of theoretical orientations in their conceptualizations. Constructivist

metatheory recognizes the complexity of human processes (Mahoney & Gabriel, 1987).

Similarly, higher levels of constructivist commitments predicted higher levels of self-

exploration, openness, and tolerance in therapists (Neimeyer & Aksoy, 2005).

Therapists' becoming increasingly constructivist might mean increasing appreciation of the

complexity of human processes, increasing tolerance for the complexity and increasing openness

to integrate different perspectives on their part. Such changes, then, would be consistent with

their openness to change the ways in which they have framed their work and to integrate a

variety of theoretical orientations in their therapeutic work. As therapists' constructivist

commitments grow stronger, their openness for sampling different theoretical orientations and

for integrating different orientations might grow stronger.

It is significant to note that the current study establishes an association between the field's

two significant trends, namely its increasing commitment to constructivist epistemology

(Mahoney, 1995a, 1995b) and theoretical integration (Goldfried, 2001a; Norcross et al., 2002;

Norcross, 2005). Although it is beyond the scope of this project to attain causality to this

interaction, it is most likely that a dialectical relationship exists between these trends. As

therapists' embraces the complexity human change processes, they might utilize complementary

orientations injunction to facilitate clients' change processes. The constructivist mindset would

allow therapists to combine various orientations in idiosyncratic ways. Increasing theoretical

plurality, in return, might lead to increased appreciation of diversity and complexity of involved

processes, and hence may solidify therapists' constructivist commitments.









On the other hand, participants who shifted in their epistemic journey towards increasing

rationalism tended to experience less theoretical orientation change. The nature of rationalistic

epistemology can be defined as relatively determined, definitive, and confident in understanding

and helping clients (Mahoney & Gabriel, 1987). Similarly, higher levels of rationalist

commitments predicted lower levels of self-exploration and openness in therapists (Neimeyer &

Aksoy, 2005). Hence, therapists with increasing rationalist commitments might be less

compelled to explore other theoretical orientations and change their theoretical commitments. It

is also important to note that the data indicated a decrease in rationalist epistemology in general

which would translate to further increase in practitioners' theoretical change experiences.

Rationalism change experience did not account for the degree to which therapists have

integrated different theoretical orientations. For our participants, changes in their rationalistic

commitments did not translate to their tendency to integrate a number of theoretical orientations.

Considering the nature of the rationalist epistemology, one might expect to find decreasing

plurality with increasingly higher levels of commitment to rationalism. The failure of the data to

indicate such might be a result of other influences dominating the field. For instance, increasing

valuing for and occurrence of theoretical integration might have outweighed the possible impact

of rationalist epistemology despite the nature of rationalist epistemology might conflict with the

use of a variety of lenses in conceptualizing therapy.

Epistemic and Stylistic Change

Epistemology has been associated with therapy style. Therapists conducting rationalist and

constructivist therapies differed in the way they set the direction of the therapy, related to client,

and conceptualized and worked through clients' emotional distress, relapse and regression

(Nagae & Nedate, 2001; Vasco, 1994; Viney, 1994; Winter & Watson, 1999). Moreover,









therapists with different epistemic commitments appeared to have different styles in their

therapeutic closeness, focus, engagement, and spontaneity (Neimeyer & Saferstein, 2006).

The results of the current study supported and extended the relationship between therapy

style and epistemology by indicating that therapists' epistemic journey predicted their current

stylistic standings. As therapists have perceived greater commitment to constructivism across the

course of their practice, they indicated higher levels of emotional expressiveness with clients,

higher levels of spontaneity in conducting therapy and broader focus in gathering information.

Moreover, perceived decrease in their commitment to rationalism across the course of their

practice accounted for additional variance in predicting higher levels of expressiveness and

spontaneity and broader focus.

These findings are consistent with the literature investigating the relationship between

epistemology and therapy style. Expressive, operative, and attentional dimensions of therapy

style have been associated therapists' epistemic commitments. Neimeyer and Saferstein (2006)

established that higher constructivist commitments related to higher levels of expressive (i.e.

increased emotional openness and closeness to clients), lower levels of operative (i.e. increased

operative spontaneity in conducting therapy) and lower levels of attentional (i.e. broader range of

attention in therapeutic information gathering).

Other studies further supported the link between epistemology and therapy style. With

respect to expressive dimension, Viney (1994) suggested that therapists conducting constructivist

cognitive therapies tended to acknowledge their clients' negative emotions more compared to

rationalist cognitive therapists. Moreover, Winter and Watson (1999) suggested that

constructivist therapists might tend to be more communicative of unconditional positive regard

to their clients than rationalist therapists. With respect to operative dimension, Vasco (1994)









established that more the therapists are committed to constructivist epistemology, less they lean

on therapeutic structure and direction.

Overall, our data extended the translation of epistemology into practice by suggesting that

therapists' epistemic journey in the form of increasing commitment to constructivism and

decreasing commitment to rationalism would account for where therapists finalized their journey

on expressive, operative, and attentional dimensions of therapy style.

Discussion of how our findings are supported by the literature may be strengthened by

utilizing the literature associating therapists' personal characteristics with their epistemic

commitments where higher levels of constructivist commitments predicted higher levels of self-

exploration, attending to emotions, ambiguity tolerance and openness in therapists, and yet

higher rationalism scores predicted lower levels of these characteristics (Neimeyer & Aksoy,

2005). Therapists' personal characteristics may facilitate therapists' change processes. For

instance, increasingly constructivist therapists may tend to have strengthened commitment to

self-understanding as well as attendance to their emotional processes, which might facilitate their

emotional expressiveness in the session and emotional closeness to their clients as well.

Similarly, those who are more increasingly open to and tolerant of ambiguity may be more likely

to welcome a broad attention to variety of areas and concerns in their information gathering

processes and may operate with increasing spontaneity in their therapeutic work.

Therapists' increasing commitment to constructivism and decreasing commitment to

rationalism, then, may translate to higher levels of expressive, operative, and attentional through

facilitating individual change processes that might relate to stylistic commitments (and future

studies can explore this). Overall, the finding that increased constructivism predicts emotional

expressiveness, spontaneity and range of attention positively across the course of therapists'









practice seems to be consistent with the personal characteristics that mirrors the assumptions of

constructivist epistemologies.

It is important to note that when both epistemologies were entered into the analyses, the

results were more robust and somewhat different than the results of analyses with only

constructivist epistemology. For instance, after including rationalist commitment change score,

constructivist commitment change score lost some of its power to account for the variance in the

professional variables of interest. For theoretical change index, the change was substantial

enough for the constructivism-change score to lose its statistical significance. Moreover,

rationalist-change journey of therapists seemed to be a better predictor of operative and

attentional dimensions of therapy style than their constructivist-journey. Decrease in rationalist

commitment across therapists' course of practice predicted the increase in spontaneity and range

of focus much strongly than increase in constructivist commitment did.

Our focus on the distinction between constructivist and rationalist epistemologies aimed to

enhance our understandings of the ways in which epistemological change accounted for

professional commitments. As Mahoney (1995b) suggested, our interest was on "the potential

contribution that rationalist-constructivist contrast may offer to emerging theory and research

relating the cognitive sciences and clinical services" (p. 9). Complementary ways of acquiring

and evaluating knowledge and understanding the world are equally valuable (Lyddon, 1989b),

and as it is shown in this study, the rationalist-constructivist contrast serves us with a better

understanding of how epistemic worldview relates to theoretical and stylistic commitments.

Limitations

In this section, we noted some significant sampling, instrumental, procedural and

methodological limitations of this study that might have hindered the external validity of the









findings. First, the obtained data might have been provided by a biased sample and its

generalizability must be questioned. Those who volunteered to participate in this study might

have been different from non-volunteers in the characteristics of interest as indicated by the

behavioral research (Rosenthal & Rosnow, 1991). Furthermore, the collecting data via Internet

through online survey may have widened the gap between those who volunteered to participate

and those who did not. However, research failed to find difference in participant responses when

compared to online data collection methods to paper-pencil methods (Gosling et al., 2004).

We cannot determine the representativeness of our population as a sample due to the

information restrictions as well as the snowballing that might have happened through invited

professionals forwarding the invitation email to other colleagues. Yet, our population that was

mainly composed of practitioner psychologists has a strong resemblance to the demographic

make-up of the members of the American Psychological Association (APA) that identified

themselves as practitioners (http://research.apa.org/prac_profile_12-7-07.pdf, 2007). In 2007,

APA members reported to be approximately 57.8% female and 42.2% male, and similarly 59.5%

of the population of the current study was female and 40.5% of the sample was male. APA

members' mean age was reported as 50.4 (SD = 10.7), and in the current study, the mean age of

participants was 50.36 (SD = 11.7), which is again comparable. Ethnicities in the current study

were Caucasian, 88.6% (vs. 93.3% of APA), Hispanic, 3.6% (vs. 2.7%), African-

American/Black, 2.4% (vs. 1.3%), Asian-American, 1.2% (vs. 1.8%), and multiracial, 1.2% (vs.

0.6%). Such similarities in the demographic composition of a part of the sample (i.e.

psychologists) and obtained population is encouraging with respect to external validity of the

obtained findings.









Generalizability of the findings was hampered by the self-report nature of the present

study. Self-reports are subject to distortion and social desirability. The postmodern zeitgeist

might prompt therapists to provide answers in line with the constructivist viewpoint even though

they might not have internalized this standpoint or transferred their assumptions to therapy room.

Moreover, self-reports may not correlate well with the participants' actual behavior or

experience (Rosenthal & Rosnow, 1991). It is important to consider that what therapists claim

they do in therapy setting might be quite different from what they actually do. The personal

narrations of certain well-known therapists could facilitate our understanding in this matter. For

instance, Albert Ellis noted repeatedly that he was committed to constructivist epistemology and

his therapy was constructivist in nature. Yet other researchers such as Mahoney and

Meichenbaum (see Zeig, 1992) had suggested that a closer inspection to the basic assumptions

and operations of REBT, and Ellis's himself, indicated the contrary. The variables of interest in

the current study such as epistemic commitment, theoretical orientation and therapy style are

subject to such misconstructionss" where self-reports do not correlate with behavior.

The current study asks participants to provide self-reports for not only their current

experiences but also for their experiences that took place during the time frame that they have

first started practice after graduation from their highest degree. Hence the limitations of self-

report studies might have been further complicated by memory biases. The literature on

cognitive psychology, specifically on recall, indicated that our memory is far from impartial and

subject to bias (Schacter, 1999). Certain facts can be "construed" as years move on and more

experience is gained. Hence, it must be clear to our reader that this study is based on the

constructions of professional practitioners as they had "recalled" themselves to be in their









professional start point and as of today, and caution must be exerted while interpreting the

obtained findings to not to equate these findings as "the reality" of the practitioners.

Another significant methodological limitation of the study is the number and nature of the

measures employed to collect the data regarding the variables of interest. Our understanding of

how therapists' epistemic journeys parallel their professional journey could be improved through

employing additional measures or indicators of therapy style and theoretical orientation as well

as measures of other professional variables. Providing an operational definition for the

theoretical orientations cited on the survey would also further the depth in which we interpreted

the findings. Such engagements would also enhance the validity and viability of the findings.

Another limiting factor to the current study is its efforts to approximate a longitudinal

research question through a cross-sectional research design. Although collecting data regarding

the times that practitioners first started their professional journey provides us with a quasi-

longitudinal data, the present study was far from detailing practitioners' journey, which threatens

its validity. Moreover, we have data regarding the two positions across therapists' practice with

little or no information regarding the trajectories that took place between their initial and current

experiences. Ideally, the inquiries posed in this study would be answered by longitudinal studies

with multiple data collection points. The logistical difficulties and limitations associated with the

longitudinal studies did not allow us to conduct a longitudinal study where we would be able to

track psychotherapists from the beginning of their practice for years. Such studies are needed in

the future to deepen our understanding of practitioners' epistemic and professional journey.

It is also important to note that the obtained findings are simply associations between the

variables of interest and do not imply causal relationships. For instance, perceived decrease in

therapists' rationalist commitment was associated with increase in their theoretical change









experiences; however we cannot claim that change in therapists' epistemologies cause them to

have increasing experiences of theoretical change. Obtained results only suggest relationship, not

necessarily causality.

Significance and Directions for Future Research

Despite the apparent limitations detailed above, the present study is an important addition

to the current literature on epistemology and psychotherapist experiences for a variety of reasons.

In this section, first we highlight the contributions of this study to the field and then we explore

the directions that future research can pursue following the lead of this study.

The current study is the first study investigating therapists' epistemic journey. Our findings

present empirical support for the claims of Mahoney (1995a, 1995b) and extend the literature on

epistemology as participated therapists perceived themselves to become increasingly

constructivist and decreasingly rationalist across the course of their practice. The current study

also presents a preliminary empirical exploration for the dynamics underlying therapists'

epistemic shifts. Specifically, it suggests that therapists' career development trajectories, rather

than their year of entry to the profession, color their epistemic journey. Moreover, it provides the

first empirical argument against the claim that the field's increasing commitment to

constructivism is a reflection of the infusion of therapists with stronger constructivist

commitments. This study also extends our understanding of the ways in which therapists'

epistemic journey is related to their professional experiences, specifically their theoretical and

stylistic commitments.

As Meichenbaum (1993) suggested, the story on which the theory and practice of

psychotherapy has been based "continues to unfold and to change" (p. 204). Field continues to

rely increasingly constructivist principles, cultural values and theoretical integration (Goldfried,









2001a; Norcross et al., 2002; Norcross, 2005; Norcross, Hedges, & Prochaska, 2002).

Recognizing the ways in which our understanding of the world, clinical practice and change

processes are linked to one another would be beneficial given the continuing change that the

field as well as its members experience.

This study also supports the claims of Mahoney (1995b) who suggested focusing on the

ways in which rationalist-constructivist contrast may be useful for clinical work and studies.

Constructivism and rationalism presents complementary ways of acquiring and evaluating

knowledge and understanding the world, and "... none of these worldviews provides the

'correct' or 'best' frame of reference. They simply suggest different forms of understanding,

inquiry and theory." (Lyddon, 1989b, p. 446). Together they extend our understanding of the

"complexities of human experience" (Mahoney & Lyddon, 1988, p. 223). Our findings in

general exemplify how the rationalist-constructivist contrast would extend our knowledge when

employed together and it encourages researchers to make use of such epistemological contrasts

sensibly.

The present study also contributes to the literature through opening up a fertile area of

research to investigate various dimensions of therapists' epistemic change processes. To begin

with; future research can extend our understanding by studying impacts and/or correlates of

therapists' changing epistemologies. As this study is focused on the association between

epistemological, theoretical and stylistic change experiences; future studies can explore how

change in epistemological commitments is associated with change in other sets of professional

characteristics. Therapists' epistemic commitments were not only associated with their

professional qualities but also with certain personal qualities such as self-exploration, openness

and tolerance (Neimeyer & Aksoy, 2005). Future research can also investigate how therapists'









epistemic journey interacts with their personal qualities which may also be moderating and/or

mediating the ways in which epistemic and professional journeys interact.

Most importantly, future studies can investigate further implications of the link between

therapists' epistemic journey and their professional experiences. Kramen-Kahn and Hansen

(1998) suggested that therapists perceived their change processes among the rewards of their

work. The current study can also be continued by exploring how these changes in therapists'

epistemic, theoretical and stylistic commitments translate to therapists satisfaction, and perhaps,

effectiveness of their work. Future research can investigate how epistemic and professional

changes of therapists are perceived by their clients and facilitated their change processes.

This study also partially validated the expectations that therapists' career development

processes play a significant role in their epistemic journey. It is known that therapists' personal

and professional lives are impacted by their conducting psychotherapy in multiple and complex

ways. Yet, more research is needed to understand the underlying dynamics of therapists'

epistemic journeys. Future research can also explore which individual processes facilitated

therapists' epistemic and professional change. Narrations of certain psychotherapists (such as

Goldfried, 2001a) highlighted why therapists change and what aspects of their personal life and

career have impacted their developmental process. Studies can investigate if therapists' epistemic

journey interacts with such personal accounts for reasons of change.

Conclusion

In conclusion, the present study examined the perceived epistemic changes of

psychotherapists, the impact of cohort on these change processes and the ways in which such

processes relate to therapists' professional standings in theoretical orientation and style of

conducting psychotherapy. Results of the study suggested that therapists perceive that they have









changed in their epistemic, theoretical and stylistic commitments across their professional

journey. Therapists reported that they have become increasingly constructivist and decreasingly

rationalist in their epistemic commitment, increasingly pluralist in their theoretical commitment

and increasingly expressive, spontaneous, and attentive to a broad spectrum of information in

their therapeutic styles. Results of the study also suggested that cohort effects did not account for

the levels of therapists' initial epistemic commitments or epistemic change experiences.

Moreover, results of the study revealed that therapists' increasing commitment to constructivist

epistemologies and decreasing commitment to rationalist epistemology together were perceived

to be associated with their current theoretical and stylistic commitments. Epistemological change

processes predicted where therapists have reached in their theoretical and stylistic commitments

even after accounting for their initial commitments.

The current study is a significant contribution to the field given that it was the first study

empirically investigating the epistemic change processes of therapists. It extended the developing

literature on epistemology as a factor relating to psychotherapists' professional change.

Additional and ideally, longitudinal work is needed to clarify the nature and correlates of

therapists' epistemic journeys. It also opens up a fertile area of research to extend our

understanding of practitioners' epistemic change processes, which may increase our

effectiveness in dealing with the changes that our profession generates.









APPENDIX A
THERAPIST ATTITUDE QUESTIONNAIRE-SHORT FORM (TAQ-SF)

Please rate the following items along the following 5-point scale. In considering yourself
"NOW", we are interested in how you currently view yourself and your professional practice
today. In considering yourself "THEN", we are interested in how you view yourself when you
first started practicing following the completion of your graduate training.


2
Moderately
disagree


Neither agree
nor disagree


Moderately
agree


NO\\


I Reality\ is siniuilar. stable and eternal to hiuiman experience

2 Kno\\ ledue s determined to be \alid b\ louic and reason

3 Learimni, In\ ol\ es the contiuOltisi oi continent chaliminu of
discrete e\ ents

4 Nlental representations of realmit\ in\ol\ e accurate. e\pilicit
and e\tensi\ e couples of tie e\teirnal \\ 0ord. \\ hlclc are encoded
in memory\
III Ille11101A

5 It is best for ps chllil.erapists to focI'u treatment on clients
current problems and the el 1min atlon or control of these
problems

11 Disturbed affect comes from irrational. I\ alild. distorted
or and i inirealistic tlhnlkin

SClients reistance to chanlle reflects a lack of lmoti\ nation.
ambi\ alence oo moti acted a\ oidalnce and such resistance to
challne is an Imlpedilment to therapy \\h ch tle 1is\ chlotlherapist
\\ oirk to o\ ercome

S Reality\ is relati\ e Realities reflect lndli\ dual or collect\ e
construction of order to one' experiences

0 Leartnin in\ ol\ es thle refinement and transformation
(assilnlationl and accommllodation of mIental representation

10 Coun'ition. beha\ 101or and affect are interdependent
expressions of holistic s\ steic processes The three are
fLinctionall\ and structl rall\ Inseparable


1 2 3 4 5 1 2 3 4 5

1 2 3 4 5 1 2 3 4 5


1 2 3 4 5 1 2 3 4 5



1 2 3 4 5 1 2 3 4 5



1 2 3 4 5 1 2 3 4 5



1 2 3 4 5 1 2 3 4 5



2345 12345
1 2 3 1 2 3 4



1 2 3 4 5 1 2 3 4 5


1 2 3 4 5 1 2 3 4 5



1 2 3 4 5 1 2 3 4 5


1
Strongly
disagree


5
Strongly
agree


SHEN










I I Intense emotions Ila\ e a disora Inizin 1 eff ect on bell\ 101or
This disoruanization ma\ be functional in that it it ntiates a
reorganization so that more \ able adapt\ e coItILructionIs canl
be formed to meet the enl\ ronmental demands

12 Ps\ chotheralists slhoiil encourage emotional e\lielence.
e\xpression. and e\lloration

13 Clinical problems are current or recurrent discrepancies
between our eternal en\ ironmental challenges and internal
adapti\ e capacities Problems can become poo\\erful
opporTiounities for learmninu

14 A\\areness or insiuht is one of man\ strategies for
impro\ ement. ho\\ e\er. emotional and or beha\ loral
enactments are allo \ en Important


1 2 3 4 1 2 3
1245 12345



1 2 3 4 1 2 3

1 2 3 4 5 12 4 5

12345 12345


1 2 3 4 5


1 2 3 4 5


15 Therapists relationship \\ ith clients is best conceltualized
as a professional hellpi nu relationships. \\ Ich entails the se\ ice 4
and lell\ enr of technical. instructional Infol'rmation or
uiIJidalnce


1 2 3 4 5


Il Ps\chotherapists' relationship \\Ith clients caln best be
once itualize s la Iz I unique social e\challe. X\ hch pro\ ides
the clients a safe sUllpporli\ e context to explore anld dle elopl
relationships \\ th themsel\ es and the \\ world


1 2 3 4 5


1 2 3 4 5









APPENDIX B
THEORETICAL ORIENTATION RATINGS

Directions: Below you will find a list of theoretical orientations. You can list a variety of
orientations. Please rate yourself along the provided scale identifying the extent to which the
given theoretical orientation is and was a part of your clinical practice. In considering yourself
"NOW", we are interested in how you currently view yourself and your professional practice
today. In considering yourself "THEN", we are interested in how you view yourself when you
first started practicing following the completion of your graduate training.


Not a Part
of My Therapy


1 2 3 4 5


A Significant Part
of My Therapy


NOW THEN

1 Cognitive 1 2 3 4 5 1 2 3 4 5

2 Behavioral 1 2 3 4 5 1 2 3 4 5

3 Humanistic Existential 1 2 3 4 5 1 2 3 4 5
Gestalt

4 Narrative/constructivist 1 2 3 4 5 1 2 3 4 5

5 Systemic Family 1 2 3 4 5 1 2 3 4 5

6 Psychodynamic 1 2 3 4 5 1 2 3 4 5

7 Feminist Multicultural 1 2 3 4 5 1 2 3 4 5

SIf you would have to Drop Down Menu Saying Drop Down Menu Saying
Please Select Please Select
choose only one
1. Cognitive 1. Cognitive
theoretical orientation as ontve ognve
your main base, which 2. Behavioral 2. Behavioral
one would that be? 3. Humanistic 3. Humanistic -
Existential Gestalt Existential Gestalt
4. Narrative/constructivist 4. Narrative/constructivist
5. Systemic- Family 5. Systemic -Family
6. Psychodynamic 6. Psychodynamic
7. Feminist Multicultural 7. Feminist Multicultural
8. Integrationist 8. Integrationist
9 When you consider your therapeutic orientation across Same 1 2 3 4 5 Changed
time, to what extent do you see that orientation has having
remained the same, or changed?











APPENDIX C
PERSONAL STYLE OF THE THERAPIST (PST-Q)

Directions: Please rate the following items along the following 7-point scale. In considering
yourself "NOW", we are interested in how you currently view yourself and your professional
practice today. In considering yourself "THEN", we are interested in how you view yourself
when you first started practicing following the completion of your graduate training.


Total Disagreement 1


2 3 4 5 6 7 Total Agreement


'1' represents total disagreement with the statement and '7' means total agreement.


NO )\\


I I ild to10 bc op ln11-1111n d lld 1icccptl' cin IIsI h1int 11 ilici
lill l1 Ikll 00 -illlll ld llid 1iq1cli l c
2 I I' l 1 n I aI I \ [ III 10 id I 10 c ill lii foim oI\ Cn
[I I t O lll_' p I), llclllu ito I lllI l 10li l'l II lO l l oll" 1\



lolildl do liI cJ.Ici .c ioni

4 I lccp a lo'\ pioflIc of iii\ o\ c cll niinl \ l ill pi.lUicI iII oicki to
bc' noic obictil\ c

5 I lind chalii t' n Ill K cll lii ciinI t cil l i I'

S The cillotOIiollsn i pxll t aoioc_ Ill IlK c ac kc\\ to ilh COllik
ol Ilk IIc JI llIn

I III 1110iioi 1ichiicI ccollk ip lli\ I Ilkc llic il III c\pi)I01111
ilhall t1 poIli Otl lll h l lk t 10 lolIo'\

N I a1 Old coIilltlliniiw Iiothl ,2iw I .1 C1lIC o1 dIccp11 c111IIoIoiia









I I E il\ l I _lll_11 lllll IllliS [11. 1 occllcll [ o Lll ll ll |l, In Cl ll. ic_
tic lli 1p ti to ll i ,polld \ oii tii ia IIlc ill, Ictih II U1 tll


Ij I don li thili iboutl l xi ICn.U otLikidc _c.iik ll

14 ( I i i n office 11jh a1 a i i in- c i ipact O 10111 11Ca I i

15 Real[ clih i' iakc pi|lc diliinl i' [lih'llh no111 ioi1.11 c..ion1.


1 4 5 5 -


1 4 5 5 -


1 4 5 5 -


1 1 4 5 5 -


I 2 1 4 5 -


1 4 5 i -


I 2 1 4 5 -


S1 4 5 -


1 2 4 5 -

1 2 4 5 -

1 2 4 5 -


1 2 1 4 5 1 -


1 2 4 5 -

1 2 4 5 -

1 2 1 4 5 -


I 12 4 5 -


I 12 4 5 -


1 1 4 5 -


I 1 4 5 -


I 2 4 5 -


I 1 4 5 -


1 1 4 5 -


I 1 4 5 -


I 2 4 5 -

I 2 4 5 -

I 2 4 5 -


1 1 4 5 i -


I 2 4 5 -

I 2 4 5 -

I 2 4 5 -


THEN











Il, I b'lic' c I ll I tllK I llhe _il t \\ li If\. iblc s i ii.lll

I' I filld II ui luC l to 10c. C.l sO clll lllllni.li pli onll .lbo t ll ii s I
dIullit_' sessions _

IN I like to f1 l iuriprnisi l b \ \\ .i .IiIch |lci.iII brhinit'_ 10 iliK
session l Ii ll t oI ld111 I | Ii piCCOICC IN c d no110t1ls

I' I often Ii11J tlid pInlli.s ouW L itclk ilic office

_'2 Tihe best IllI cii n olln 1.in I IcIllIlllll occin ll spoill conI.ll\i

2 I \\ hll.\.i hllJppl(. 10 111to pitilh J_ I lle, ullull .nIKiv on my1
0'I 11 In-I






24 I \0old Ic l IJilll' m111 CellollOills tO 111 plillIll

25 I aiml pil I n Ii C ll lli iJ lll I 1 l ll cIll (ii Oil t _i.l '




11'I$li111f

-' 11f soIlllillIlc, both ls d li illl lll' i iSsii llII. l c II C i\p


E I OIIl1i.1 closIness IAh pliIls is esse lloll nil tO bingI ,boutl

24 I >ild .i to l li\ Ioiin c i \ i.h 10 I hiiul- I. l d Ili l
,In Ittlon to 1I sessI ons

25 I C.I pil ol ,l11k i.l ll\ i. Ilh Illc ll \\ .1 iit i1 11 I cl l\ ocui I.d



4 ll lllOll ,0bo t i I p1bl. .1,i .i sessions
' I I|ccp\Ii Ii2cK iiOl I llid ll i d iccioli i i .llll i 1. 10. 11 C1 11lh0 c



-' I illc c1ie 111C Ii llllh 11110c l l 0k lli 1cioii ld'1 llll' LI11ic d li.llic l'c


24 I (l1111 joiiic |iill o lic piii kiiLil d lcliii ICdi c IlO IIl

''5 I li qiiict llc.\iblc \\ w ith _s lich lik.s

i i Rl'hl f 110o111 ll ii 11111o 1' tO1 t l _Iicc sionl I J1 llo1\ I mIllelllOll tO
alloJ


I 2 1 4 5' -


I 2 1 4 5 -


1 2 ; 4 5 -


I 2 1 4 5 n -


1 2 1 4 5 -


I 2 1 4 5 '' -


1 2 1 4 5 -


1 2 1 4 5 -


1 ; 4 5 -


1 ; 4 5 -


1 2 1 4 5 -


I 2 1 4 5' -


I 2 1 4 5' -


I 2 ; 4 5' -


I 2 1 4 5 -


I 2 1 4 5' -


I 2 1 4 5'' -


1 2 1 4 5' -


1 2 1 4 5' -


1 2 1 4 5' -


1 2 1 4 5' -


1 2 ; 4 5' -


I 2; 1 4 5 '' -


I -1 4 5 1









APPENDIX D
DEMOGRAPHIC INFORMATION

Please tell us a little about yourself. This information will be used only to describe the sample as
a group.


1. Gender: Male Female

2. Age:

3. Ethnic background: White/Caucasian, Black/African-American, Hispanic/Latino/a -
Black, Hispanic/Latino/a White, Asian-American-Pacific Islander, American Indian
/Native-American, Multi-racial, Other

4. Name of your highest degree: BA/BS, MA/MS, MSW, PsyD, PhD, EdD,
Other

5. Years of college and higher education in total:

6. The year you obtained your highest degree:

7. Total number of years you spent engaging in clinical practice:

8. Specialty area: Psychologist, Mental Health Counselor, Marriage and Family therapist,
Social worker, Psychiatrist, Other

9. Primary job responsibility: Practice/Clinical work, Research, Academic, Administrative,
Other

10. Primary employment setting: Private practice, University academic department,
University service delivery department, Hospital, Mental health care, School setting,
Research setting, Community Center, Other

11. Number of clients you see weekly on average. Please count each group you work with as
1 client.

12. Country you live in: Drop Down Menu: List of Countries












LIST OF REFERENCES


American Psychological Association Website. (2008). 2007 psychology practitioner profile.
Retrieved January 2, 2008, from http://research.apa.org/prac_profile_12-7-07.pdf.

Arthur, A. R. (2000). The personality and cognitive-epistemological traits of cognitive
behavioral and psychoanalytic psychotherapists. British Journal of Medical Psychology,
73, 243-257.

Babbage, D. R., & Ronan, K. R. (2000). Philosophical worldview and personality factors in
traditional and social scientists: Studying the world in our own image. Personality and
Individual Differences, 28, 405-420.

Beck, A. T. (2002, June). Emotional arousal in cognitive therapy. Beck Institute Newsletter, 7.
Retrieved April 15, 2007, from
http://www.beckinstitute.org/InfoID/78/RedirectPath/Addl/FolderID/168/SessionID/o%7
B002A9969-B2FE-49A9-BOEC34BEF53B311B%7D/InfoGroup/Main/InfoType/
Article/PageVars/Library/InfoManage/Zoom.htm.

Beck, A. T. (n.d.). Retrieved April 15, 2007. Aaron T. Beck writes in: Early response to CT, and
current success. Cognitive Therapy Today, Beck Institute 's Blog. Retrieved April 15,
2007, from http://cttoday.org/?p=91.

Beitel, M., Ferrer E., Cecero, J.J. (2004). Psychological mindedness and cognitive style. Journal
of Clinical Psychology, 60, 567-582.

Berzonsky, M. D. (1994). Individual differences in self-construction: The role of constructivist
epistemological assumptions. Journal of Constructivist Psychology, 7, 263-281.

Bloch, S. (2004) An interview with Aaron (Tim) Beck. Retreived April 15, 2007, from
http://www.beckinstitute.org/Library/InfoManage/Zoom.asp?InfoID=304&RedirectPath=
Addl&FolderID=208&SessionID= CA5E7FE1-9C4B-4AEA-978E-5EADA
0B3 5BOA}&InfoGroup=Main&InfoType=Article& SP=2.

Botella, L., & Gallifa, J. (1995). A constructivist approach to the development of personal
epistemic assumptions and worldviews. Journal of Constructivist Psychology, 8, 1-18.

Brown, L. S. (2005). Don't be a sheep: How this eldest daughter became a feminist therapist.
Journal of Clinical Psychology, 61, 949-956.

Castafieiras, C., Garcia, F., Lo Bianco, J., Fernandez-Alvarez, H. (2006). Modulating effect of
experience and theoretical-technical orientation on the personal style of the therapist.
Py hth1 e1 /i p Research, 16, 595-603.

Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155-159.









DeAngelis, T. (2006). Finding focus. Monitor on Psychology, 37, 59-61.


DiGuiseppe, R., & Linscott, J. (1993). Philosophical differences among cognitive behavioral
therapists: Rationalism, constructivism, or both? Journal of Cognitive Psychotherapy: An
International Quarterly, 7, 117-130.

Eagle, M. N. (2001). Reflections of a psychoanalytic therapist. In Goldfried, M. R. (Ed.), How
therapists change: Personal and professional reflections (p. 37-53). Washington, DC:
American Psychological Association.

Ellis, A. (1990). Is rational-emotive therapy (RET) "rationalist" or "constructivist"? Journal of
Rational-Emotive & Cognitive-Behavior Therapy, 8, 169-193.

Ellis, A. (1992a). Discussion by Albert Ellis, Ph.D. In Zeig, J. K. (Ed), The Evolution of
psychotherapy: the second conference. New York: Brunner/Mazel.

Ellis, A. (1992b). My early experiences in developing the practice of psychology. Professional
Psychology: Research and Practice, 23, 7-10.

Ellis, A. (1993). Constructivism and rational-emotive therapy: A critique of Richard Wessler's
critique. P~jy h1 1itheii -, 30, 531-532.

Ellis, A. (1995). Reflections on rational-emotive therapy. In M. J. Mahoney (Ed), Cognitive and
constructive py hll/Wh'i ipiie Theory, research, andpractice (pp. 69-73). New York:
Springer.

Ellis, A. (1999). Why rational-emotive therapy to rational emotive behavior therapy?
Pyhrlhtheiq-, 36, 154-159.

Farber, B. A. (1983). The effects of psychotherapeutic practice upon psychotherapists.
Pyh 111 1hiw/ I~qj Theory, Research and Practice, 20, 174-182.

Farber, B. A., Manevich, I., Metzger, J., & Saypol, E. (2005). Choosing psychotherapy as a
career: Why did we cross that road? Journal of Clinical Psychology, 61, 1009-1031.

Fernandez-Alvarez, H., Garcia, F., Lo Bianco, J. L., & Corbella Santoma, S. (2003). Assessment
questionnaire on the personal style of the therapist PST-Q. Clinical Psychology and
P y-h,,t/hlquy, 10, 116-125.

Frankel, Z., & Levitt, H. M. (2006). Postmodern strategies for working with resistance: problem
resolution or self-revolution? Journal of Constructivist Psychology, 19, 219-250.

Freudenberger, H. J. (1977). Burn-out: Occupational hazard of the child care worker. Child Care
Quarterly, 6, 90-99.

Germer, C. K., Efran, J. S., & Overton, W. F. (1982). The Organisicm-Mechanism Paradigm
Inventory: Toward the measurement of metaphysical assumptions. Paper presented at the
53rd Annual Meeting of the Eastern Psychological Association, Baltimore, MD.









Goldfried, M. R. (Ed.). (2001a). How therapists change: Personal and professional reflections.
Washington, DC: American Psychological Association.

Goldfried, M. R. (2001b). Conclusion: A perspective on how therapists change. In Goldfried, M.
R. (Ed.), How 7/the/ 1,,i i change: Personal and professional reflections (p. 315-330).
Washington, DC: American Psychological Association.

Gosling, S. D., Vazire, S., Srivastava, S., & John, O. P. (2004). Should we trust web-based
studies? A comparative analysis of six preconceptions about Internet questionnaires.
American Psychologist, 59, 93-103.

Greenberg, L. S. (2001). My change process: From certainty through chaos to complexity. In
Goldfried, M. R. (Ed.), How ithe1iqpi\%\ change: Personal and professional reflections (p.
247-270). Washington, DC: American Psychological Association.

Grosch, W. N. & Olsen, D. C. (1994). When Helping Starts to Hurt. A New Look at Burnout
Among Py/ hI,/thei,/pi\\. New York: W. W. Norton.

Horner, A. J. (1993). Occupational hazards and characterological vulnerability: The problem of
"burnout." American Journal ofPsychoanalysis, 53, 137-142.

Hoyt, M. F. (2005). Why I became a (brief) psychotherapist? Journal of Clinical Psychology, 61,
983-989.

Jennings, L., & Skovholt, T.M. (1999). The cognitive, emotional, and relational characteristics of
master therapists. Journal of CounselingPsychology, 46, 3-11.

Johnson, J. A., Germer, C. K., Efran, J. S., & Overton, W. F. (1998). Personality as the basis for
theoretical predilections. Journal ofPersonality and Social Psychology, 55, 824-835.

Kestnbaum, J. D. (1984). Expectations for therapeutic growth: One factor in burnout. Social
Casework, 65, 374-377.

Kivlighan, D. M., & Quigley, S. T. (1991). Dimensions used by experienced and novice group
therapists to conceptualize group processes. Journal of Counseling Psychology, 38, 415-
423.

Kramen-Kahn, B., & Hansen, N. D. (1998). Rafting the rapids: Occupational hazards, rewards,
and coping strategies of psychotherapists. Professional Psychology: Research and
Practice, 29, 130-134.

Kramer, D. A., Kahlbaugh, P. E. & Goldston, R. B. (1992). A measure of paradigm beliefs about
the social world. Journal of Gerontology: Psychological Sciences, 47, 180-189.

Lyddon, W. J. (1988). Information-processing and constructivist models of cognitive therapy: A
philosophical divergence. The Journal of Mind and Behavior, 9, 137- 166.









Lyddon, W. J. (1989a). Personal epistemology and preference for counseling. Journal of
Counseling Psychology, 36, 423-429.

Lyddon, W. J. (1989b). Root metaphor theory: A philosophical framework for counseling and
psychotherapy. Journal of Counseling & Development, 67, 442-448.

Lyddon, W. J. (1990). First- and second-order change: Implications for rationalist and
constructivist cognitive therapies. Journal of Counseling & Development, 69, 122-127.

Lyddon, W. J. (1991). Epistemic style: Implications for cognitive psychotherapy. Py, h,,iq/iu3'y,
28, 588-597.

Lyddon, W. J., & Adamson, L. E. (1992). Worldview and counseling preference: An analogue
study. Journal of Counseling and Development, 71, 41-47.

Mahoney, M. J. (1988). Constructive metatheory: II. Implications for Psychotherapy.
International Journal of Personal Construct Psychology, 1, 299-315.

Mahoney, M. J. (1991). Human change processes: The scientific foundations ofpsychotherapy.
New York: Basic.

Mahoney, M. J. (Ed). (1995a). Cognitive and constructive pyiL ihItwheiqpie Theory, research,
and practice. New York: Springer.

Mahoney, M. J. (1995b). Theoretical developments in the cognitive psychotherapies. In
Mahoney, M. J. (Ed), Cognitive and constructive py %hiI ,ithetiqiep' Theory, research, and
practice. (pp. 3-19). New York: Springer.

Mahoney, M. J. (1995c). The Psychological Demands of Being a Constructive Psychotherapist.
In R. A. Neimeyer & M. J. Mahoney (Eds.), Constructivism in psychotherapy (pp. 385-
399). Washington, DC: American Psychological Association.

Mahoney, M. J. (2001). Behaviorism, cognitivism, and constructivism: Reflections on people
and patterns in my intellectual development. In Goldfried, M. R. (Ed.), How /wti ,1/,ipi
change: Personal and professional reflections (pp. 183-200). Washington, DC: American
Psychological Association.

Mahoney, M. J., & Gabriel, T. J. (1987). Psychotherapy and the cognitive sciences: An evolving
alliance. Journal of Cognitive Therapy: An International Quarterly, 1, 39-59.

Mahoney, M. J., & Lyddon, W. J. (1988). Recent developments in cognitive approaches to
counseling and psychotherapy. The Counseling Psychologist, 16, 190-234.

Mahoney, M. J., Lyddon, W. J., & Alford, D. J. (1989). An evaluation of rational-emotive theory
of psychotherapy. In M. E. Bernard & R. DiGiuseppe (Eds.), Inside Rational-Emotive
Therapy. A Critical Appraisal of the Theory and Therapy ofAlbert Ellis. (pp. 69-94). San
Diego, CA: Academic Press.









Martin, J., Slemon, A. G., Hiebert, B., Hallberg, E. T., & Cummings, A. L. (1989).
Conceptualizations of novice and experienced counselors. Journal of Counseling
Psychology, 36, 395-400.

Maslach, C., Jackson, S.E. & Leiter. M. (1996). MBIManual (3rd ed.). Palo Alto, CA:
Consulting Psychologists Press.

McCann, I. L., & Pearlman, L. A. (1990). Vicarious traumatization: A framework for
understanding the psychological effects of working with victims. Journal of Traumatic
Stress, 3, 131-149.

Meichenbaum, D. (1990). Evolution of cognitive behavior therapy: Origins, tenets and clinical
examples. In J. Zeig (Ed.), The evolution ofpyh1i1theli'iq (pp. 96-115). New York:
Brunner/Mazel.

Meichenbaum, D. (1993). Changing conceptions of cognitive behavior modification: Retrospect
and prospect. Journal of Consulting and Clinical Psychology, 61, 202-204.

Myers, R. (1990). Classical and modern regression i/ ith applications (2nd ed.). Boston:
Duxbury Press.

Nagae, N., & Nedate, K. (2001). Comparison of constructive cognitive and rationalist cognitive
psychotherapies for students with social anxiety. Constructivism in the Human Sciences,
6, 41-49.

Neimeyer, G. J., & Aksoy, G. (2005). Epistemology and psychotherapists: Clarifying the link
among epistemic style, experience, and therapist characteristics. Unpublished manuscript,
University of Florida.

Neimeyer, G. J., & Morton, R. J. (1997). Personal epistemologies and preferences for rationalist
versus constructivist psychotherapies. Journal of Constructivist Psychology, 10, 109-123.

Neimeyer, G. J., Prichard, S., Lyddon, W. J., & Sherrard, P. A. D. (1993). The role of epistemic
style in counseling preference and orientation. Journal of Counseling and Development,
71, 515-523.

Neimeyer, G. J., & Saferstein, J. (2003). Personal epistemologies and psychotherapists'
preferences. Unpublished manuscript, University of Florida.

Neimeyer, G. J., & Saferstein, J. (2006). The relationship between therapists' epistemology and
their therapy style, working alliance, and use of specific interventions. Unpublished
manuscript, University of Florida.

Neimeyer, R. A. (1993). Constructivism and the cognitive psychotherapies: Some conceptual
and strategic contrasts. Journal of Cognitive PyL h,1the/I /qy, 7, 159-172.









Neimeyer, R. A. (1995). Constructivist psychotherapies: Features, foundations, and future
directions. In R. A. Neimeyer & M. J. Mahoney (Eds.), Constructivism in Psychotherapy
(pp. 11-38). Washington, DC: American Psychological Association.

Neimeyer, R. A. (2005). The construction of change: Personal reflections on the therapeutic
process. Constructivism in the Human Sciences, 10, 77-98.

Norcross, J. C. (2000). Psychotherapist self-care: Practitioner-tested, research-informed
strategies. Professional Psychology: Research and Practice, 31, 710-713.

Norcross, J. C. (2005). A primer on psychotherapy integration. In J.C. Norcross & M.R.
Goldfried (Eds.), Handbook ofp tyhIl hiwiqj' integration (2nded). New York: Oxford
University Press.

Norcross, J. C., Hedges, M., & Prochaska, J. O. (2002). The face of 2010: A Delphi Poll on the
future of psychotherapy. Professional Psychology: Research and Practice, 33, 316-322.

Norcross, J.C., Karpiak, C.P., & Lister, K. M. (2005). What's an integrationist? A study of self-
identified integrative and (occasionally) eclectic psychologists. Journal of Clinical
Psychology, 61, 1587-1594.

Orlinsky, D. E. (1999). The master therapist: Ideal character or clinical fiction? Comments and
questions on Jennings and Skovholt's "The Cognitive, Emotional, and Relational
Characteristics of Master Therapists". Journal of Counseling Psychology, 46, 12-15.

Orlinsky, D. E., Ronnestad, M. H., Ambuehl, H., Willutzki, W., Botermans, J-F., Cierpka, M.,
Davis, J., & Davis, M. (1999). Psychotherapists' assessments of their development at
different career levels. PyL hwhIel,,wq-, 36 (3), 203-215.

Padesky, C. A. (2002). Mind and men introduction for the Festschrift in honor of Aaron T. Beck,
M.D. Beck Institute Newsletter, 6. Retrieved April 15, 2007, from
http://www.beckinstitute.org/InfoID/132/RedirectPath/Addl/FolderID/174/SessionID/%7
B002A9969-B2FE-49A9-
BOEC34BEF53B311B%7D/InfoGroup/Main/InfoType/Article/PageVars/Library/InfoMa
nage/Zoom.htm

Pepper, S. C. (1942). World lhipol,,ih Berkeley, CA: University of California Press.

Pepper, S. C. (1967). Concept and quality: A world hypothesis. LaSalle, IL: Open Court.

Radeke, J. T., & Mahoney, M. J. (2000). Comparing the personal lives of psychotherapists and
research psychologists. Professional Psychology: Research and Practice, 31, 82-84.

Raquepaw J. M., & Miller, R. S. (1989). Psychological burnout: A componential analysis.
Professional Psychology: Research and Practices, 20, 32-36.









Ronnestad, M. H., & Skovholt, T. M. (2001). Learning arenas for professional development:
Retrospective accounts of senior psychotherapists. Professional Psychology: Research
andPractice, 32, 181-187.

Ronnestad, M. H., & Skovholt, T. M. (2003). The journey of the counselor and therapist:
Research findings and perspectives on professional development. Journal of Career
Development, 30, 5-44.

Rosenthal, R., & Rosnow, R.L. (1991). Essentials of behavioral research: Methods and data
analyses (2nd Edition). Boston: McGraw-Hill.

Royce, J. R. (1964). The encapsulated man: An interdisciplinary essay on the search for
meaning. Princeton, NJ: Van Nostrand.

Royce, J. R., & Mos, L. P. (1980). Psycho-epistemologicalprofile manual. Edmonton, Canada:
University of Alberta Press.

Royce, J. R., & Powell, A. (1983). Theory ofpersonality and individual differences: Factors,
systems, processes. Englewood Cliffs, NJ: Prentice-Hall.

Schacht, T. E., & Black, D. A. (1985). Epistemological commitments of behavioral and
psychoanalytic therapists. Professional Psychology: Research and Practice, 16, 316-323.

Schacter, D. L. (1999). The seven sins of memory: Insights from psychology and cognitive
neuroscience. American Psychologist, 54, 182-203.

Skovholt, T. M. & Jennings, L. (Eds.) (2004). Master therapists: Exploring expertise in therapy
and counseling. Boston: Allyn & Bacon.

Skovholt, T. M. & Ronnestad, M. H. (1992). Themes in therapist and counselor development.
Journal of Counseling and Development, 70, 505-515.

Skovholt, T. M., & Ronnestad, M. H. (2003). The hope and promise of career life-span counselor
and therapist development. Journal of Career Development, 30, 1-3.

Stricker, G. (2001). How I learned to abandon certainty and embrace change. In Goldfried, M. R.
(Ed.), How therapists change: Personal and professional reflections (p. 67-81).
Washington, DC: American Psychological Association.

Vasco, B. (1994). Correlates of constructivism among Portuguese therapists. Journal of
Constructivist Psychology, 7, 1-16.

Viney, L. L. (1994). Sequences of emotional distress expressed by clients and acknowledged by
therapists: Are they associated with some therapists than others? British Journal of
Clinical Psychology, 33, 469-81.









Winter, D. A., & Watson, S. (1999). Personal construct psychotherapy and the cognitive
therapies: Different in theory but can they be differentiated in practice? Journal of
Constructivist Psychology, 12, 1-22.

Zeig, J. K. (1992). The Evolution ofpyi% Irirhi /, py The second conference. New
York: Brunner/Mazel.









BIOGRAPHICAL SKETCH

I was born in Ankara, Turkey, in 1981. In 1995 my family moved to Istanbul, Turkey. I

attended the Bogazici University in Istanbul, double-majoring in guidance and psychological

counseling and psychology programs, as an undergraduate. In 2003, I graduated, ranking first in

the Department of Education.

I joined the Department of Psychology at the University of Florida as a counseling

psychology graduate student in August 2003. I completed my Master of Science degree in

December 2005. I completed my Doctor of Philosophy degree in August 2008.





PAGE 1

1 ME NOW, ME THEN: THERAPISTS AND CONSTRUCTIONS OF THEIR EPISTEMIC JOURNEY By GIZEM TOSKA A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL OF THE UNIVERSITY OF FLOR IDA IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY UNIVERSITY OF FLORIDA 2008

PAGE 2

2 2008 Gizem Toska

PAGE 3

3 To Michael J. Mahoney, for inviting me to a ppreciate the complexity of life, and to my academic and clinical supervisors, Drs. Greg Neimeyer, Michael Murphy, Roberta Seldman, Elizabeth M. Koshy, Marshall L. Knudson, and Pa ul Schauble, for their everlasting impact on my journey. I am grateful that my path crossed with the minds and hearts of these incredible individuals.

PAGE 4

4 ACKNOWLEDGMENTS I would like to thank m y advisor and comm ittee chair Dr. Greg J. Neimeyer, and my beloved husband Ferit Toska, for their extensive guidance, support, and encouragement. I thank my dear friend Burhan t for his guidance in the conduct of the statistical analyses of this project. I thank to my dear father Yal n Aksoy for his help in improving the quality of writing. I am thankful for the assistance given to me by my committee members, Dr. Kenneth Rice, and Dr. Michael Farrar. I am grateful to my family and my friends in Turkey and in Gainesville for their love and support. I could not have done this project without their help.

PAGE 5

5 TABLE OF CONTENTS page ACKNOWLEDGMENTS...............................................................................................................4 LIST OF TABLES................................................................................................................. ..........7 ABSTRACT.....................................................................................................................................8 CHAP TER 1 INTRODUCTION....................................................................................................................9 2 REVIEW OF THE LITERATURE........................................................................................ 13 Epistemic Style................................................................................................................ .......13 Root-Metaphor Theory....................................................................................................13 Theory of Knowledge......................................................................................................16 Epistemic Style and Psychotherapy........................................................................................18 Epistemic Style and Theories of Psychotherapy............................................................. 18 Epistemic Style and Preferences for Psychotherapy....................................................... 21 Epistemic Style and Practices of Psychotherapy............................................................. 22 Epistemic Style and Characteristics of Psychotherapists................................................ 27 Epistemic Change............................................................................................................... ....30 Epistemic Change of the Field........................................................................................30 Personal Examples of Epistemic Change........................................................................ 32 Albert Ellis............................................................................................................... 32 Donald Meichenbaum..............................................................................................32 Michael J. Mahoney................................................................................................. 33 Narrations of other psychotherapi sts including Aaron Tim Beck........................ 34 Professional Change as a Counterpart of Epistemic Change..................................................37 Theoretical Orientation Change...................................................................................... 43 Therapy Style Change.....................................................................................................44 Epistemic and Professional Change................................................................................ 51 Purpose of Study.....................................................................................................................55 3 METHODS.............................................................................................................................58 Participants.............................................................................................................................58 Procedure................................................................................................................................58 Instruments.................................................................................................................... .........59 4 RESULTS...............................................................................................................................63 Demographics.........................................................................................................................63 Descriptives and Preliminary Analyses.................................................................................. 65 Primary Analyses............................................................................................................... .....67

PAGE 6

6 Research Question #1: How Do Therapists Change in Their Epistemic Comm itment and in Professional Charact eristics across the Course of Their Professional Practice?..................................................................................................68 Research Question #2: Do Cohort Eff ects Explain Changes in Therapists Epistem ic Commitments?............................................................................................ 72 Research Question #3: What Is the Relationship between Therapists Epistemic and Professional Change Experiences? ..............................................................................74 5 DISCUSSION.........................................................................................................................86 Summary of Results............................................................................................................. ...86 Epistemic Journey Constructi ons of Psychotherapists ........................................................... 87 Cohort Effect on Perceived Changes on Epistemic Leanings................................................90 Theoretical and Stylistic Change C onstructions of Psychotherapists ..................................... 92 Theoretical Change.......................................................................................................... 92 Stylistic Change...............................................................................................................94 Association between Epistemic and Professional Change Constructions ............................ 101 Epistemic and Theoretical Change................................................................................ 102 Epistemic and Stylistic Change.....................................................................................104 Limitations.................................................................................................................... ........107 Significance and Directions for Future Research................................................................. 111 Conclusion............................................................................................................................113 APPENDIX A THERAPIST ATTITUDE QUESTI ONNAIRE -SHORT FORM (TAQ-SF)...................... 115 B THEORETICAL ORIENTATION RATINGS.................................................................... 117 C DEMOGRAPHIC INFORMATION.................................................................................... 120 LIST OF REFERENCES.............................................................................................................121 BIOGRAPHICAL SKETCH.......................................................................................................129

PAGE 7

7 LIST OF TABLES Table page 3-1 Personal Style of the Therapist Ques tionnaire (PST-Q): Subscale directions ................... 62 4-1 Summary statistics of the variables of interest.................................................................. 80 4-2 Intercorrelations among the variables of interesta..............................................................81 4-3 Repeated measures ANOVA summary tabl e for perceived epistem ic and stylistic commitment differences across time.................................................................................81 4-4 Repeated measures ANOVA summary table for perceived theoretical co mmitment differences across time....................................................................................................... 82 4-5 Current and initial theoretic al orientation endorsem ents...................................................82 4-6 Post-hoc analyses examining the moderating effect of the theoretical comm itment on perceived engagement differences across time.................................................................. 82 4-7 Hierarchical regression analyses showi ng am ount of unique vari ance in therapists current professional standing accounted for by their initial standing and epistemic commitments......................................................................................................................83 4-8 Hierarchical regression beta coefficients for constructivism difference scores at steps 2, 3, and 4...........................................................................................................................85

PAGE 8

8 Abstract of Dissertation Pres ented to the Graduate School of the University of Florida in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy ME NOW, ME THEN: THERAPISTS AND CONSTRUCTIONS OF THEIR EPISTEMIC JOURNEY By Gizem Toska August 2008 Chair: Greg J. Neimeyer Major: Counseling Psychology Our study investigated the epistemic change processes of psychotherapists and attempted to identify the nature of the epistemic journe y of this group. We conduc ted a retrospective study where therapists were asked to reflect on their cu rrent and past epistemic commitments as well as theoretical orientations and therapeutic styles. This method provide d us with a unique set of data where we learned about the therapists personal constructions of their epistemic journeys and other professional change processes accompanying this journey. Findings suggested that when reflected on th eir current experiences and their initial experiences as blossoming practitioners, therapis ts perceived their commitment to constructivist epistemology as amplified, and their commitment to rationalist epistemology as reduced over their practice. The cohort effects failed to explain these changes or to differentiate therapists initial constructivist commitments. The obtained resu lts also indicated that the perceived change in epistemic commitments predicted therapis ts theoretical and stylistic commitments. Our study facilitated our unders tanding of the developmental trajectory of therapists epistemic commitments as they perceive it and it provided empirical data with respect to how therapists construe the profe ssional change processes that accompany their epistemic change.

PAGE 9

9 CHAPTER 1 INTRODUCTION Epistem ic style refers to an individuals prev ailing set of assumptions regarding the way in which knowledge is acquired, organized, and deve loped and it can be summarized within the dichotomy of rationalist and cons tructivist epistemologies that has become common within the recent psychotherapy lite ratures (Mahoney, 1991). On the one hand, rationalist epistemologies assume that human beings are passive recipients of a reality external to themselves that is itself stable, universal, and potentially knowable. They value the validity of knowledge and knowledge is considered valid to the extent to which it matches external reality (Neimeyer, 1993). Rationalist epistemologies can include those identified as a Mechanistic Worldview (P epper, 1942), social-deterministic worldview (Berzonsky, 1994), Objectivist Simple Worldview (Botella & Gallifa, 1995) or simply Rationalism (Royce, 1964). Constructivist epistemologies, on the other hand, assume that human beings actively construe their own reality and that this reality is dyna mic and contextual (Lyddon, 1988; Mahoney & Lyddon, 1988). Individuals can only know reality indirect ly and cannot be separated from the reality that they perc eive. Constructivists seek viable knowledge that is internally consistent and consensually validated (Neime yer, 1993). Constructivist epistemologies may include Organicism (Pepper, 1942), Constructivi st Complex Worldview (Botella & Gallifa, 1995), and Metaphorism (Royce, 1964). Previous research has linked epistemology to psychotherapy and to psychotherapists. Specifically, therapists epistemic style was related to therapists theoretical inclinations, therapeutic behavior, and pers onal characteristics (e.g. Johnson Germer, Efran, & Overton, 1988; Lyddon, 1989a; Lyddon & Adamson, 1992; Mahoney & Gabriel, 1987; Neimeyer & Aksoy,

PAGE 10

10 2005; Neimeyer, Prichard, Lyddon, & Sherrard, 1993) However, the literature regarding the nature of the epistemic development and change in therapists or in any other groups is scarce. A brief overview of the topics, content, and framework of the published articles reveals that the field of psychology and particularly psychotherapy became increasingly constructivist over the course of the last 20 years (Mahoney, 1995a; 1995b). Such a change in the fields understanding might be reflection of the infusion of a new generation of therapists who were steeping in post-modern epistemologies and psyc hotherapies. Yet the personal writings of some longstanding prominent psychotherapists also reflect this epistemic journey towards constructivism, suggesting that this development may also be the result of a shift within the current field of practitioners, in addition to the inclusion of a new generation of post-modern therapists. Psychotherapists such as Ellis (1993; 1995), Meichenbaum (1993), and Mahoney (1991; 2001) have repeatedly reported and descri bed their epistemic journey where they have become increasingly constructivis t in their epis temic commitment. Goldfrieds (2001a) work where he collected personal change narrations of 15 seasoned psychothera pists also reveals a similar journey where they pursued a path from relative certainty and simplicity to increasing complexity in their worldview. Nonetheless, research is s carce concerning epistemic shifts within the field and its practitioners. Although substantial anecdotal, conceptual, and case-based information is on hand, strikingly little empirical research is available that documents this shift in the field across time or traces these changes over time in relation to partic ular practitioners. As a result, not only is the field lacking empirical evidence of its putative epistemic shift, but it also remains unclear whether this shift is due to the infusion of new, post-modern therapists or significant developmental shifts among its curre nt practitioners in the field. Thus; to explore any perceived

PAGE 11

11 epistemic shifts in the field and examine the correlat es of these shifts in relation to the years that therapists have entered to the field was the focus of the current research project. In our efforts to understand the nature of the epistemic change experienced by psychotherapists, another intere sting inquiry would be the inve stigation of the factors that contributes to or accompany the epistemic change Investigations of the personal reports of above-mentioned psychologists offer some insight into the subject. For instance, these authors comment on their change in theoretical orienta tion and therapeutic style that accompanied their epistemic journey (see Goldfried, 2001a; 2001b). Recent qualitative and quantitative studies focused on the career development of the psychotherapists that they define d as the organized systemic ch ange of psychotherapists that involves succession over time (R nnestad & Skovholt, 2003). These studies also revealed the sources influencing therapists organized change processes, i.e. their career development (Orlinsky et al., 1999; Rnnestad & Skovholt, 2003). Moreover, Jenni ngs and Skovholt (1999; Skovholt & Jennings, 2004) collected further narrations from master therapists to explore their developmental processes. These studies collectiv ely suggested that practitioners do develop, as documented in their successive changes in syst emic ways across their professional lifetimes. Professional development included, but was not limited to, change in therapists theoretical adherence and therapeutic style. Yet whether or to what extent psychologists theoretical orientation and their professional activities were related to their epistemic journey remained unknown. The current study aimed to investigate th e epistemic change processes of the psychotherapists as they percei ve it. Specifically, we investigated (1) whether therapists perceived their epistemic commitments as being sh ifted as they become more experienced; (2)

PAGE 12

12 whether these perceived epistemic trends could be explained through cohort effects; (3) whether therapists perceived epistemic change was asso ciated with their self -reported theoretical orientations or therapeutic styles in coherent ways.

PAGE 13

13 CHAPTER 2 REVIEW OF THE LITERATURE This chapter provides a literatu re review that supports sp ecific predictions regarding psychotherapists epistem ic journeys and relate d professional change experiences. First, the review introduces and explains the notion of epistemic styl e, which is followed by the examination of the ways in which epistemic styl e is linked to psychotherapy-related attitudes and practices. Next, the literature on th e change of the field of psychothe rapy is explored. Within this section, the review first focuses on the epistemic journey of the field and of certain well-known psychotherapists and then it explores psychothe rapists theoretical and stylistic change experiences and why such professional change experiences might align with therapists epistemic journey. The literature review ends with an outline of the studys overarching questions and specific predictions. Epistemic Style Personal epistem ology is ones theory a bout knowing and knowledge. Epistemic style refers to an individuals way of testing the validity of his or her knowledge. Peppers (1942) Root-Metaphor Theory and Royces (1964) Th eory of Knowledge have been the most predominant ways of conceptualizing and studyi ng the implications of epistemic style. Root-Metaphor Theory Peppers (1942) Root-Metaphor Theory is com posed of four root m etaphors that are basic analogies for the four distinct ways in which we see the world and organize experience. Pepper (1967) suggested that individuals en gage in analyses of their root metaphors to make sense of the world and to solve problems. Ones root metaphor implies certain ways of dealing with events and generates possible solutions to existing problems. Categories of hypothesis that arise from such analysis of root metaphors are unrestricted by the field of inquiry, and such a hypothesis is

PAGE 14

14 responsible for the interpretation of any item of criticism proffered (Pepper, 1967, p. 3). In other words, ones dominant root metaphor pr ovides an intuitive sense of reality. The first metaphor, form (or similarity ), focuses on similarities among entities and it reflects the formistic way of seeing the world and organizing experience. Formism perceives reality within the set of predet ermined universal forms and type s. An objects essence can be discovered via understanding its similarity to other objects through categorical analysis of objects. Similarly, formistic individuals w ould make sense of an experience through understanding its similarity to and differences from other experiences. In psychology, formistic thinking underlies trait models of personality and psychiat ric diagnostic practices (Lyddon, 1989b). The second metaphor, machine, focuses on similarity betwee n machines and world and it reflects mechanistic way of seeing the world a nd organizing experience. Mechanism assumes a machine-like deterministic universe in which obs ervable effects are caused by natural factors, and it focuses on this linear cause-effect relations hip to understand the world and experiences. In psychology, mechanistic thinking underlies behaviorism, rationa list cognitive therapies and certain aspects of Freudian theory (Lyddon, 1989b). The third metaphor, context, focuses on historic events and it reflects a contextualistic way of seeing the world and organizing experience. Contextualism assumes that meaning is embedded in the context and hence, context would determine the ways in which events would be experienced. Like historic events make sense only when they are considered in their context, an experience can be understood only in its cont ext. While formism and mechanism focus on analysis of parts, contextualism tends to focus on synthesis of wholes. In psychology,

PAGE 15

15 contextualistic thinking underlie s Banduras revised social-lea rning perspective, Rice and Greenbergs change process research progr am and existential theories (Lyddon, 1989b). The fourth metaphor, organ, focuses on integration of expe riences of living organisms and it reflects organismic way of seeing the world an d organizing experience. Organicism assumes that reality is dialectically-constructed and that it evolves over time with increasing differentiation and integration. In contrast to cont extualism, organicism s uggests universal and/or teleological principles govern th e functioning of the phenomena and it strives to understand these principles (Lyddon, 1989b). Organic worldview seeks to understa nd integrative associations among the various aspects of a phenomenon. In psychology, organicist thinking underlies developmental, humanistic, and transpersonal m ovements as well as systems thinking and selforganizational processes (Lyddon, 1989b). Pepper (1942) suggested that contextualistic and organismic worldviews were very similar to one another in nature while mechanisti c worldview could be considered an opposing worldview. While contextualism and organicism have been associat ed with the worldview of the postmodern era, mechanism has represented the do minant worldview of the modern era. Pepper (1942) claimed that each root metaphor and related worldview provides a different lens to interpret the reality and he encour aged individuals to be able to employ a number of lenses to understand a given phenomenon. Different measures have been constructed to assess individuals worldviews as Pepper defined them. The Organicism-Mechanism Para digm Inventory (Germer, Efran, & Overton, 1982; OMPI) has been designed and employed to assess organismic and mechanistic worldviews of the individuals. Peppers four world hypothe ses can also be meas ured through Kramers Worldview Beliefs Measure (Kramer, Kahlbaugh, & Goldston, 1992).

PAGE 16

16 Researchers such as Berzonsky (1994) and Botella and Gallifa (1995) further studied Peppers (1942) root metaphors and consolidated our knowledge of personal worldviews. Their studies introduced more condensed categorizatio ns of epistemic style following Peppers four root metaphors and worldviews. In general, thes e studies reflected the dichotomous nature of contextualism and organicism ve rsus formism and mechanism. Berzonsky (1994) conceptualized three core ep istemological assumptions that were named as formistic, social-deterministic, and constructivi st worldviews. Formistic worldview is parallel to Peppers formistic view and social-deterministic worl dview is congruent with Peppers mechanistic view. Constructivist worldview embodies Peppers contextualist and organismic views. Berzonskys (1994) Cons tructivist Assumption Scale (C AS) measures the degree to which one endorses constructivist epistemologi cal assumptions as opposed to formistic and social-deterministic worldviews. As a part of a comprehensive study, Bote lla and Gallifa (1995) employed Berzonskys CAS as well as Germer et al.s (1982) OMPI am ong other measures in a factor-analytic study and revealed two main and opposing views underlying the above-mentioned worldviews and epistemic assumptions: Constructivist Complex Worldview and Objectivist Simple Worldview. The Constructivist Complex Worldview was related to the Peppers organismic worldview that characterized the world as a living organism and to Berzonskys constructivist epistemic assumptions that emphasized human beings active construction of their ow n reality. Participants operating from this worldview rejected formis m and mechanism and rather they construe knowledge in a multidimensional way (Botella & Gallifa, 1995, p. 15). Theory of Knowledge Royces Theory of Knowledge (Royce, 1964; R oyce & Powell, 1983) is another wellknown and valuable conceptualiza tion of personal epistemologies. Royce (1964) identified three

PAGE 17

17 fundamental ways of knowing, namely empi ricism, rationalism, and metaphorism. Royce derived these epistemologies from the dominan t cognitive process that can be employed by individuals. According to Royce (1964), people utilize perceptual, conc eptual, and symbolic processes during their daily pursuits and one of these three cognitive processes would be dominantly employed over the others. This dominan tly used cognitive pro cess would indicate the individuals domi nant way of knowing the world. Empiricism reflects dominant use of perceptual cognitive processes. Empiricists seek out sensory experience. They engage in induction and te st reality in terms of reliability and validity of their perceptions and sensor y experiences. Rationalism reflects dominant use of conceptual cognitive processes. Rationalists seek out rational analyses of id eas. They engage in deduction and test reality by its logical consistency. Metaphorism refl ects dominant use of symbolic cognitive processes. Metaphorists emphasize the symbolizing nature of events arguing that knowledge is constructed symbolically. Hence, they seek viability of know ledge rather than its validity and they engage in information analys is through making use of analogies (Royce, 1964; Royce & Mos, 1980; Royce & Powell, 1983). Empiricism and rationalism reflect the epistemic style of the modern era, while metaphorism refl ects the epistemic framework of the postmodern era. Individuals commitment to Royces (1964) three epistemologies can be measured by Psycho-Epistemological Profile (Royce & Mos, 1 980; PEP). PEP has been frequently employed in investigating the ways in which epistemic style related to the theory and practice of psychology.

PAGE 18

18 Epistemic Style and Psychotherapy Various studies dem onstrated that epistemic style is related to theories, practice and practitioners of psychothera py. Understanding the relations hip between epistemology and psychotherapy provides the groundwork of the presen t study. This section illustrates the ways in which epistemic style is linked to these psychotherapy variables. Studying epistemic commitments has enha nced our understanding of psychotherapy practice and practitioners. The psychotherapy variab les that relate to epistemic style can be studied under four categories: Theories of psychotherapy (Lyddon, 1989b; 1991), preferences for psychotherapy (Lyddon, 1989a; Neimeyer et al., 1993; Neimeyer & Morton, 1997; Schacht & Black, 1985), practices of psychotherapy (Lyddon, 1988; Mahoney & Gabriel, 1987; Mahoney & Lyddon, 1988; Neimeyer & Saferstein, 2006, and pers onal characteristics of psychotherapists (Neimeyer & Aksoy, 2005). Epistemic Style and Theories of Psychotherapy Theories of psychotherapy reflect a certain way of understandi ng the world and they can be conceptually tied to epistem ic worldviews that had been identi fied in the l iterature. Lyddon (1989b, 1991) identified epistemological framew ork of the various therapy approaches suggesting that psychotherapy theo ries were related to the episte mologies in systematic ways. Lyddon employed both Peppers (1946) Root-Met aphor Theory and Royces (1964; Royce & Powell, 1983) Theory of Knowledge to identify these relationships. Lyddon (1989b) suggested that trait models of personality and psyc hiatric diagnostic practices were supported by formistic worldviews because they bot h utilized the matters similarity to establish their reality. Both trait ta xonomies and psychiatric diagnostic systems classify traits or disorders based on the pres ence and absence of certa in characteristics or

PAGE 19

19 symptoms. They ignore temporal and contextual f actors and assume stability of the nature of their subject matter as well as of their similarities to others. Behavioral, rationalist cognitive and psychodyna mic approaches to psychotherapy have been linked to Peppers mechanistic worldview because they assumed a machine-like deterministic view of human psyche. Behavioral approach assumes that behaviors of human beings are determined by antecedent conditions and they objectively study these behaviors to understand human psychology. Rationalist cognitive th erapies suggest that human emotions are determined by antecedent beliefs and thoughts a nd they focus on such linear relationships between thoughts and feeli ngs to understand human psychology. Psychodynamic therapies regard mind in mechanistic terms and they focu s on the linear interactions among psychological forces to understand human mental processe s (Grof, 1985, as cited in Lyddon, 1989b). All of these three approaches to psychotherapy analyze parts of human psychology and assume that an observer, a psychologist, can objec tively identify these causal linear interactions among aspects of human experiences and processes. Banduras revised social-learning theory, Rice and Greenbergs change processes and existential theories have been identified as reflecting the contextualist worldview since these theories seek to understand human experience in its context and focus on the synthesis of wholes rather than analysis of parts. Banduras soci al learning theory high lights the importance of context in learning. Rice and Greenberg focus on context of client-therapist interaction to understand and facilitate clients change processes. Existential th eories study human experience through individuals being-in-the-w orld where they act on the worl d as the world acts on them. Developmental theories, humanistic and tran spersonal movements, and systems thinking were linked to the organicist worldview. They all focus on univers al principles that govern the

PAGE 20

20 functioning of human psychology, namely the pro cesses of self-evolutio n, self-actualization, self-transcendence, and self-organization. They de fine these processes as organs: They evolve over time with increasing differentiation and in tegration and they study these dialectically constructed processes to understa nd our psychological functioning. Royces theory of knowledge (Royce, 1964) wa s also associated w ith the psychotherapy theories. Royces (1964; Royce & Powell, 1983) em pirical, rational, and metaphorical epistemic styles were associated with behavioral, rati onalist and constructivist approaches respectively. Lyddon (1989a) suggested that behavioral a pproaches to psychotherapy were founded on empiricism considering behaviorist therapists emphasis on sensory experiences. Behaviorists assume that the true nature of the human psychology can be understood from our objective observations of human beings and they engage in induction to reach the truth. Rationalist cognitive psychotherapies were tied to rational epistemic styles evident in rationalist therapists emphasis on conceptual cognitive abilities (Lyddon, 1991). Rationalist therapists tend to analyze their clients logical consistenc y, challenge their clients irrati onal thinking and invite their clients to a reality that is defined by logical consistency. Cons tructivist psychotherapies were associated with metaphorical epistemic style cons idering that constructiv ist therapists tend to construct client experiences symbolically. C onstructivist psychologists try to understand their clients experiences through maki ng use of analogies and they e xplore and facilitate clients developmental processes (Lyddon, 1991). After arguing the ways in which psychothe rapy theories are systematically tied to epistemic styles, it remains important to understand the implications of these ties on our attitudes and experiences of psychothera py. Given that theories on whic h psychotherapies are built are tied to certain epistemologies, w ould individuals epistemic style guide them to seek a form of

PAGE 21

21 psychotherapy that shares similar assumptions ? Next, we will invest igate the literature supporting this link between individuals episte mic style and psychotherapy preferences. Epistemic Style and Preferences for Psychotherapy Following the idea that psychotherapy theories a re systematically related to certain epistemic viewpoints, researchers explored th e impact of epistemic style on preferences of psychotherapy approach. The result s suggested that individuals epistemic framework play at least a moderate role in gu iding their psychotherapy prefer ences (Lyddon, 1989a; Neimeyer et al., 1993; Neimeyer & Morton, 1997; Schacht & Black, 1985). Lyddon (1989a) measured epistemic styles of pote ntial clients and asked them to evaluate audiotaped presentations of behavioral, rationalist, and c onstructivist approaches to psychotherapy. Results suggested that participants with empirical, rational, and metaphorical epistemic styles preferred beha viorist, rationalist, and constructivist therapy approaches respectively. Lyddon and Adamson (1992) extended the findings of Lyddon (1989a) to Peppers root-metaphor theory. Participants with an or ganismic worldview indicated preference for the constructivist approach, while participants with a mechanistic worldview preferred the behavioral approach. Overall, lay people reported preference for the therapy approaches that were congruent with their own epistemological framework suggesting that individuals dominant epistemological commitments had an impact on their therapy preferences. These findings were extended for counselor tr ainees and mental health practitioners (Arthur, 2000; Neimeyer et al., 1993; Neimeyer & Morton, 1997; Schacht & Black, 1985). Despite the differences among various studies, the overall fi ndings confirmed a moderate relationship between epistemological commitments and psychotherapy preferences for therapists. Organismic worldview and metaphorical epistemic style predicted a prefer ence for constructivist therapies. The empirical epistemic style was linked to a preference for a behavioral approach.

PAGE 22

22 Rationalistic epistemic style was linked to the preference for rationalist therapies (Neimeyer et al., 1993; Neimeyer & Morton, 1997). Psychoana lysts tended towards organicism and metaphorical orientation, whereas cognitive-beha vioral therapists tended towards mechanism and empiricism in their dominant worl dviews (Arthur, 2000; Schacht & Black, 1985). Taken together, empirical evidence strength ened the link between epistemic style and preference for different psychothera peutic approaches for future cl ients, future therapists and seasoned practitioners. Epistemic Style and Practices of Psychotherapy Epistem ic commitments underlie theories of psychotherapy and at least moderately account for therapists psychotherapy prefer ences. Epistemology was also linked to psychotherapy practices. The mindset underlyi ng psychotherapy practi ces was studied to understand the practical differences among differen t forms of therapy, especially among different forms of cognitive therapies (Lyddon, 1988; Mahoney & Gabriel, 1987; Mahoney & Lyddon, 1988). Cognitive therapy is an umbrella term coveri ng a variety of approaches to psychotherapy. Lyddon (1988) and Mahoney (1991) s uggested that we could differe ntiate cognitive therapies from one another through studying the epistemi c assumptions underlying these approaches. A continuum of epistemic worldviews have b een employed in this purpose where cognitive approaches fall along the continuum of rationalis m and constructivism (D iGiuseppe & Linscott, 1993). Differences between rationalist and constr uctivist epistemologies in their understanding of reality and knowledge reflect upon the ways in which cognitive therapies are conceptualized and conducted. Hence, understanding how epistemologies underlying cognitive therapies impact psychotherapy practices help differentiating di fferent cognitive approaches to therapy.

PAGE 23

23 Rationalist epistemologies reflec t belief in a-priori truths and in a singular, universal, and historical reality (Mahoney & Gabriel, 1987). This reality can be passively and objectively perceived through thought processes (Mahone y, Lyddon, & Alford, 1989). Modern cognitive therapies show commitment to ra tional theories of knowledge and assume reasoning and logicalanalytic processes are fundamental means of validating knowledge (Lyddon, 1988; Mahoney & Gabriel, 1987; Mahoney & Lyddon, 1988). Modern cognitive therapies such as Ellis Rational Emotive Therapy (RET) seek to replace clients irrational thoughts with ra tional ones to set them free from their negative experiences (DiGiuseppe & Linscott, 1993; Lyddon, 1990). Constructivist epistemologies challenge the basic assumptions of rationalistic epistemologies suggesting that knowing is a much more complex process than rationalist epistemology sustained (Mahoney & Gabriel, 1987) Constructivist epistemo logies assume that individuals actively construct their realities and he nce, reality is multiple, contextual, historical, and paradigmatic. Postmodern cognitive therapies show commitment to constructivist epistemology (Mahoney & Gabriel, 1987). Constr uctivist cognitive therapies such as Kellys Personal Construct Therapy (Neime yer, 1995) seek viability of know ledge over validity and they explore the ways in which cl ients organizations of pe rsonal knowing systems (Lyddon, 1988; Neimeyer, 1993). The ways in which epistemology reflected on practice and differentiated rationalist and constructivist therapies were identified conceptu ally and sustained empi rically. Conceptually, rationalist and constructivist therapies were differentiated in numerous aspects, such as therapists thinking style, focus and direction of therapy, conceptualiz ation of therapeutic concepts such as therapeutic relationship, client problems, resistance, emotional distress, relapse and regression (Mahoney & Gabriel, 1987) and level of intervention (Lyddon, 1990).

PAGE 24

24 First, rationalist and constructivist therapies were differentiated in therapists thinking style. Rationalist cognitive therap ies tend to utilize a basic thinking style and to follow a simple format with clear-cut methods, while constructivist cognitive therap ies tend to have a complicated thinking style and to follow a complex format with unclear methods (Mahoney & Gabriel, 1987). Second, rationalist and construc tivist therapies were differentiated in therapy focus. Rationalist cognitive therapies tend to focus on the clients present problem as it roots from clients irrational thoughts. Constructivist cognitive therapies, on the other hand, tend to shift the focus from presenting problems to clients way of processing life within their given history (Mahoney & Gabriel, 1987; Mahoney et al., 1989). Third, rationalist and constructivist therapies were differentiated in the direction of the therapy. Rationalist cognitive therapies tend to follo w a set specific client goals determined at the very beginning of the therapy, while constructivist c ognitive therapies refrain from following a pre-determined route and conceptualize therapy as a journey without a set itinerary (Mahoney & Gabriel, 1987). Fourth, rationalist and constructivist therapies we re differentiated in the kind of the clienttherapist relationship that they value and seek. Rationalist therapies tend to value objective relationships where therapists maintain an analy tical stance, while constructivist therapies tend to seek personal and emotionally intense relations hips between therapists and clients (Mahoney & Gabriel, 1987). Fifth, rationalist and constructivist therapies were differentiated in their conceptualization of certain therapeutic concepts. Rationalist c ognitive therapies tend to conceptualize client problems as cognitive dysfunctions, view negative emotions as a problematic outcome of such

PAGE 25

25 thought errors and perceive client resistance, relapse and regression as indicators of client failure in maintenance and generalization of therapy out comes. Constructivist th erapies, on the other hand, tend to define client problems as indicat ors of the discrepancies between external challenges and internal capacities, view negative emotions as an indicator of clients current functioning, perceive client resist ance, relapse and regression as indicators of clients selfpreservation efforts (Mahoney & Gabriel, 1987; Mahoney & Lyddon, 1988). Frankel and Levitt (2006) recently detailed the postmodern strategies for working with resistance, demonstrating the similarities across the rich ways that constructivist therapies con ceptualize and work with client resistance. Sixth, rationalist and constructivist therapies were differentiated in their conceptualization of change. Rationalist approaches to therapy tend to seek first-or der change that is defined as surface-level change achieved without distur bing the existing systems. Therapies with constructivist commitments, on th e other hand, tend to facilitate change entailing fundamental restructuring of the existing systems that is recognized as secondorder change (Lyddon, 1990). Empirical studies supported that rationalist and cons tructivist cognitive therapies differed in direction of the ther apy, relationship with client, concep tualization of clients emotional distress, relapse, and regression and approaching such client vari ables in the context of therapy (Nagae & Nedate, 2001; Vasco, 1994; Viney, 1994; Winter & Watson, 1999). The empirical evidence supporting the link between epistemology and practice were mainly in-depth studies of therapy transc ripts (Nagae & Nedate, 2001; Vasco, 1994; Viney, 1994; Winter & Watson, 1999) with a recent additi on of a self-report study of psychotherapists (Neimeyer & Saferstein, 2006). These studies su pported the assumptions that rationalist and constructivist cognitive th erapies differed in direction of th e therapy, relationship with client,

PAGE 26

26 conceptualization of clients emotional distress, relapse and regression, and approaching such client variables in the context of therapy. Vasco (1994) observed therapy sessions of Portuguese therapists with constructivist commitments. The results of his study suggest ed that therapists c onducting constructivist therapies tended to reject therapeutic structur e and directive helping styles yet they were technically eclectic compared to rationalistic cognitive therapists. Constructivist commitment was negatively associated with therap ists focus on clients problems. Viney (1994) sampled and content analyzed thera py transcripts of five therapists with five different orientations including personal construct, client centered, and rational emotive therapies. Therapist conducting constructivist cognitive therapy, i.e. personal construct therapy acknowledged the negative emotions of their c lients more compared to therapists conducting rationalist cognitive therapy, i.e. rational-emotive therapy. Winter and Watson (1999) studied the therapy se ssion transcripts of the two therapists, one adhered to personal construct ther apy that is identified as a constructivist cognitive therapy, and the other adhered to rationalist cognitive therapy. Their in-depth analyses revealed that constructivist therapist was more empathic of clients, more comm unicative of unconditional positive regard towards the client and more e ngaging in complex levels of processing during therapy. Rationalist therapist, on the other hand, was more directive in therapy. Moreover, in dealing with clients failure to complete a given assignment, rationalist therapists were more likely to encourage clients to go through with it, while constructivist ther apists strived to understand the dynamics of clients resistance. Nagae and Nedate (2001) extended these result s to Japanese therapists. Therapists engaged in rationalist cognitive therapies were more likely to engage in psycho-educational instruction,

PAGE 27

27 while therapists conducting constructivist c ognitive therapies were more successful in establishing rapport wi th their clients (N agae & Nedate, 2001). Studies of Vasco (1994), Vine y (1994), Winter and Watson (1999), and Nagae and Nedate (2001) inferred the impact of epistemology on practice through inve stigating practice of therapists conducting constructivist or rationalist cognitive therapies. Neimeyer and Saferstein (2007), on the other hand, conducted a self-report study that measured psychotherapists epistemic commitments. This methodology provided the authors with an opportunity to study the relationship between epistemology and practice independent of the name of the conducted therapy. Neimeyer and Saferstein (2007) focused on therapists emphasis on therapy style and working alliance. Their results were consistent with the assumptions of Mahoney and Gabriel (1987) and the findings of the pr eceding studies. Therapists with higher levels of constructivist epistemology were more likely to pursue closene ss, broad focus, engagement, and spontaneity in therapy. Commitment to constructivist episte mology was also positively associated with therapists emphasis on the persona l bond in the therapeutic relati onship. Overall, their results supported the assumptions that commitment to constructivist epistemology may influence the ways in which therapy is conducted and therap eutic relationship is built and maintained. Altogether, these conceptual and empirical studi es suggested that epis temologies influence how therapists construct therapy variables, how they conduct therapy, how they relate to their clients and what kind of results they pursue. Next, we clarify the ways in which epistemology relates to personal characteristics of psychotherapists. Epistemic Style and Characteristics of Psychotherapists Mahoney (1995c) had suggested that basic tenets of constructiv ist therapies m ay reinforce therapists to value and pursue self -awareness, to be more attuned to personal feelings, to be more

PAGE 28

28 tolerant of ambiguous circumstances, to be more socially tolerant of dive rsity and to be more open to new experiences. Constructivist worldview assumed that individuals understandings are limited by their perceptions, emotions are primitive knowing syst ems, the direction and outcome of therapy gradually emerge from the context and individu als experiences are informed by the social, historical and cultural contexts. Hence, therapists hol ding these assumptions were expected to seek self-awareness to understand the ways in which their constructs shape their perceptions. Therapists with constructivist commitment would attend to emotions to learn from them. The complex way that they construe therapy and clients r eality would ask for tolerating ambiguity as well as social differences and being open to experience and learning (Mahoney, 1995c; Neimeyer & Aksoy, 2005). Rationalist approaches, on the other hand, present as largely complementary views and the differences between the two epistemic commit ments reflect upon the conceptualization and practice of psychotherapy (Lyddon, 1988; Ma honey & Gabriel, 1987; Mahoney & Lyddon, 1988). Rationalist therapists tend to operate assuming that they ar e objective observers of the stable and single reality and they can correct their clients faulty cognitions of reality and hence their clients negative emotions through change processes that ar e presumed to be uniform and universal. The processes and direction involved in rationalist thera py would be clear and straightforward. Hence, therapists with rationali st commitments were expected to have lower levels of self-awareness, persona l attending to emotions, ambiguity tolerance, social tolerance and openness to experience given that these char acteristics would not be necessitated by their epistemic commitment.

PAGE 29

29 Moreover, the literature on the association be tween epistemology and personality provides additional support for the above-mentioned conceptua lizations. For instance, social tolerance and openness to experience were found to be positiv ely related to organismic worldview and negatively related to the mechanistic worldvi ew (Babbage & Ronan, 2000; Johnson et al., 1988) supporting the expectation that therapists with co nstructivist standpoints woul d be more likely to have higher levels of social tolerance and openness. Organismi cally-oriented individuals were more likely to be empathic (Johnson et al., 1988) and cognitively flexible (Botella & Gallifa, 1995) supporting the proposition that therapists with constructivist standpoints would be more likely to have higher levels attendance to emoti ons and ambiguity tolerance that increase the ability to deal with complexity (Beitel, Ferrer, & Cecero, 2004). Neimeyer and Aksoy (2005) provided empi rical evidence supporti ng the theoretical conceptualization of Mahoney (1995c) and others (Lyddon, 1988; Mahoney & Gabriel, 1987; Mahoney & Lyddon, 1988). Their findings suggested that commitment to constructivist epistemology predicted higher levels of pursu it of self-awareness, at tending to emotions, ambiguity tolerance, social tolerance for individual diversity and ope nness to experience, whereas commitment to rationalist epistemology pr edicted lower levels of these characteristics. The developing literature on epistemology confirms that therapists epistemic standpoint relates to their personal characteristics. Overall, the literature suggest s that epistemology has been conceptually and empirically related to the theories of psychotherapy, to th erapy preferences of pr ospective clients and prospective and practicing psychotherapists, to the forms of intervention and to the personal qualities of psychotherapists.

PAGE 30

30 Epistemic Change Epistem ic change experiences of the field of psychotherapy can be studied by examining the general directions the field has undertaken as well as by studying specific examples of psychotherapists who had experien ced an epistemic shift. This section highlights the literature that indicated how the field of psychotherapy is changing with respect to its epistemic commitment in general and it provides specific examples from seasoned psychotherapists where these experts convey their own epistemic journe y that parallels the journey of the field. Epistemic Change of the Field The world of psychotherapy has faced multiple changes such as increase in the number of distinguishable psychotherapies, increase in integration a nd collaboration and expanse of information (Mahoney, 1995a). Farber and his coll eagues (2005) also note d the dramatic change the field of psychotherapy endured over the pa st three or four decades, suggesting that psychotherapy now tends to be short-term, problem-focused, cogniti vely oriented and psychopharmacologically influenced (p. 1018). Ellis (1992b) noted the change as well in his writings: When I started RET in 1955, psychologi sts were mainly split into conflicting psychotherapy camps, most of which violently fought each other. Those who followed the theories and practices of Freud, Jung, Adler, Rogers, Perls, and Skinner were dogmatically tied to their own schools and only rare eclectics, su ch as Frederick Thorne, were multimodal and integrated. (p. 9). The field was increasingly interested in the integration of diverse forms of psychotherapy. Cognitive and constructivist therapies assumed an active role in psychotherapy integration movement providing a rich avenue for in tegration (Mahoney, 1995b). Cognitive therapies mushroomed to more than 20 different types in a period of 40 years a nd through its development and growth, cognitive therapies encouraged productive exchanges with behavioral, humanistic,

PAGE 31

31 and psychodynamic traditions (Mahoney, 1995b). Cognitive therapies have been found to be the most frequent theoretical contributor to integr ative practice at least among clini cal psychologists (Norcross, Karpiak, & Lister, 2005). Mahoney (1995b) pointed out to the dialectical interaction between the field and its practitioners and he suggested th at such changes in the field impact the way psychotherapists practice. That, in return, further facilitate th e conceptual developments within the cognitive psychotherapies, and hence, within the field. On e of the major conceptu al developments was recognized as the differentiation of rationalist and c onstructivist approaches to cognition (Mahoney, 1995b). Development of constructivism or constructiv e metatheory has been recognized as a revolution within the cognitive revolution (Mahoney, 1995a; 1995b). Constructivist metatheory has developed rapidly; it conti nues to expand and today it is international in scope (Mahoney, 1995b). The field experiences a shift towards in creasingly embracing cons tructivist metatheory and epistemologies. Moreover, prac titioners expect the field to ch ange further in this direction. According to the Delhi Poll that Norcross and his colleagues conducted at 2002, 62 experts predicted growth of culturally sensitive and multicultural therapies which rely more on constructivist principles and cultural values that seek to protect the experiences of minority groups from being dominated by the worldviews of powerful groups that do minate the discourse of mental health. (Norcross, Hedges, & Prochaska, 2002, p. 321). And this ongoing shift is further evident in a nd could be the partially attributed to the individual work of prominent cogni tive psychologists (Mahoney, 1995b).

PAGE 32

32 Personal Examples of Epistemic Change Albert Ellis Albert Ellis (1990; 1995), the founder of rational em otive beha vior therapy (REBT) clearly projects a personal and professional pathway where his theory and practice moved to become more constructivist and humanistic in nature. Ellis (1995) distinguished between general RET and preferential REBT where the former stands for general cognitive-behavioral therapy and the latter stands for what Ellis has practiced for past 15 years. Ellis clarified that both his practice and the empirical work of the fellow psychologi sts such as Beck and Meichenbaum made an impact on his conceptualization of REBT and pushe d him in more constructivist directions. Ellis (1990; 1993) strongly suggested that not only the theory of REBT, but also the practice of REBT is constructivist. Ellis has used various publications to draw at tention to the fact that the term rational had been misunderstood by the field. He suggested that in REBT, rational referred to effective cognitions rather than empirica lly and logically valid cogni tion (Ellis, 1999). Ellis (1999) emphasized that What is deemed rational by one person, group, or community can easily be considered irrational by others ( p. 154) suggesting his commitment to constructivist metatheory. Ellis (1992a) even claimed that his therapy is probably the most constr uctivist of all cognitive behavioral therapies (p. 122). Donald Meichenbaum Donald Meichenbaum has been considered among the fathers of cognitive therapy and he is among the leaders of cognitive revoluti on. Meichenbaum (1990; 1993) advocated for constructivist perspective encouraging fellow pr actitioners to help their clients in their identifying the ways in which th ey construe reality and then a ffected by their constructions and in developing coherent and adaptive narrati ons that would enable change and growth.

PAGE 33

33 Meichenbaums analysis of the past and future of cognitive behavior modification shed further light onto the epistemic change cogni tive-behavior practitioners had experienced. Meichenbaum (1993) noted that psychotherapists adhered to cognitive-behaviorist theory has been going through a change process where the way they conceptualize the role of cognition in behavior change has shifted. He utilized three guiding metaphors, namely, conditioning, information processing and constructive narrat ives to illuminate the shift experienced by cognitive-behaviorists practi tioners including himself. At first, client cognitions were viewed as conditioned responses, c overt behaviors that control overt behavior and hence, treatment focused on deconditioning and reconditioning. Subsequently, human mind was equated to computer s where the individuals were the architects of their experiences through the way they collec ted and processed data and treatment focused on helping clients to learn the way their mind pr ocess and the ways of interrupting cognitivebehavioral-affective chains. Meichenbaum (1993 ) suggested that the idea that clients are architects of their mind led to the use of constr uctivist metaphor where cognitions are believed to be active constructions of individuals. He identi fied that cognitive-behaviorist practitioners are increasingly committed to constructivist worldview where therapists function as a coconstructivist helping clients to alter their stories (p. 24). Meichenbaum (1993) expected the change to continue for cognitive-behaviorist practitioners. He suggested that not only himsel f but also the field of CBM has come a long way since its inception. The story continues to unfold and to change as new metaphors are adopted and new narratives constr ucted. (Meichenbaum, 1993, p. 204). Michael J. Mahoney Mahoney (1991) is also am ong the prominen t psychologists who had taken a journey headed towards constructivism even tough he st arted his practice as a committed behaviorist.

PAGE 34

34 Mahoney (2001) described his inte llectual and emotional journe y as a therapist where he identified his starting point as a behaviorist psychol ogist. Mahoney noted that as he faced the limitations of this approach in dealing with the complexity introduced by his clients and as he was involved in the quest of human change proc esses, he was immersed in the function of cognitions and he eventually participated in the cognitive revolution and identified himself as a cognitivist. His involvement in th e depth of human cognition, his pers onal therapy as a client and his interactions with his colle agues and with different culture s opened up novel ways of thinking and practicing and Mahoney (2001) had developed an increasing interest in constructivism and has contributed to our understand ing of constructivist metatheory through his intensive work as a researcher, practitioner, and editor. Narrations of other psychotherapi sts including Aaron Tim Beck Interested in the change th at psychotherapists themselv es had gone through, Goldfried (2001a) asked 15 seasoned psychotherapists to narrate their personal change and growth experiences as a result of their personal and professional interac tions. In their personal accounts, various contributors mentioned thei r path where they had started their practice being adhered to one camp of theoretical orient ation and moved towards more eclectic and complex ways of approaching their clients as their learning experien ces challenged their limited ways of looking at the world of psychotherapy. One of the contribut ors, Greenberg (2001), summarized a shared process in the title of his narration as he named his story as My change process: From certainty through chaos to complexity. A related example comes from the communi cations provided by Aaron Tim Beck and his colleagues that highlighted hi s increasing appreciation and pursu it of complexity in his work. Becks professional journey towards complexity could have started th rough his rebellion against the autocratic nature of psychoanalysis (Bloch, 2004). Instead of following that faith-

PAGE 35

35 based approach to therapy, Beck developed an empirically-driven practice that aimed to explore the cognitive processes underlying human suffering, namely Cognitive Therapy (Bloch, 2004). His approach was criticized for its mechanical, over-simplified nature yet in his recent arguments, Beck claimed that the change processes facilitated by the cognitive therapy can be complex (Bloch, 2004), while cognitive therapy is much richer than mechanical treatment (Bloch, 2004) and individually designed consider ing the client and presenting concern at the hand (Beck, n.d.). Beck (Bloch, 2004) also questioned if applying certain techniques would ever be enough to conduct effective therapy. He sugge sted that treating a presenting concern in a mechanical way would not work especially with complex cases. Therapists who are good at the technical end of cognitive therapy fall flat on their faces when it comes to the more complex cases. Empathy, sensitivity, considerateness together with the abi lity to put them together with technical aspects is the combination ne eded. (para. 107). Moreover, Beck demonstrated constructivis t commitment through his conceptualization and utilization of emotions, personally and profe ssionally. In a paper written in his honor, Beck was praised for his attention to hi s emotional processes and his will ingness to learn from them in his personal and professional li fe (Padesky, 2002). Beck (2002) himself suggested that emotional arousal and expression were essential parts of cognitive therapy since he assumed that the expression of emotion would have certain meaning to client and the interaction taking place can provide an experiential fo r of reframing (similar to what Franz Alexander terms The Corrective Emotional Experience) (para. 2). Beck (n.d.) also referred to other stra tegies that parallel constructivist therapy strategies such as guided discovery and he encouraged collaboration

PAGE 36

36 between therapist and the client to understand the cognitive and emotional processes of his clients. The appreciation of complexity is among the ba sic tenets of construc tivist epistemologies. Constructive metatheory promotes a complex systems model in which thought, feeling, and behavior are interdependent expressions of a life span developmental unfolding of interactions between self and (primarily so cial) systems (Mahoney, 1995b, p. 8) Similarly, paying attention to complex affective experiences that are presen t in the therapy room and inviting clients to actively experience, explore and express a much broader range of emotions are central to constructivist therapies (Mahoney, 1995b, p. 9). Practitioners increasing appreciation of complexity as well as increasing emphasis on emotionality and experiential processes may reflect a change in their epistemic style where they have become increasingly more committed to constructivist epistemology. Moreover, Rnnestad and Skovholt (2003) suggest ed that therapists career development involved increased understanding of knowledge as a constructi on. Experienced practitioners were more likely to reject precisely defined realities in understanding matter of human interaction (p. 31). The authors focus was on themes concerning therapists career development and yet their findings provided implicit support fo r the proposition that th erapists engage in increasingly more constructivis t processing of the therapy room and of the world as they seasoned. Therapists increasing commitment to constructivist epistemology may be a related theme of their career development. All in all, individual narrations of certain psychotherapists di rectly and indire ctly speak to an ongoing epistemic shift in the field and imply the epistemic shift was a result of personal change processes, at least to some degree. Nonetheless, the field is lackin g empirical evidence of

PAGE 37

37 its claimed epistemic shift and it is unclear to what extent this shift can be attributed to the individual change processes of psychotherapists in time and/or to cohort effect facilitated by the inclusion of post-modern therapists to the field. The current study aims to explore any perceived epistemic shifts in the field and its underlying dynamics. Professional Change as a Counterpart of Epistemic Change Change concerning ther apists is not limited to their personal epistemologies. Psychotherapists change profe ssionally as they conduct ther apy. This section highlights psychotherapists change processes and then focuses on two professiona l variables that may complement therapists epistemic journey: Theoretical orientation and therapeutic style. Psychotherapists do change as th ey practice; at least, they report they do. The scarce literature on therapist change is built on psychotherapists self-repor t collected in various forms. Interviews, questionnaires, as well as persona l narrations were empl oyed to understand their personal and professional journe y as psychotherapists (Farber, 1983; Goldfried, 2001a; Radeke & Mahoney, 2000). First, Farber (1983) conducted one-hour semi-structu red interviews with 60 psychotherapists and pooled their answers toge ther in order to understand the effects of psychotherapy practice on psychothe rapists. Their results sugg ested that psychotherapists believed their personal characteristics as well as social relations had changed since they have began conducting therapy and they attributed some of this ch ange experience into the their therapeutic work as therapists. Overall, Farber (1983) suggested th at the effects of therapeutic work is not confined within the office, but rather have a substantial impact on therapists outside behavior and self-i dentity (p. 180).

PAGE 38

38 Second, Radeke and Mahoney (2000) compared the impact of their work for psychologists who were primarily involved w ith research and psyc hologists who were primarily identified as practitioners. This study revealed that compared to researchers, therapists experienced a stronger impact of their work on their personal problems as well as their personal life. Practitioner therapists were more likely to acknowledge feeling emotionally exhausted, anxious, and depressed. Impact of work on personal life included reports of becoming a better and wiser person with increased self-awareness, increase d appreciation for relationships and increased ambiguity tolerance. In general, psychotherapist s reported more change experiences in various forms than researchers did. These studies focused on or provided answers for how psychotherapist s personal lives and experiences changes through their lives as professional practitione rs. Goldfried (2001a)s edited work, on the other hand, provided information on the therapists professional change experiences. In Goldfried (2001a)s work, a group of seasone d practitioners indivi dually reflected on their professional change processes. These narrations revealed intr icate yet shared ways in which practitioners change as they conducted th erapy. Summarizing the common points of the narrations of 16 seasoned psychotherapists, Goldfried (2001b) conc luded that conducting psychotherapy with a mindset of being helpful to clients often demanded therapists to change the ways in which they understand and approach cert ain conditions and that impacted the way they approached to their clients and the way they conducted therapy. Sporadic interviews with established ps ychotherapists (such as DeAngelis, 2006) and infrequent publications where ps ychologists told thei r personal stories (such as Hoyt, 2005 and Brown, 2005) make the last group of resources that can shed light into the process of change

PAGE 39

39 experienced by therapists alt hough they do not include a compar ison among one another nor they provide a tentative conclusion. For instance, DeAngelis (2006) interviews with psychotherapists as well as a series of articles published in the Journal of Clinical Psychology under the title of Why I became a psychotherapist tapped on the transformations that practitioners have undergone. Some conceptualized their growth and change not only as an outcome of conducti ng therapy but also as a requirement of it and at least some conceptua lized the change as a s ource of motivation to become and remain as a therap ist (see Brown, 2005). Similarly, a group of practitioners that participated in a study investigating occupati onal hazards and rewards facing psychotherapists cited their opportunity to learn and grow as well as their incr eased self understanding among the rewards of their work (Kramen-Kahn & Hanse n, 1998) suggesting that they have changed throughout their career and that chan ge process was rewarding for them. Overall, the results implied that psychothera pists go through a complex change process and at least some aspects of their change were tied to their work. Different groups of psychotherapists already reporte d that personal change (Farber, 1983; Radeke & Mahoney, 2000) and a smaller group implied that their pr ofessional attitudes and experiences were not spared from the process of change (Goldfried, 2001a). Recently there has been an incr eased attention on the change experiences of practitioners from the developmental perspective. A group of researchers such as Orlinsky, Rnnestad, Skovholt and Jennings started to study the career traj ectories of mental hea lth practitioners from various parts of the world. They maintained th at therapists not just change; their change processes are systematically organized and th ey involve progression over time (Rnnestad & Skovholt, 2003). Combined with the studies on expertise in counse ling and psychotherapy

PAGE 40

40 (Jennings & Skovholt, 1999; Kivlighan & Quigle y, 1991; Martin, Slemon, Hiebert, Hallberg, & Cummings, 1989; Skovholt & Jennings, 2004), these st udies provided an alternative, systemic way of conceptualizing change experiences of therapists. Qualitative studies on master, expert, and/or experienced therapists (Jennings & Skovholt, 1999; Kivlighan & Quigley, 1991; Martin et al., 1989; Skovholt & Jennings, 2004) and on American practitioners at different experience levels (Rnnestad & Skovholt, 2001; Skovholt & Rnnestad, 1992; Rnnestad & Skovholt, 2003), as we ll as an internationa l quantitative study of development of 5000 psychotherapists from differ ent countries (Orlinsky et al., 1999) revealed insight into the career paths that psychotherapists pursue. Martin et al. (1989) studied the differences between novice and experienced counselors by studying the counselors conceptu al associations regarding th e therapy process. Their study included 23 counselors. Experience d counselors had at least 4 year s of experience in university counseling centers and novice couns elors were interns in the 2nd year of a counseling masters program. Their findings differe ntiated novices from experienced practitioners in their conceptualizations of client issues as well as their ways of proceeding. They established that novice counselors were more likely to pay atte ntion to procedural, how to, aspects of counseling; whereas experienced counselors tend to conceptualize their clients at a broader level in a more inclusive manner. Kivlighan and Quigley (1991) further supporte d such cognitive differences between novice and experienced group counselors. They identified novice counselors as graduate students and expert counselors were professional counselors with more than 1,000 hours of active group leadership. In that study, 30 group counselors, half novice and half expert, were asked to differentiate between the members of a couns eling group after watchi ng a session of the group

PAGE 41

41 and experienced counselors engaged in more comple x and richer cognitive conceptualizations in their distinctions. Jennings and Skovholt (1999; Skovholt & Jennings, 2004) studied not only cognitive, but also emotional and relational characteristics of master therapists. They have conducted interviews with 10 therapists who were nominat ed by their peers as masters of their work. Jennings and Skovholt identified significant pe rsonality characteristic s shared by master therapists and proposed a CER model of master th erapist that referred to the triad of cognitive, emotional and relations expertise on the part of ma ster therapists. Master therapists demonstrated cognitive complexity, openness and desire for continuous learning, emotional receptivity and maturity, and interpersonal skillfulness. This wo rk was criticized for its lack of a comparison group that would allow the reader to infer the di stinctive characteristics of master therapists (Orlinsky, 1999). Moreover, the authors did not provide an initial de finition of "master therapist". That combined with their atten tion to uniformities and neglecting the individual differences across therapists might create a fictio nal ideal with little understanding of what being a master therapist really entails (Orlinsky, 1999). Still, this study provided a sense of what experience could promote in therapists and stimulated research on full spectrum of therapist development. Rnnestad and Skovholt carried out a qualitati ve study where they have conducted crosssectional as well as longitudinal interviews with 100 American psychotherapists at different experience levels. Their findings we re placed in the literature at different instances (Rnnestad & Skovholt, 1991; Rnnestad & Skovholt, 2001; S kovholt & Rnnestad, 1992). Recently, they have provided a reformulation of the main conclusions (Rnnestad & Skovholt, 2003). They structured their findings into a phase model of therapist career de velopment that were identified

PAGE 42

42 as the phases of the lay helper, the beginning student, the advanced student, the novice professional, the experienced professional and the senior professiona l. They have also established 14 themes of therapist developmen t describing central processes of therapist development. The themes addressed various issues such as processes of personal and profession integration and shifts in atten tional focus and emotional functi oning. A more detailed account of these themes will be provided across this lite rature review in relation with the professional variables of interest, namely theoretical orientation and th erapeutic style. Rnnestad and Skovholt (2003) have also high lighted certain constants that emerged across the therapists professional developmen tal span. Most importantly, interpersonal interactions in both personal and professional realms of life have been found as a consistent contributor to therapists profe ssional development. Moreover, commitment to learn as well as the experience of professional growth was invariable for therap ists of all experience levels. Personal and professional growth never ceased for practitioners rega rdless of the length of their journey. Orlinsky and his colleagues (1999) findings from 5,000 international psychotherapists confirmed the constancy of growth experience. Although therapist reports of perceived mastery increased as therapists years in practice increa se, the experience of professional growth was independent of years spent in practice. Novice and veteran therapists did not differ in the amount of perceived growth. Even after two decades of practice, therapis ts reported improvement in their skills as well as growth in their enthusiasm. The authors suggested that the very experience of growth provided therapists with the motivation to continue their work. In this section, we have intr oduced the literature suggesti ng that therapists do change personally and professionally. We have also estab lished that therapists ch ange processes are not

PAGE 43

43 haphazard. On the contrary, processes of change reflect a certain career trajectory where the experiences of therapists are de fined by the stage of their devel opmental stage. The current study focuses on the systemic change of two professi onal therapist variables, namely theoretical orientation and therapy style. Following sect ions will clarify the existing literature on psychotherapists change experiences in thei r theoretical orientat ion and therapy style. Theoretical Orientation Change As we noted above, change is a constant in the field of psychotherapy. The field has been changing, practitioners have been changing a nd the change in practitioners theoretical orientation is am ong the most noticeable and cite d changes. Today it is suggested that the average practitioner changes theoretical orienta tions 2 or 3 times during his or her career (DeAngelis, 2006, p. 59). Mahoney (2001), for instance, has described how he transformed from a behaviorist, to a cognitivist and then to a constructivist in his theoretical adherence, as mentioned above. Various theoretical orientations such as cognitive and constructive theories are gaining more popularity over others such as psychoana lytic theories. Reports of the 62 psychotherapy experts who participated at the Delphi Poll at 2002 suggested that th is shift was expected to carry on (Norcross et al., 2002). Specifically, experts anticipated that cognitivebehavior, culturesensitive, cognitive and eclectic/integrative theories to become more frequent, whereas classical psychoanalysis, solution focused th eories and transactional analys is would become less frequent (Norcross et al., 2002). Moreover, the field is increasingly open to theoretical integration and technical eclecticism. As much as the idea of integration has been rejected by certain groups of people who were strictly adhered to their theoretical orientation (see Goldfried, 2001a and Mahoney, 2001 for striking instances of opposing psychot herapy integration), increasing number of

PAGE 44

44 practitioners move away from th eir original theoretical orientation towards utilizing various perspectives (Goldfried, 2001a). Today, eclecticism is the moda l theoretical orientation for American psychotherapists (Norcross, 2005). Rnnestad and Skovholt (2003) observed therap ist integration of personal self and professional self among the 14 themes of therapist development. As therapists seasoned, they reported increasing consistency between who they were personally (e.g. their values, belief systems and such) and the ways in which they have conducted therapy. Eagle (2001) provided an example to this theme from his personal expe riences suggesting that he had become more authentic and genuine as a pers on and this personal developmen t reflected on his professional work: Comparing my early way of practicing with my current ways brings to mind the awkwardness I felt when I first began doing ther apy. I felt that I was role-playing and the person I was when I was doing therapy was radi cally different from the person I was when I was not doing therapy. I would say that wash ing away that marked discrepancy between person as therapist and just person and th e accompanying reduction in my awkwardness replaced by a greater sense of ease and naturalnessare the mo st important ways in which I have changed as a therapist. I think I have become more so with the years (p. 49). Rnnestad and Skovholt (2003) c onceptualized therapists changing their theoretical orientation as an indicator of such an incr eased integration and congruency. They further suggested that as their theoreti cal adherence shifted, the ways in which they connect with their clients and assign responsibilities within the therapeutic relationship have changed. Next, we investigate the nature and development of psychothe rapists therapy style that includes the way therapists related to their clients. Therapy Style Change Knowing that therapist variables account fo r a significant portion of therapy outcome, resea rch in therapist variables gained moment um. Fernndez-lvarez, Garca, Lo Bianco, and Corbella (2003) suggested that therapy style could be among the therapist variables influencing

PAGE 45

45 the process of change and recove ry for the clients. They have contributed to the literature by conceiving the Personal Style of the Therapis t (PST) construct and providing a detailed description this understudied variable. Fernndez-lvarez et al. (2003) defined PST as the set of char acteristics that each therapist applies in ever y psychotherapeutic situation, shaping its basic attributes (p. 117). In other words, PST is the collection of conditions that guide the therapist s therapeutic behavior. They conceptualized style of the therapist as composed of five bipolar dimensions of instructional, expressive, engage ment, attentional, a nd operative, and this conceptualization was validated empirically (Fern ndez-lvarez et al., 2003). First dimension was identified as instructional and it referred to th erapists ways of establishing and regulating the ru les of therapy such as scheduling and ways of negotiating change. It was defined within the bipolarity of flexibility-rigidit y. Second dimension was identified as expressive, and it referred to therapists level of expressing emotions to their clients. It was defined within the bipolar ity of distance-closeness. Thir d dimension was identified as engagement and it referred to therapists level of co mmitment to therapy and clients. It was defined within the bipolarity of lesser degree-gre ater degree. Fourth dimension was identified as a ttentional and it referred to therapists range of attention when gathering information from clients, and associated level of activity in the search of certain client information. It was defined within the bipolarity of broa d focused-narrow focused. Broad focus accompanied therapist receptiveness as well as lacking preconceived exp ectation of what client may bring to session, while narrow focus accompanied therapists active pursuit of certain realms of knowledge. Fifth dimension was identified as operative and it referred to therapists way of implementing intervention. It was defined within the bipolarity of spontaneous-planned.

PAGE 46

46 Fernndez-lvarez et al. (2003) suggested that these dimensions appear in an integrated manner through therapists work. Th ey also suggested that all co mbinations in personal style were valuable, and some combinations would be more convenient or benefi cial than others for specific clinical situations. In or der to investigate the nature of this construct further, Fernndezlvarez et al. (2003) developed a self-administered questionnaire measuring these five dimensions of the therapist style, called the Pers onal Style of the Therapist Questionnaire (PSTQ). They have further employed this questionnai re to study the relationships between personal style of the therapist, theoreti cal orientation, years of professi onal experience and length of treatment for a group of Argentinian psychothe rapists (Castaeiras, Garca, Lo Bianco & Fernndez-lvarez, 2006). The findings of this study informed the aims of the current study and we will explore these findings in depth. In genera l, the findings suggested that therapy style was associated with these identified therapist variables in complex and dynamic ways. Most importantly, preliminary evidence suggested the stab le yet flexible nature of the PST construct. The therapy style was conceptualized as a stable variable over the time, yet Fernndez-lvarez et al. (2003) had also claimed that PST could withstand minor or major changes as therapists endure significant changes in their life or work circumstan ces. Castaeiras et al. (2006) supported this assumption by showing significant PST differences fo r therapists with different levels of experience. Castaeiras et al. (2006) first assigned therapists into three different theoretical adherence categories based on participants self-descriptions, and therapists were classified into the groups of psychoanalytic therapy, cogniti ve therapy, and integrative th erapy with respect to their theoretical orientation. They identi fied beginner level therapists as the therapists with up to 5 years of experience and expert therapists as th e therapists who had 15 years of experience or

PAGE 47

47 more. Then, they analyzed how PST, experience and theoretical orientation relate to one another by slicing their findings in different ways. First, we will present the findings that focused on PST differences across theoretical orientations. Th en we will present the comparisons between beginner and expert therapists on their PST sc ores for each theoretical orientation group separately. Castaeiras et al. (2006) f ound significant PST differences between therapists with different theoretical orientati ons. They studied the association between style and theoretical orientation separately for begi nners and experts since level of experience was found to be a modulating factor. For beginners, there were no difference in therapists level of expressiveness and engagement across three orientation groups; participat ed beginners were fairly committed to and emotionally expressive with their client s regardless of their th eoretical orientation. Instructional rigidity separated beginner cognitive therapists from beginner integrative therapists: Cognitive therapists were more rigid in their establishing and maintaining the rules and regulations relating to thera py than integrative therapists. At the both levels of experience, cognitive and integrative therapists were similar in the dimensions of attentional and operative, and scored significantly higher than the psychoanalytic therapists. Compared to psychoa nalytical therapists, cognitive a nd integrative therapists were significantly more active in eliciting information and narrower in their focus and they were more planned in the implementation of therapeutic interventions. For experts, the cognitive and integrative therapists also score significantly higher on expressive dimension of style than psychoanalytical therapists; expert cognitive and integrative therapists reported more emotional presence and communication with their clients compared to expert psychoanalytical therapists. And for the expertise level, integrative therapists scored

PAGE 48

48 significantly higher on engagement dimension than the psychoanalytical therapists; expert integrationists reported higher le vels of commitment to the act of therapy and to their actual clients. Overall, the findings indicated that adheren ce to cognitive and integrative theories was associated with similar levels of attentional, operative, and expressi ve, and psychoanalytical therapists had a broader focus, more spontaneity and more distance than cognitive and integrative therapists. The findings indicated that the therapy style is asso ciated with theoretical orientation in different ways depending on therapists experience level (Castaeiras et al., 2006). Then, Castaeiras et al. (2006) compared beginner level therap ists to expert therapists on their PST scores for each theore tical orientation group separatel y. Among cognitive therapists, differences between beginners and e xperts emerged for the domains of instructional and expressive : Beginner level cognitiv e therapists were more rigid in setting and maintaining rules regarding therapy (instructional) and more emotionally distant towards clients (expressive) compared to experts. Among integrative therapis ts, differences across e xperience level emerged for the dimensions of attentional operative, and engagement Beginner level integrative therapists were more narrowly focused, activel y searching for a specif ic realm of knowledge (attentional), more planned in implementing interventions (operative), and yet less committed to therapy and client (engagement) as compared to expert integrationi st. Among psychoanalytic therapists, differences between beginners and experts emerged for the dimension of attentional : Beginner level psychoanalytic therapists endorsed significantly narrower focus (attentional) than their expert counterparts. The authors concluded that years of experi ence partially modulated the evolution of therapist style in each specific theoretical orientati on (Castaeiras et al ., 2006). These findings

PAGE 49

49 implied that therapy style is related to years of experience and that therapy style could change over the course of professional development. R ecognizing the cross-sectio nal nature of this study, one might speculate that th e obtained differences between be ginner and expert therapists could indicate a cohort effect where the fiel d and/or contemporary training models locate distinctive demands on recently graduated therapists. Yet, the findings on therapist professional development (Jennings & Skovholt, 1999; Martin et al., 1989; Rnnestad & Skovholt, 2003; Skovholt & Jennings, 2004) support the conclusion that the stylistic differences between beginner and expert therapists was a reflection of prof essional change experiences. The therapist career development studies and Cast aeiras et al.s (2006) study concur that therapists relax in their style, broaden their attentional perspec tive, and become skillful in communicating their emotions as they season in the profession and gain expertise. Specifically, Martin et al. ( 1989) differentiated novice prac titioners from experienced practitioners in their co nceptualizations of client issues. Novice couns elors were more likely to present a preoccupation with pro cedural concepts. On the other hand, experienced counselors tended to conceptualize their clients at a br oader level and in a more inclusive manner These findings can be translated to the PST terminol ogy employed by Castaeiras et al. (2006) where novice counselors had narrow attentional focu s and planned way of conducting therapy interventions guided by their how to knowledge, while experienced counselors had broader focus, openness to wide-range of client mate rial and willing to incorporate spontaneous interventions. Martin et al. (1989) provided an early evidence for the assumption that therapy style, in particular w ith the dimensions of attentional and operative, differ with respect to therapists level of experience. The more recent research on master therapists and professional

PAGE 50

50 development provided more compelling evidence s upporting stylistic change of therapists with experience. Likewise, Rnnestad and Skovholt (2003) suggest ed that therapists reported increased professional flexibility throughout their career development. As therapists seasoned, they have confronted various challenges that facilitated a gradual disillusi onment with training. With this disillusionment, the practitioners attention gradually shifted from what their training solicited to an internally-based flexible professional functioning. This inferred flexibility across professional development was aligned with the findings that expe rt therapists were significantly more flexible in setting and maintaining rules regarding therapy (instructional ), more broadly focused and open-minded while listening to client material ( attentional ) and more spontaneous in implementing interventions ( operative ), at least for the expert therapists with certain theoretical commitments (Castaeiras et al., 2006). Additionally, Jennings and S kovholt (1999; Skovholt & Jennings, 2004) found that master therapists were strong in their emotional and re lational skills Specifical ly, among other qualities, emotional receptiveness, ability to attend to self and others emotions, recognition of the ways in which their own emotions impact their work, rela tional skillfulness, strong adherence to working alliance and exceptional use of re lational skills in therapy were among the qualities shared by and hence define the master therapists. These find ings were supportive of the findings that expert therapists had higher scores on the dimensions of engagement and expressive compared to beginner therapists, at least for master ther apists with certain theoretical commitments (Castaeiras et al., 2006). The narrations of 16 seasoned psychotherap ists further confirmed these findings (Goldfried, 2001a). These practitioners that re flected on their professi onal change processes

PAGE 51

51 reported increased flexibility, broadened understa nding and appreciation of client concerns and enriched ways of reaching out to their clients. Most importantly, each narrative described ways of breaking free from original teachings and deve loping integrative, expansive, pliable ways of being and doing in their therapeutic work. Ev en though these practitioners did not employ the PST framework or language, they were clearly providing further evidence from their own perspective on how they have changed in their th erapy style as they seasoned as therapists. Castaeiras et al.s (2006) study was significant as it provided empirical support for the usefulness of the PST construct, for the sensi tivity and specificity of the PST-Q, and most importantly, for the change processes of dimens ions of therapy style. Combined with the therapist development studies (Jennings & Skovholt, 1999; Rnnestad & Skovholt, 2003; Skovholt & Jennings, 2004) and pers onal narratives of seasoned therapists (Gol dfried, 2001a), the findings of Castaeiras et al. (2006) suggest that therapists st yle in which they engage with therapy might change with experience. The current study aims to clarif y whether therapists perceive stylistic change as a part of their professional development and growth experiences, and if so what the direction of change would be fo r the participating therapists. In line with the above-mentioned findings, we expect to find incr ease in therapists emotional expressiveness, engagement, attentional focus and spontaneity. This clarification would be a significant edition to the limited literature on psychotherapists change experienced in therapy style. Epistemic and Professional Change Our literature review studied two change pr ocesses regarding psychotherapists, nam ely epistemic change and professional change. We agree with Stricker (2001) who conceptualized change as a synergist and suggested that change of any sort can facili tate other changes (p. 79). Hence, once we have accumulated informa tion with respect to therapists change experiences in epistemology, theore tical orientation and therapy style, then we shall investigate

PAGE 52

52 the ways in which these change processes facilitate one another. The existing literature suggests that these two processes are associated; yet this interaction remains to be studied. As we have clarified above, certain schools of thought and theoretica l orientations have been associated with certain epistemic styles. Conceptually, rational epistemic style was linked to rationalistic cognitiv e therapies whereas metaphorical epistemic style was linked to constructivist cognitive therapies (Lyddon, 1991). Consistent with these conceptual links, epistemic style moderately accounted for individual s attitudes and preferences for theories of psychotherapy (Lyddon, 1989a; Lyddon & Adamson, 1992; Neimeyer et al., 1993; Neimeyer & Morton, 1997; Schacht & Black, 1985) : Participants prefe rred theoretical orient ations that were consistent with their own epistemic view. Considering that the epistemic style of a therapist accounts for his or her theoretical orientation preferences, it is reasonable to ex pect that a change in a therapists epistemic commitment would reflect on the therapists choi ce of theoretical orientation. It can be argued that therapists epistemic change experiences would be related to the quan titative and qualitative changes in their theoretical orientation. In other words, as th e psychotherapists see the world differently, they may adhere to new theories that capture their most recent worldview. We assume that psychotherapists change in the ep istemic commitment can predict the change in their theoretical orientation. The more psychothera pists experience an epis temic shift, the more likely they may be to report a change in their theoretical orientation. As constructivist metatheory reflects rec ognition of complexity in human processes, epistemic shift of practitioners towards constr uctivism may further enc ourage practitioners to integrate various forms of therapy. Alternativel y (and additionally), the ongoing integrationist movement might have endorsed a more constr uctivist framework on its members. In other

PAGE 53

53 words, it is likely that the fields increasi ng commitment to constructivism and the increasing theoretical integration on the part of psychotherapists may be related to and promoting one another. Hence, we expect that increase in therapists commitment to constructivist epistemologies might correlate with their enga gement in more integrated ways of conducting therapy. Epistemic style has also been employed to understand the differences among psychotherapy practices. Therapists conducting rationalist and constructivist therapies differed in the way they set the direction of the therapy, re lated to client, and conceptualized and worked through clients emotional distress, relapse, and regression (Nagae & Nedate, 2001; Vasco, 1994; Viney, 1994; Winter & Watson, 1999). Therapists with different epistemic commitments appeared to have different st yles in their therapeutic clos eness, focus, engagement, and spontaneity as well as different emphasis on bon ding with their clients (Neimeyer & Saferstein, 2006). Moreover, Castaeiras et al. (2006) demonstr ated the complex ways in which therapy style, experience, and theoretical orientation interacted. Their findi ngs indicated that the ways in which therapy style related to theoretical orientat ions (psychoanalytic, cognitive, and integrative) was different across the two levels of experien ce (beginners with less than five years of experience and experts with 15 years of experience or more). Overall, the findings indicated that adherence to cognitive and integrat ive theories was associated with similar levels of attentional, operative and expressive, and psychoanalytical th erapists had lower scores on each of these three dimensions of therapy style compared to cognitive and inte grative therapists. Castaeiras et al.s (2006) findings indicated that the therap y style was associated with theoretical orientation in differe nt ways depending on therapists experience level. Given that

PAGE 54

54 theoretical orientations reflected an u nderlying epistemic commitment (Lyddon, 1989b) and certain dimensions of therapy style have alrea dy linked to epistemic commitments of therapists (Neimeyer & Saferstein, 2006), it is reasonable to expect therapist epistemic change to account for or to align with therapists stylistic change experiences. Hence, any increase in therapists commitment to constructivist epistemologies might correlate with increase in certain dimensions of therapeutic style, specifically therapeutic closeness, engagement, spontaneity, and focus. Castaeiras et al. (2006) did not include epistemology as a variable, nor did they group their participants into groups of epistemically divergent categor ies of theoretical orientation. Rather it is safe to assume that these categorie s were fairly generic, each involving a wide range of theories and practices. As this literature review suggested, c ognitive therapy is an umbrella term combining a variety of approaches (Lyddon, 1988; Mahoney, 1991). The current study aimed to further our understanding between the therapy style and theoretical orientation by separating how epistemic commitments underlying theo retical orienta tions related to levels of and changes in therapy style. Recognizing the wa ys in which epistemology is linked to therapy style could improve our understanding of these significant therapist variables. Overall, the existing literature provides a cogent rationale to pursue and expect association between therapists epistemic and prof essional journeys. This relationship would be a complex one, impacting one another at different levels through differe nt dynamics. Uncovering this multifaceted association starts with simply establishing that therapists perceive their epistemic and professional change processes to correlate. This basic question of whether and if so, to what extent psychotherapists perceive d epistemic change accounts for where therapists stand in their theoretical stylis tic journey has remained to be answered, and was identified among the inquiries of the present study. The purpose of the present work was to help lay the foundation

PAGE 55

55 for developing an increased understanding of ther apists developmental pr ocesses and the place of epistemic commitment within that framew ork, as construed by therapists themselves. Taken as a whole, the literatur e indicates psychotherapist theory preferences as well as therapeutic conceptualizations and behavior are colored by their epistemic commitments. Yet such professional attitudes and behaviors as well as the epistemic commitments are subject to development and growth. Moreover, these change processes are likely to interact with one another: Any change experienced in the way we perceive the world a nd test the validity of knowledge as psychotherapists are likely to mark the growth and change in our therapy-related attitudes and behaviors. Overall, the complex associations between epistemic worldview and psychotherapy preferences and behaviors have been yet to be clarified within a developmental framework that supposes change and growth in both aspects. Purpose of Study As the literature review points out, the psychotherapy literature suggests that the field has experienced an epis temic shift where its members have become increasingly more constructivist, and numerous seasoned psychotherapists endors ed this shift thr ough narrating their own epistemic change. However, despite the general a cceptance of the notion in the current literature, there is no empirical evidence documenting that toda ys practitioners have in fact experienced an epistemic shift in their perspective and practice, apart from the anecdotal evidence of selected prominent practitioners in the fi eld. The "increasingly constructivist" lands cape of contemporary psychotherapy could be an indicator of a cohort effect rather than an indicator of therapists developmental changes across time. For instance, early-career th erapists might have stronger commitments to constructivism than therapists of the previous generations, and/or therapists who entered the field at different times have differe nt epistemic trajectories. The dynamics underlying

PAGE 56

56 the fields and its practitioners increasing co mmitment to constructivism have yet to be empirically investigated. The literature also indica tes that therapists change in their theoretical orientation and therapy style in so mewhat consistent ways and that therapists epistemic journeys might relate to these professional change experiences. Yet, these in teractions have also remained to be investigated empirically. The present work was an expl oratory study investigating the epistemic change experiences of practitioners, as therapists perceived them. This study attempted to answer three umbrella questions including specif ic hypotheses following two of the questions. The main questions and accompanying hypotheses are specified as followed. Question 1. How do therapists perceive themselves to change in their (a) epistemic worldview, (b) theoretical orient ation characteristics, and (c) therapeutic style across their professional lifetime? Specifically we expected that (1) when compared to their initial epistemic commitments, therapists would report having increasingly higher levels of commitment to constructivist epistemologies; (2) when compared to the plurality, i.e. eclecticism of their initial commitments, therapists would report having increasingly higher levels of plurality in their therapeutic orientation; and (3) when compared to their initial levels, therapists would indicate increasingly higher levels of (a ) expressiveness, (b) engagement, (c) attentional focus, and (d) operative spontaneity in their therapeutic st yles across the course of their practice. Question 2. What are the reasons behind the fields increasing commitment to constructivist epistemol ogy? More specifically, to what extent do cohort effects account for the epistemic shift in the field of psychotherapy? As an exploratory analysis, we attempted to clarify how much of the variance in therapists initial epistemic commitments as well as their epistemic trajectories can be explaine d by the time in which they have entered the field.

PAGE 57

57 Question 3. What is the relationship between th erapists epistemic and professional change experiences? In other words, to what ex tent can therapists epis temic journeys account for their current standing with th eir therapeutic orientation and style after accounting for their initial standing with thes e variables? We hypothesized that incr eases in therapis ts constructivist commitments would predict (1) greater changes in their theoretical orie ntation throughout their professional lifetime; (2) greater levels of theo retical plurality, indicati ng greater adherence to theoretical integration and eclecticism; (3) gr eater levels of expres sive and engagement dimensions of therapy style, indicating greater adherence to emotional expressiveness with and engagement to clients; and (4) lower levels of operative and attentional dimensions of therapy style, indicating greater levels of spontaneity in implementing interventions and wider range of attention in collecting information from the clients.

PAGE 58

58 CHAPTER 3 METHODS Participants Participants were professiona l psychologists and they were recruited online from the American Psychological Association (APA) Practice Organization (www.apapractice.org) online practitioner directory (approximately 13,000 members). The solicitation email also encouraged participants to forward the survey invitation on to other eligible practitioners. Procedure An Internet survey was conducted w here partic ipants were invited to complete a set of questionnaires online that requ ired approximately 25 minutes to complete on average. Participants were informed that the study aims to understand their descriptions of themselves as therapists at different stages of their career. We refrained from using the word change to limit the potential bias that might be introduced by the nature of th is word. Informed consent was required before the survey appeared on the screen. The survey was anonymous and the confidentiality of completed surveys was insured. In the survey, participants were asked to answer some sets of questions twice with different directions. Participants rated certain items once reflecting on th eir current experiences and once reflecting on their past, specifica lly on the time where they had started post-graduate practice of psychotherapy. The order of these two sets of directions were alternated, half of the participants reflecting on their past first, and their current selves later, and the other half of the participants reflecting on their today first and their past later. This enabled us to test and if necessary control the possible operation of any order effects as we detailed in the results section.

PAGE 59

59 To avoid a likely frustration on the part of participants that may stem from answering several questions twice, the st udy was set-up such that the it ems would appear only one time asking therapist to respond to the given item once from their current standing point and once from their initial standing point. We anticipated that this set-up would shorten the time spent on reading and answering the questions twice and lessen the likely frustration. Yet, attending to same item considering now and then side by side would provide participants with an immediate opportunity to compare their ratings for their past and presen t, and hence, might artificially stretch the gap between two ratings. A pilot study conducted with 34 professional practitioners and practitioners in training failed to support such possibility. When half of the participants responded to ratings of past and present side by side, the other half responded to such items separately. The obtained findings failed to indicate a significant difference between the two groups ratings; hence encouraged us to believe that reflecting on items side by side had minimum or no considerable impact on the participants ratings. Participants were also debrie fed at the end of the study and they were provided with the contact information of the primary in vestigator for further inquiries. Instruments Epistemic c ommitments: Therapists epistemic commitments were measured with the Therapist Attitude Questionnaire Short Form (TAQ-SF). This scale assesses the degree of participants commitments to rationalist and c onstructivist epistemol ogies. DiGiuseppe and Linscott (1993) developed the Therapist At titude Questionnaire (TAQ) to measure the philosophical, theoretical, and technical dimensions of the rationalist and constructivist positions. Neimeyer and Morton (1997) developed the short ve rsion of the TAQ, named Therapist Attitude

PAGE 60

60 Questionnaire Short Form (TAQ-SF). The TAQSF measures the same constructs the TAQ measures using a total of 16 items. Eight items represents rationalist pos itions and the other 8 items represents constructivist pos itions. As in the TAQ, the re spondents determine the degree to which they endorse the statements on a five-point scale ranging from 1 (strongly disagree) to 5 (strongly agree). Sample items include Realit y is singular, stable and external to human experience and Reality is relative Realities reflect individual or collective constructions of order to ones experiences. Higher rationalism and construc tivism scores reflect higher commitments to rationalist a nd constructivist epistemologies The TAQ-SF was found to reproduce the basic factor stru cture of the TAQ. Predictive validity of the measure was established as it predicted the th erapeutic identifications and desc riptions of a group of practicing professionals (Neimeyer & Morton, 1997). Theoretical orientation: Theoretical orientation was measured by asking therapists to rate their orientation on a list of seven categories of analyt ic-psychodynamic-neo-analytic, behavioral, cognitive, humanistic -existential, systemic, construc tivist-narrative, and feministmulticultural. The respondents were asked to rate each orientation on a five-point scale ranging from 1 (not a part of my practice) to 5 (a ve ry significant part of my practice). Then, the respondents were asked to identify their main th eoretical orientation from a menu that included the above-mentioned orientations and integrationi st orientation. At last the respondents were asked to rate the extent to which they perceive their theoretical orient ation has remained the same, or changed on a five-point scale ranging from 1 (same) to 5 (changed). The plurality, i.e. eclecticism, of theore tical orientation was defined based on the cumulative number endorsed on the theoretical or ientation ratings. Higher numbers indicated higher plurality. Therapists indica tion of their main theoretical base was used as an anchor.

PAGE 61

61 Therapist style: Therapist style was measured with the Personal Style of the Therapist Questionnaire (PST-Q) This questionnaire assesses therapists characteristics ways of conducting psychotherapy. Fernnd ez-lvarez et al. (2003) deve loped the questionnaire to measure the ways in which therapists engage in therapy and shape the conduct of their therapeutic work. The questionnaire is composed of five subscales that were designed to assess five different dimensions of th erapist style. (1) Instructional subscale assesses flexibility in establishing and regulating the th erapy setting; higher scores represent greater rigidity vs. flexibility. (2) Expressive subscale assesses em otional communication; higher scores represent greater closeness vs. distance. (3) Engagement s ubscale assesses level of commitment to therapy and client, higher scores repres ent greater degree vs. lesser de gree. (4) Attentional subscale assesses therapists range of attention and activity level in gathering info rmation; higher scores represent narrower focus vs. broad focus. (5) Operative subscale assesses spontaneity in implementing interventions; higher scores repres ent more planned vs. spontaneous. See Table 31. PST-Q is a 36-item self-report measure. The respondents rate how accurately each statement described their practice on a seve n-point scale ranging from 1 (tot al disagreement) to 7 (total agreement). The questionnaire have yielded th e following Cronbachs alpha scores for each subscale: Instructional, .69; expressive, .75; engagement, .78; attentional, .80; operative, .78. The measure has shown adequate 4-month te st-retest reliability (instructional, r = .82; expressive, r = .76; engagement, r = .78; attentional, r = .81; and operative, r = .78). Theoretical validity is established through obtained factorial compos ition, and further supported by the work of Castaeiras et al. (2006). Demographics: Participants were asked to give information about their demographic information. These included gender, age, ethnic background, name of thei r highest degree, the

PAGE 62

62 year they obtained their highest de gree, total number of years they have spent in clinical practice, specialty area, primary employment setting, primary job responsibil ity, average number of clients seen weekly and the country they live in. Table 3-1. Personal Style of the Therapist Qu estionnaire (PST-Q): Subscale directions Subscales Low High 1. Instructional Flexibility Rigidity 2. Expressive Distance Closeness 3. Engagement Lesser degree Greater degree 4. Attentional Broad focus Narrow focus 5. Operative Spontaneous Planned

PAGE 63

63 CHAPTER 4 RESULTS The results s ection is composed of three sectio ns. First, the sample characteristics of the participants are provid ed. Second, the descriptive informa tion concerning the overall scores, psychometrics and relationships among the primary variables of interest are presented. And last, the three primary analyses are reported. A series of repeated measures ANOVA first address the primary questions regarding the ways in which therapists regard themselves as changing in relation to their theoretical orientations and th erapy styles (expressive engagement, operative, and attentional) across the course of their pr actice. Next, multiple regression analyses are reported to address the question regarding whether cohort effects (i.e. the year of entry to the profession) accounted for therapis ts perceptions regarding their initial epistemic commitments and epistemic shifts. And third, a series of multip le regression analyses are reported to address the question regarding whether ch ange in therapists epistemic leanings predict levels of therapists current theoretical and stylistic commitments, above and beyond their initial commitments. Demographics The sam ple consisted of 702 participants of which 94.2% designated their demographic information. Among those who responded, 59.5% women and 40.5% men, with a mean age of 50.36 ( SD = 11.7, age range = 25-84 years). The majority of the participants were Caucasian, 88.6% ( N = 584), followed by Hispanic, 3.6% ( N = 24), African-American/Black, 2.4% ( N = 16), Asian-American, 1.2% ( N = 8), multiracial, 1.2% ( N = 8), and Other, 2.9% ( N = 19). The majority of the participants repo rted to be from the U.S., 96% ( N = 630), whereas 4% ( N = 26) of the participants were from other countries.

PAGE 64

64 The majority of the participan ts had a Ph.D. degree, 68.9% ( N = 449), followed by a Psy.D., 16% ( N = 104), M.A. or M.S., 8.4% ( N = 55), Ed.D., 1.8% ( N = 12), M.S.W., 1.5% ( N = 10), or other degrees, 3.4% ( N = 22), as their highest degree. Th e majority of the participants were self-identified as psychologist, 87.4% ( N = 577), followed by mental health counselor, 4.2% ( N = 28), marriage and family therapist, 2.4% ( N = 16), and social worker, 1.2% ( N = 8). The remaining participants designated themselves as Other, 4.7% ( N = 31). The majority of the participants defined thei r primary responsibility as practice/clinical work, 80.2% ( N = 528), followed by academic, 8.2% (N = 54), administrative, 4.1% ( N = 27), research, 1.2% (N = 8) and other, 2.7% (N = 18). The remaining 23 participants designated themselves as being equally involved in multiple responsibilities, 3.5%. The majority of the participants indicate d their primary employment sett ing as private practice, 47.0% ( N = 309), followed by hospital, 10.8% ( N = 71), mental hea lth care, 10.2% ( N = 67), university academic department, 8.5% ( N = 56), university service delivery department, 6.1% ( N = 40), community center, 3.8% ( N = 25), school, 2.7% ( N = 18), correctional facility, 1.7% ( N = 11), and other, 9.1% ( N = 60). Mean number of years spent in clinical practice was 18.66, and ranged between 1 and 52 ( SD = 10.94). The mean number of clients seen weekly was 17.38, and ranged between 1 and 61 ( SD = 10.69). The majority of the participants identified integrative as their primary theoretical orientation at the present time, 32.2% (N = 213), followed by cognitive, 27% ( N = 179), psychodynamic, 17.1% ( N = 113), humanistic-exist ential-gestalt, 8% ( N = 53), systemic-family, 4.7% ( N = 31), behavioral, 4.7% ( N = 31), narrative/constructivist, 4.2% ( N = 28), and feministmulticultural, 2.1% ( N = 14). Psychodynam ic theory was the most common primary theoretical orientation designated by therapists at the time that they started practice after graduation, 26.5%

PAGE 65

65 ( N = 175), followed by cognitive, 23.9% ( N = 158), humanistic-exist ential-gesta lt, 16.9% ( N = 112), behavioral, 12.4% ( N = 82), integrative, 11.3% (N = 75), systemic-family, 6.4% ( N = 42), narrative/construc tivist, 1.5% ( N = 10), and feminist-multicultural, 1.1% ( N = 7). Descriptives and Preliminary Analyses In order to a ssess the potential impact asso ciated with the vari ous orderings of the questionnaires used in this study, one-way ANOVAs were c onducted along the six different orderings, using each of the questionnaire scores as dependent variables in the analysis. These analyses suggested that there were no difference in the mean scores of the variables of interest among the six types of questionnaire forms (all p s > .01). Thus for all analyses, the data from six different forms were combined. Table 4-1 depicts summary sta tistics of the primar y variables used in this study. This includes the measures of rationalism and cons tructivism derived from the Therapist Attitudes Questionnaire (TAQ), the therapeutic change index, the measure of therapeutic plurality, and the measures of therapy styles of (a) expressive, (b ) engagement, (c) attentio nal, and (d) operative, scores indicated separately according to their cu rrent (now) and initial (t hen) ratings from the practitioners. All scores were normally distributed. Skewness and kurtosis values were in the acceptable range for appropriate distribution. The epistemology scores obtained from TAQ were consistent with the scores reported by Neimeyer and Morton (1997). Overall, the scales yielded low to moderate reliability coefficients. Table 4-2 depicts the Pearson Product-Mo ment correlation coefficients among the variables of interest. Consistent with previous dis tinctions outlined in the literature, a number of therapist qualities were associated with epistemic leanings in theoretically consistent ways. Levels of constructivism, for example, were ge nerally positively related to greater levels of

PAGE 66

66 therapist expressive, and theoretical pluralit y, while rationalist lean ings were negatively associated with these variables. Levels of c onstructivism were generally negatively related to narrower levels of attentional focus, and operati ve spontaneity (reflecting higher levels of planinduced approach to therapy), while rationalist l eanings were positively associated with these variables. Similarly, conceptually linked variab les showed low to mode rate associations. For example, attentional and operative dimensions we re positively associated with one another, as were levels of expressive a nd engagement factors, and thes e two groups of variables were negatively associated with one another. Preliminary analyses investigating whether the scores on the dependent variables were different across demographic variab les revealed that certain variab les of interest were different across the levels of gender, age, and average nu mber of clients seen weekly. T-test analyses revealed gender differences in constructivism-now ( t = -3.98, p < .001), constructivism-then ( t = -2.98, p < .003), and rationalism-now ( t = 3.61, p < .001) scores. Males scored significantly higher than females in their current comm itment to rationalist epistemology (males, M = 23.41, SD = 5.71, females, M = 21.84, SD = 4.90); whereas females scored significantly higher than males in their current (males, M = 32.83, SD = 3.95, females, M = 33.99, SD = 3.17); and past commitment to constructivist epistemology (males, M = 30.62, SD = 4.25, females, M = 31.57, SD = 3.52). Regression analyses revealed that age significantly accounted for variance in engagement-now ( F (1, 492) = 9.51, p = .002; = -.14), and attentional-then ( F (1, 494) = 11.41, p = .001; = -.15) scores, and theoretical orientation change index ( F (1, 504) = 13.01, p = .000; = .16). The average number of clients seen weekly accounted for significant variance in attentional-now scores ( F (1, 630) = 11.20, p = .001; = -.13). Hence, these three demographic variables (i.e., gender, age, and average number of clients se en weekly) were entered into the

PAGE 67

67 primary analyses as covariates when subsequent analyses involved the above-mentioned variables. Primary Analyses The final set of analyses utilized three sets of analyses. First, repeated ANOVA analyses were conducted to exam ine whether there was a perceived change in therapists epistemic leanings, theoretical orientati on, and therapy styles of expres sive, engagement, operative, and attentional across the cour se of their practice. It was hypothesized that comp ared to their initial levels, therapists would report increasingly higher levels of commitment to constructivist epistemologies, plurality in their therapeutic orie ntation. In addition, they were expected to have higher levels of expressive and engagement dimens ions in the therapeutic styles and lower levels of operative and attentional dimensions. S econd, regression analyses were conducted to investigate whether the participants cohort of graduation would account for some of the variance in the epistemic shift in the field of psychotherapy. In other words, we wanted to determine whether the shifts towards greater constr uctivism were the result of the influx of new constructivist therapists trained in recent ye ars, versus perceived developmental changes occurring within longstanding psycho therapists. No predictions were specified for this research question. Third, regression analyses were conducted to examine whether change in epistemological commitments predicted the therapis ts current levels of theoretical orientation, adherence to theoretical integra tion, and therapy styles of expressive, engagement, operative, and attentional dimensions, above and beyond what their initial standing was. Increasing commitment to constructivist epis temologies was expected to predic t higher levels of theoretical change and plurality, higher levels of expressive and engagement styles, and lower levels of operative and attentional styles.

PAGE 68

68 Research Question #1: How Do Therapists Ch ange in Their Epistemic Commitment and in Professional Characteristics across the Co urse of Their Professional Practice? W ithin this broad research question, we ha ve specifically hypothesized that when compared to their initial sta nding, therapists would have (1) increasingly higher levels of commitment to constructivist epistemologies; (2) increasingly higher levels of plurality in their therapeutic orientation; and (3) increasingly hi gher levels of expres sive and engagement subscales, and lower levels of attentional and operative subscale. We conducted a series of repeated measures ANOVA, with now-versus-then (i.e. time factor) as the within-subjects factor, and epistemology, theoretical orientation, and therapeutic style scores as the dependent variables, to investigate whether there were significant reported changes in the therapists epistemic commitments and identified professional variab les over the course of their practice. Gender was entered as a covariate to the analys es involving the variable s of constructivism and rationalism. Age was entered as a covariate in the analyses regarding engagement, attention, and theoretical orientation change. In addition to age, the average number of clients seen weekly was entered into the analysis involving the at tention variable. A Bonferroni adjustment was employed within the analyses to guard against the Type I error, and alpha level was established at .007 (.05/7), which is the orig inal alpha level (.05) divided by the number of statistical tests. Obtained partial eta-squared sc ores were reported as effect size indices. Table 4-3 summarizes the obtained coefficients. Findings indicated statistically significant changes in therapists epistemic leanings, therapy styles and theoretical pl urality. Consistent with our hypot heses, analyses revealed an increase in therapists perceived commitment to constructivist epistemology. This finding was not only statistically significant, but also modestly robust, as indi cated by a partialeta squared of .21. Another statistically and clin ically significant finding was ther apists perceived change in

PAGE 69

69 theoretical plurality. Data indi cated a significant increase in therapists employing a greater variety of theoretical orientati ons in their practice with a pa rtial-eta squared of .38. Hence, therapists reported increase not only in their constructivist leanings but also in their theoretical eclecticism i.e. plurality. Data al so indicated a significant reduction in therapists perceived commitment to rationalist episte mology across their practice. Therapists change in their theoretical orienta tion can be understood further by comparing individual theoretical orientati on ratings for now and then. We conducted a series of repeated measures ANOVA, with now-versus-then (i.e. ti me factor) as the with in-subjects factor and seven theoretical orientations as the dependent variables, to investigate whether there were significant reported changes in the therapists commitment to these specific theoretical orientations over the course of their practice. Bonferroni adjustment was employed within the analyses to guard against the Type I error, and alpha level was established at .007 (.05/7), which is the original alpha level (.05) divided by the number of statistical test s. Table 4-4 summarizes the obtained coefficients. With respect to theoretical orientation changes within therapists, data indicated statistically and clinically significant increa se in therapists commitment to cognitive, constructivist and feminist-multicultural therapies. There was also a significant increase in behavioral therapy, and systemic-family therapies although these changes were failed to be clinically meaningful suggested by their low effect size indices. Da ta failed to indicate ch ange for therapists commitment to psychodynamic and humanis tic-existentialgestalt orientations. An overall change in therapists theoretical pe rspectives is also evident when we compare their initial and current theoretical base. When th erapists were asked to choose one theoretical orientation as their main base among the eigh t options (cognitive, behavioral, humanistic

PAGE 70

70 existential gestalt, narrativ e/constructivist, systemic family, psychodynamic, feminist multicultural, and integrationist), the cumulative picture of primary commitments showed perceived differences over time (See Table 4-5). Cochran-Mantel-Haenszel statistics were used to test the significance of the observed differences The results suggested that the now and then percentages were statistically different from one another for this cross-tabulation ( 2 = 124.56, p < .001). These percentages are consistent with the pr evious findings concerning theoretical shifts. Commitments to cognitive, narrative-constructivi st, feminist-multicultural, and integrationist perspectives as primary theoretical bases have strengthened, while commitment to behavioral, humanistic-existential-gestalt, systemic-family, and psychodynamic perspectives as therapists primary theoretical bases have weakened. Results of the analyses for therapy style variables are depicted in Table 4-3. Data indicated a statistically and clinically significant increase in the expressive subscale that assesses emotional communication, where higher scores represent great er emotional closeness. Data supported our hypothesis that therapists would pe rceive increased closeness and emotional expressive in their therapy styles across time. There was a statistically significant decrease in operative subscale that assesses spontaneity in im plementing interventions, where lower scores represent more spontaneity in conducting therapy. Hence, the results supported our pr ediction of perceived decrease in operative style, in dicating that therapists perceived themselves as increasing in spontaneity across time. Ther e was also a decrease in attentional scores that assesses therapists range of attention and activity in gathering information, where lower scores represent broader focus. Data supported our prediction that therap ists perceived themselves as having increasingly

PAGE 71

71 broader focus in the way they have collected da ta during therapy. But the low partial eta squared for the change in operative and attentional raised question into the magnitude of these findings. The data failed to support our hypothesis of increased engagement across years. Higher levels of engagement represent higher degrees of engagement with clients. We expected therapists to report increased commitment to th erapy and their clients acr oss their practice. The obtained results, on the other hand, suggested therapists viewed their engagement level as remained stable across time. Due to these finding s, engagement as a therapy style variable was excluded from the analyses investigating the relationship between therapists epistemic and professional change experiences. In order to understand the da tas failure to support our hypothesis regarding increased therapist engagement across practice, we conducted exploratory post-hoc analyses. Specifically we investigated if differences across experience levels emerge for the dimension of engagement only for those therapists with certain theoretic al orientation and we engaged in the post-hoc analysis by entering therapists current and initial theoretical orientations into the model. In the post-hoc analysis, we used a repeated measures ANOVA, with now-versus-then as the withinsubjects factor, theoretical orie ntation as the between-subjects fact or, age as the covariate and the engagement scores as the dependent variable to examine whether there was significant increase in the engagement scores over the course of th erapists practice. We c onducted this analysis twice, once current theoretical orientation as the between-subjects factor and once initial theoretical orientation as the between-subjects factor. A total of 488 therapists were included in both of the analyses, with engagement-then scores ( M = 28.4, SD = 5.34) higher than engagement-now scores ( M = 27.5, SD = 5.70). This less than 1-point score difference failed to repres ent a significant change in both of the analyses,

PAGE 72

72 for the analysis including therapis ts current theoretical orientation, one-tailed F (1, 479) = 0.06, p = .405, and for the analysis including ther apists initial theoretical orientation, one-tailed F (1, 479) = 0.00, p = .496. Thus, there was no substantial mean change in engagement scores over therapists practice. Yet, the analyses reveal ed a significant interaction between engagement now-versus-then scores and theore tical orientation, for therapists current theoreti cal orientation, F (7,479) = 3.30, p = .002, partial eta squared = .046, for therapists initial theoretical orientation, F (7,479) = 2.35, p = .023, partial eta squared = .033. Table 4-6 depicts the post-hoc results locating the interacti on for both of the analyses. Data indicated that engagement levels have de clined across the practice of therapists that identified their current theoretical commitment as cognitive and integrative, while no significant changes appear for therapists with other theoreti cal commitments. Data also suggested a decline for therapists that identified their initial th eoretical orientation as behavioral, humanisticexistentialist-gestalt, and integrative. The enga gement levels seemed to increase across the practice only for therapists that identified their initial theoretical orientation as narrative/constructivist. Research Question #2: Do Cohort Effects Exp lain Changes in Therapists Epistemic Commitments? As a part of this study we wanted to provide a tentative answer to the question regarding whether cohort effects may have accounted for th e epistemic shift in th e field of psychotherapy. Answering this question in a sa tisfactory manner is beyond the scope of this project, yet we attempted to provide a preliminary answer to this question through conducting hierarchical regression analyses where the number of years that therapists had been in the field was utilized as a continuous indica tor of the cohort.

PAGE 73

73 To conduct this set of analyses, we first computed change scores for the epistemic variables where the THEN scores were subt racted from the NOW scores. Specifically, a constructivist-change score was computed such that we subtracted participants original constructivist commitment score from their current constructivist commitment score. This computation provided us with an index of cha nge, with higher scores indicating therapists increasing commitment to cons tructivist epistemologies. To investigate if the entry-year to the field, numerated by the years that therapists had been in the field, account for their epistemic change, we conducted a series of hierarchical regression analyses where the independent va riable was number of years therapists had after their entry to the field following as graduates and the dependent variable was the therapists epistemic change score. Gender (dummy coded: 1 = male, and 0 = fe male) was entered into the analyses in Step 1 and years after graduation was entered in Step 2 to examine whether the year entry to the field explains variance on therapists epistemic changes when the effect of gender was controlled for. To guard against alpha inflati on, a Bonferroni correction was em ployed to establish the alpha level at .025 (.05/2), which is th e original alpha level (.05) divided by the number of statistical tests. In these regression equations, VIF statistic s ranged from 1.00 to 1.08, suggesting that multicollinearity was not present in the analyses (Myers, 1990). Examination of residual plots indicated normality, linearity, a nd homoscedasticity of residual s in the model. Durbin-Watson coefficient was 1.97 indicating independence of observations. The model failed to account for therapists changing epistemic commitments; for constructivism change score, F (2,634) = 2.19, p > .05, R2 = 0.01; for rationalism change score, F (2,627) = 2.44, p > .05, R2 = 0.01. No significant

PAGE 74

74 levels of the variance in the dependent vari ables, constructivism and rationalism difference scores, was explained by the years that therapists had entered the profession. Our data also allowed us to investigate whether the epistemic shift in the field is the result of the infusion of new therapists who were more committed to the constructivist epistemology to begin with than the seasoned therapists. To investigate this question, we compared therapists initial constructivist commitments in five cohorts (1954 to 1969, N = 21; 1970 to 1979, N = 94; 1980-1989, N = 150; 1990-1999, N = 197; 2000-2008, N = 191). We conducted a one-factor ANOVA, with cohort groups as the between-subjects factor and ther apists initial constructivism scores as the dependent variable. There wa s no significant main effect of cohort, F (4,638) = 1.55, p = .185, partial eta squared = .01. The data failed to show any significant differences in therapists initial cons tructivist commitments across cohort gr oups, again suggesting that cohort effects did not account for the epistemic sh ifts observed in our sample across time. Research Question #3: What is the Relati onship betw een Therapists Epistemic and Professional Change Experiences? We conducted a series of regression analyses to examine whether changes in therapists epistemological commitments were related to the le vels of change in thei r theoretical orientation, the plurality of their theoretical orientations or therapy styles (e xpressive, operative, and attentional dimensions). In other words, we inve stigated to what extent therapists perceived epistemic shifts would explain their current theoretical and stylistic commitments above and beyond their initial standing. To conduct this set of analyses, we first computed change scores for the epistemic variables where the THEN scores were subtra cted from the NOW scores. This index was computed for the commitment to constructivist and rationalist epistemology variables.

PAGE 75

75 We then conducted a series of hierarchical multiple regression analyses to study the main effects of the two independent variables on ea ch of the four depe ndent variables while controlling for gender (dummy coded: 1 = male, a nd 0 = female), age, and average number of clients seen weekly. The independe nt variables were the initial scores for the theoretical and stylistic commitment variables, constructivism difference score, and the rationalism difference score. The dependent variables were five professional variable s: theoretical change index, current theoretical plurality score, and current ex pressive, operative, and attentional scores. For each regression analysis, gender, age, and averag e number of clients were entered in Step 1, initial scores for the dependent variable for that particular an alysis was entered in Step 2, constructivism difference score was entered in Step 3, and rationalism difference score was entered in Step 4. In the analysis where theoretic al change index was the dependent variable, the independent variables were entered in the same order but without the initial score, given that theoretical change index has been rated only once from current perspective. Hence, only this analysis was composed of 3 steps while the ot her analyses were composed of 4 steps. Gender, age, and average number of clients we re entered in the first step as covariates. When it was applicable, the initial scores for the independent vari able were entered in the second step. Constructivism difference scores were entered in the next step to reveal whether change in therapists constructivist epistemology explains the variance on the select current professional commitments over and beyond what initial commitmen ts explain; and this would be the focal point answering our research que stion #2. Rationalism difference scor es were entered in the last step to examine whether change in therapists rati onalist epistemology explains variance on the select professional variables ove r and beyond that of th eir initial commitments and change in constructivist epistemology. A Bonferroni adjustment was employed to protect against the Type

PAGE 76

76 I error, and the alpha level for the overall regres sion analyses for each dependent variable was set at .01 (.05/5), which is the orig inal alpha level (.05) divided by the number of statistical tests. Effect size indices for multiple regression analyses was f2, defined as the R2 divided by one minus R2. The obtained f2s were evaluated according to the Cohens (1992) operational definition of small (.02), medium (.15) and large (.35) effects. To assess for the presence of multicollinearity, the variation inflation factor (VIF) statistics across the independent variables were examine d. Myers (1990) pointed out that a VIF value above 10 indicates concern for the presence of multicollinearity. In our regression equation, VIF statistics ranged from 1.00 to 1.01, suggesti ng that multicollinearity was not present. Examination of residual plots indicated normality, linearity, and homoscedasticity of residuals in the models. Durbin-Watson coefficient ranged from 2.01 to 2.17 suggesting the independence of observations. The results of the hierarchical multiple regression analysis for the four dependent variables are presented in Table 4-7. The results indi cated significant regres sion equations (i.e., p < .01 for the overall F ratio at the last step) for all of the dependent variables: theoretical change, theoretical plurality, expressive, operative and attentional scores. In the first step of the models, covariates age and number of clients seen weekly were significantly related to four different variables of interest. Age accounted for 3% of variance in both theoretical change index and expressive score, while number of clients seen weekly accounted for 2% of variance in operative score a nd for 4% of variance in attentional score. Where the theoretical change was the dependent variable, the model at Step 2 explained 5% of the variance and the inclusion of rationalist commitment cha nge into the model at the Step 3 improved the model by 2%. Overall, the model explained %7 of the variance in the dependent

PAGE 77

77 variable. Only for this model, constructivism difference score failed to account for significant levels of variance after the rationalism difference score was entered into the analysis. At the third step of this model, the F valu e for constructivism difference scor e could no longer meet the alpha of .01. For the other dependent variables of theore tical plurality, expre ssive, operative, and attentional, the models at the Step 2, at which th e initial standings were entered into the model, accounted for a significant amount of variance in the dependent variables after controlling for the variance explained by gender, age, and average nu mber of clients. The models accounted for variances in four dependent va riables between 27% and 36%. At Step 3, the model accounted for a significant amount of variance in all of the f our dependent variables af ter controlling for the variance explained by gender, age, average num ber of clients, and initial standings. The inclusion of constructivism diffe rence scores into the model at Step 3 increased the accounted variances between 3% and 7%. The model at Step 4 accounted for a significant amount of variance only in three therapy style variables afte r controlling the variance explained by gender, age, average number of clients, initial standi ngs, and constructivism difference scores. For the theoretical plurality, inclusion of rationalism difference scores failed to improve the variance explained in the dependent variable. For the th ree therapy style variables, the inclusion of rationalism difference into the model at Step 4 increased the accounted variances between 4% and 9%. The overall models accounted for varian ces in four dependent variables between 37% and 50%. To identify the location and dire ction of the effects on each of these dependent variables, we examined a standardized beta coefficient for each predictor. At the first step, the results indicated that age was positively related to particip ants ratings of their theoretical change across

PAGE 78

78 the years of practice ( = 0.15), and negatively related to pa rticipants expressive scores ( = 0.13). The standardized beta coefficients suggested that with increased age, participants tended to rate their theoretical change higher, and rate their expressive lower. Average number of clients seen weekly was negatively related to both operative and atte ntional scores ( = -0.13; = 0.15), suggesting that as participan ts caseload increased, they tende d to rate their operative and attentional dimensions lower. The second step of the models for the curren t theoretical plurality, expressive, operative, and attentional variables, revealed that participants initial standing with these variables were positively related to the dependent variables. Init ial ratings were positively related to current ratings of the variables; for theoretical plurality, = 0.57, for expressive, = 0.49, for operative, = 0.60, and for attentional, = 0.53. Higher initial ratings for the variab les predicted higher scores for the current rati ngs of the variables. The next step of the models revealed that participants increasing adherence to constructivist epistemology were positively related to three of the dependent variables and negatively related to the other two. Increasingly higher constructivism scores were positively related to theoreti cal change index ( = 0.14), theoretical plurality ( = 0.21), and expressive ( = 0.27), and negatively related to operative ( = -0.12) and atten tional dimensions ( = -0.17). Consistent with our expecta tions, therapists increasing commitment to constructivist epistemology predicted increasing change in their theoretical orientation, as well as higher levels of theoretical plurality, emotional expressive, spontaneity in conducting therapy and broadened focus in gathering information in th erapy in their current practice. The last step of the models revealed that therapists increasing adherence to rationalist epistemology was positively related to operative ( = 0.32) and attentional ( = 0.21) scores and

PAGE 79

79 negatively related to the th eoretical change index ( = -0.14), and to expressive scores ( = 0.21). Therapists increasing commitment to rationa lism predicted higher scores on operative (i.e. less spontaneous) and attentional (i.e. narrower focus), and lower scores on expressive and theoretical change index. As therapists commit ments to rationalist epis temology increased, they tended to rate their current practice as low on theoretical orientation change, emotionally expressive, spontaneity and range of focus in information gathering. Therapists increasing commitment to rationalist epistemology failed to relate to their theoretical plurality scores. The addition of the rationalism difference score to the models revealed certain changes in the variance accounted by the constr uctivism difference scores for four dependent variables. Beta coefficients for constructivism difference score d ecreased for the variables of theoretical change, expressive, operative, and attentional once the ra tionalism difference scores were entered to the model. These changes are summarized at Table 48. For the theoretical change index, the decline in the beta coefficient resulted in failure for c onstructivism difference scores to significantly account for the variance on this dependent variable The results indicated that the inclusion of both spectrums of epistemic commitment, constructivism as well as rationalism, strengthened our understanding of the complex interaction between therapists epistemic and professional change experiences. Moreover, the results sugges ted that change in therapists commitment to rationalist epistemology was a better predictor of operative and attentional scores compared to change in participants commitment to constructivist epistemology. The magnitudes of the effect sizes of the main analyses, between 0.07 and 0.98, correspond to small to large effects (Cohen, 1992). Obtained e ffect sizes suggested th at results have some practical significance in addition to statistical significance for the variables of theoretical plurality and therapy style. Effect sizes suggest ed that constructivism and rationalism difference

PAGE 80

80 scores accounted for 9% to 41% of the variability in the theore tical plurality and therapy style scores. On the other hand, effects sizes suggested limited practical significan ce for the theoretical change index. Constructivism and rationalism difference scores accounted for 4% of the variability in this variable. Table 4-1. Summary statistics of variables of interest. Variable N M SD Possible Range Sample Range SkewnessKurtosis n of items Now 675 22.43 5.30 8-40 8-38 -0.05 -0.12 8 0.69 1. TAQ-R Then 673 24.46 5.25 8-40 8-39 -0.33 0.11 8 0.70 Now 683 33.51 3.55 8-40 19-40 -0.53 0.46 8 0.58 2. TAQ-C Then 680 31.20 3.82 8-40 16-40 -0.32 0.49 8 0.64 3. TCI 663 3.05 1.12 1-5 1-5 -0.20 -0.95 1 Now 653 22.61 3.72 7-35 12-34 0.05 -0.00 7 4. TP Then 650 19.92 3.94 7-35 9-33 0.15 -0.22 7 Now 630 41.26 6.41 9-63 22-60 0.02 -0.01 9 0.59 5. EX Then 628 36.61 6.43 9-63 15-59 0.12 0.40 9 0.57 Now 659 27.49 5.78 6-42 8-42 -0.30 -0.15 6 0.66 6. EN Then 656 28.43 5.31 6-42 12-42 -0.30 0.19 6 0.61 Now 660 21.64 4.20 6-42 7-35 -0.16 0.33 6 0.35 7. AT Then 659 24.16 4.60 6-42 10-37 -0.10 0.13 6 0.45 Now 646 21.87 6.37 7-49 7-45 0.41 0.14 7 0.74 8. OP Then 646 23.57 6.97 7-49 7-47 0.40 0.00 7 0.75 Note. TAQ-R = Therapist Assumption Scale Ra tionalism; TAQ-C = Therapist Assumption Scale Constructivism; TCI = Theoretical Cha nge Index; TP = Theoretical plurality; EX = Expressive; EN = Engagement; AT = Attentional; OP = Operative; Now = Therapists current view of themselves today; Then = Therapists view of themselves when they first started practicing following the completion of their graduate training.

PAGE 81

81 Table 4-2. Intercorrelations am ong the variables of interesta. Variable 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 1. TAQ-R-Now 2. TAQ-R-Then 0.7** 3. TAQ-C-Now -0.2** -0.1** 4. TAQ-C-Then -0.1* -0.3** 0.5** 5. TCI -0.1 0.1 0.1* -0.1* 6. TP-Now -0.1* -0.1* 0.3** 0.2** 0.1 7. TP-Then -0.1* -0.1** 0.1* 0.3**-0.2** 0.6** 8. EX-Now -0.3** -0.2** 03** 0.2** 0.1* 0.2** 0.1 9. EX-Then -0.2** -0.3** 0.1** 0.4**-0.1** 0.1 0.2** 0.5** 10. EN-Now -0.2** -0.1** 0.1 0.0 0.0 0.1* 0.0 0.4** 0.2** 11. EN-Then -0.2** -0.1** 0.1* 0.1 0.0 0.0 0.1 0.2** 0.3** 0.6** 12. AT-Now 0.3** 0.3** -0.3** -0.2** 0.0 -0.2**-0.1* -0.3**-0.1** 0.0 0.0 13. AT-Then 0.2** 0.4** 0.0 -0.2** 0.2** 0.0 -0.1**-0.1 -0.3** 0.0 0.0 0.5** 14. OP-Now 0.5** 0.3** -0.3** -0.2** 0.1 -0.1** 0. 0 -0.3**-0.2**-0.2** -0.1** 0.5** 0.3** 15. OP-Then 0.3** 0.5** -0.1** -0.3** 0.1 -0.1 -0.1 -0.2**-0.3**-0.1 -0.1* 0.3** 0.5** 0.6** Note. TAQ-R = Therapist Assumption Scale Rationalism; TAQ-C = Therapist Assumption Scale Constructivism; TCI = Th eoretical Change Index; TP = Theoretical plurality; EX = Expressive; EN = Engagement; AT = Attentional; OP = Operative; Now = Therapists current view of themselves today; Then = Therapists view of themselves when they first started practicing following the completion of their graduate training. aListwise N = 537; *p < .05 **p < .01 Table 4-3. Repeated measures ANOVA summary ta ble for perceived epistemic and stylistic commitment differences across time. Variable N M SD Df F Partial eta-squared Now Then Now Then 1. TAQ-C 642 33.51 31.18 3.55 3.86 1,640 173.90** 0.22 2. TAQ-R 636 22.47 24.47 5.30 5.29 1,634 107.78** 0.15 3. EX 625 41.24 36.62 6.41 6.44 1,624 327.83** 0.34 4. EN 491 27.49 28.40 5.80 5.32 1,489 0.25 0.00 5. AT 482 21.61 24.06 4.19 4.53 1,479 12.09** 0.03 6. OP 641 21.89 23.58 6.36 6.98 1,640 48.68** 0.07 7. TP 649 22.60 19.91 3.72 3.94 1,648 395.92** 0.38 Note. TAQ-R = Therapist Assumption Scale Rationalism; TAQ-C = Therapist Assumption Scale Constructivism; EX = E xpressive; EN = Engagement; AT= Attentional; OP = Operative; TP = Theoretical plurality; Now = Therapists current view of themselves today; Then = Therapists view of themselves when they fi rst started practicing fo llowing the completion of their graduate training. **p .001

PAGE 82

82 Table 4-4. Repeated measures ANOVA summary ta ble for perceived theoretical commitment differences across time. Variable N M SD Df F partial etasquared Now Then Now Then 1. Cognitive 6614.08 3.34 1.00 1.31 1,660 202.06** 0.23 2. Behavioral 6613.48 3.10 1.19 1.41 1,660 5,718.19**0.07 3. Humanistic Existential Gestalt6583.35 3.22 1.19 1.34 1,657 9.11 0.01 4. Narrative/constructivist 6522.44 1.92 1.32 1.15 1,651 163.32** 0.20 5. Systemic Family 6593.13 2.82 1.21 1.30 1,658 43.89** 0.06 6. Psychodynamic 6603.05 2.98 1.38 1.50 1,659 2.46 0.00 7. Feminist Multicultural 6593.10 2.54 1.29 1.33 1, 658 169.24** 0.21 **p < .001 Table 4-5. Current and initial theo retical orientation endorsements. Variable Valid Percentage Now Then 1. Cognitive 27.0 23.9 2. Behavioral 4.7 12.4 3. Humanistic Existential Gestalt 8.0 16.9 4. Narrative/constructivist 4.2 1.5 5. Systemic Family 4.7 6.4 6. Psychodynamic 17.1 26.5 7. Feminist Multicultural 2.1 1.1 8. Integrationist 32.2 11.3 Table 4-6. Post-hoc analyses examining the mode rating effect of the theoretical commitment on perceived engagement differences across time. *p .01, **p < .001 Main theoretical orientation Current Initial M F M F Now Then Now Then Cognitive 25.76 27.31 13.70**26.57 27.20 2.12 Behavioral 29.00 28.86 0.02 27.68 29.22 6.36* Humanistic Existential Gestalt 28.49 28.88 0.28 27.24 28.81 9.72* Narrative/Constructivist 29.01 27.61 2.11 32.06 26.63 6.87* Systemic Family 26.62 25.47 1.31 25.76 27.17 2.59 Psychodynamic 28.83 29.34 1.08 29.18 29.47 0.51 Feminist Multicultural 30.73 28.40 1.87 27.15 29.44 0.98 Integrationist 27.32 29.01 21.71**26.25 27.70 5.63*

PAGE 83

83 Table 4-7. Hierarchical regressi on analyses showing amount of unique variance in therapists current professional standing accounted for by their initial standing and epistemic commitments. Variable T R2 F df1 Df2 R2 f2 Dependent Variable: Theoretical Change Index Step 1 Gender 0.03 0.64 Age 0.15 3.27* Weekly clients 0.04 0.87 0.03 4.49* 3 468 0.03 0.03 Step 2 Gender 0.04 0.80 Age 0.15 3.23* Weekly clients 0.04 0.80 Constructivism difference 0.14 3.17* 0.05 5.95** 4 467 0.02 0.05 Step 3 Gender 0.04 0.91 Age 0.15 3.29* Weekly clients 0.04 0.77 Constructivism difference 0.10 2.05 Rationalism difference -0.14 -2.86* 0.07 6.47** 5 466 0.02 0.07 Dependent Variable: Theoretical Plurality Now Step 1 Gender -0.07 -1.44 Age 0.00 0.07 Weekly clients 0.07 1.50 0.01 1.34 3 461 0.01 0.01 Step 2 Gender -0.01 -0.12 Age -0.01 -0.14 Weekly clients 0.01 0.34 Theoretical plurality Then 0.57 14.82** 0.33 56.35** 4 460 0.32 0.49 Step 3 Gender 0.01 0.25 Age -0.01 -0.25 Weekly clients 0.00 0.09 Theoretical Plurality Then 0.61 16.03** Constructivism difference 0.21 5.61** 0.37 54.37** 5 459 0.04 0.59 Step 4 Gender 0.01 0.20 Age -0.01 -0.26 Weekly clients 0.00 0.12 Theoretical Plurality Then 0.61 16.04** Constructivism difference 0.23 5.84** Rationalism difference 0.06 1.60 0.37 45.89** 6 458 0.00 0.58 Dependent Variable : Expressive Now Step 1 Gender -.040 -0.84

PAGE 84

84 Table 4-7. Continued. Variable T R2 F Df1 df2 R2 F2 Age -0.13 -2.75* Weekly clients 0.10 2.04 0.03 4.24* 3 438 0.03 0.03 Step 2 Gender -0.01 -0.30 Age -0.10 -2.31 Weekly clients 0.06 1.34 Expressive Then 0.49 11.90** 0.27 39.60** 4 437 0.24 0.36 Step 3 Gender 0.01 0.17 Age -0.10 -2.49* Weekly clients 0.04 1.13 Expressive Then 0.56 13.77** Constructivism difference 0.27 6.74** 0.34 43.98** 5 436 0.07 0.50 Step 4 Gender 0.02 0.37 Age -0.10 -2.50* Weekly clients 0.04 1.02 Expressive Then 0.60 14.87** Constructivism difference 0.22 5.26** Rationalism difference -0.21 -5.01** 0.37 42.85** 6 435 0.04 0.59 Dependent Variable: Operative Now Step 1 Gender 0.05 1.09 Age -0.06 -1.16 Weekly clients -0.13 -2.65* 0.02 2.99 3 447 0.02 0.02 Step 2 Gender 0.03 0.84 Age 0.01 0.35 Weekly clients -0.06 -1.47 Operative Then 0.60 15.54** 0.36 63.82** 4 446 0.34 0.57 Step 3 Gender 0.02 0.55 Age 0.03 0.68 Weekly clients -0.05 -1.25 Operative Then 0.64 16.98** Constructivism difference -0.22 -5.81** 0.41 61.55** 5 445 0.05 0.69 Step 4 Gender 0.01 0.39 Age 0.03 0.87 Weekly clients -0.03 -0.96 Operative Then 0.70 19.65** Constructivism difference -0.12 -3.30* Rationalism difference 0.32 8.71** 0.50 72.54** 6 444 0.09 0.98

PAGE 85

85 Table 4.7. Continued. Variable T R2 F Df1 df2 R2 F2 Dependent Variable: Attentional Now Step 1 Gender 0.09 1.87 Age -0.11 -2.32 Weekly clients -0.15 -3.21** 0.04 5.88** 3 456 0.04 0.04 Step 2 Gender 0.10 2.50 Age -0.03 -0.71 Weekly clients -0.12 -3.08* Attentional Then 0.53 13.48** 0.31 51.59** 4 455 0.28 0.45 Step 3 Gender 0.09 2.31 Age -0.02 -0.46 Weekly clients -0.12 -3.02* Attentional Then 0.57 14.39** Constructivism difference -0.17 -4.40** 0.34 46.80** 5 454 0.03 0.52 Step 4 Gender 0.08 2.19 Age -0.01 -0.33 Weekly clients -0.11 -2.95* Attentional Then 0.62 15.64** Constructivism difference -0.11 -2.86* Rationalism difference 0.21 5.24** 0.38 45.84** 6 453 0.04 0.61 *p .01 **p < .001 Table 4-8. Hierarchical regression beta coefficients for constructivism difference scores at steps 2, 3, and 4. Step 2/3 Step 3/4 Dependent Variable T T Theoretical Change Index 0.14 3.17* 0.10 2.05 Theoretical Plurality Now 0.21 5.61** 0.23 5.84** Expressive Now 0.27 6.74** 0.22 5.26** Operative Now -0.22 -5.81** -0.12 -3.30* Attentional Now -0.17 -4.40** -0.11 -2.86* *p < .01 **p < .001

PAGE 86

86 CHAPTER 5 DISCUSSION The discussion section is com posed of three sub-sections. First, the hypotheses and findings of the study are summarized. Second, a detail ed interpretation of th e findings in the light of literature on epistemology and therapists pr ofessional experiences is provided. And last, limitations as well as implications of the present study and suggestions for future studies are presented. Summary of Results Overall, the results of the present study supported the prim ary hypotheses regarding the change processes of therapists epistemic comm itment. Therapists ratings of their epistemic commitments reflected a greater current commitme nt to constructivism (Now) than when they began their careers (Then). Conversely, they perceived themselves as having become less committed to rationalist epistemology across the cour se of their practice. The data failed to find significant cohort effects for therapists initia l epistemic commitments and their epistemic change scores. In other words, the data s uggested that therapists perceived epistemic commitments, shifting towards gr eater constructivism (and less rationalism) across time, were not a function of when they entered the field, but rather reflected per ceived changes across the course of their careers, regardless of the na ture of their initial epistemic leanings. The results also supported the hypotheses regard ing the therapists change processes in selected professional characteristics. These prof essional characteristics included their theoretical orientation, theoretical plurality, and expressive, operative and atte ntional dimensions of therapy styles. Therapists ratings of these characteristic s indicated that they perceived themselves as becoming more pluralistic, i.e. integrationist in their theoretical orientation, and more emotionally expressive, more operatively spontaneous, and broader in attention in their

PAGE 87

87 therapeutic styles. The data failed to indicate an overall change in therapists perceived engagement style in therapy; post-hoc analyses (see below) extended our understanding of this finding. The results also suggested that perceived ch ange in epistemology predicted therapists current professional standings af ter accounting for their initia l standings. After accounting for therapists initial standings and rationalist-change scores, increase in therapists constructivist commitments predicted increased levels of adhe rence to theoretical integration and increased levels of emotional expressivene ss, operative spontaneity, and a ttentional range of therapists. After accounting for therapists initial standings and constructivism-change scores, decrease in their rationalist commitments predicted increased change in theoretical commitments as well as increasing levels of emotional expressiveness, operative spontaneity, a nd attentional range of therapists. Epistemic Journey Constructions of Psychotherapists The field of psychology and particularly psyc hotherapy has changed dram atically over years (Farber, 2005). Mahoney (1995a, 1995b) considered epistemic change among the experiences of change that the field has experi enced. Substantial anecdotal, conceptual, and casebased information (such as Ellis, 1993, 1995; Goldfried, 2001a) supported Mahoneys suggestion that the field of psychotherapy has become increasi ngly constructivist over th e course of the last 20 years. Mahoney (1995b) also noted that given th e dialectical interacti on between the field and its practitioners, changes in the field would impa ct the way psychotherapi sts practice and also perceive their practice, while their pract ice would impact the field, in return. The primary aim of the present study was to i nvestigate whether psyc hotherapists perceive such an epistemic shift within themselves as a reflection of the epistemic shift in the field. We

PAGE 88

88 specifically hypothesized increasing levels of perceived commitment to constructivist epistemology as therapists continued to develop across time. Results were consistent with this hypothesis. Therapists perceived an increase in their commitment to constructivist epistemology when they reflected on their init ial and current perspectives. Thei r perceived change experiences also entailed a reduction in th eir commitment to rationalist epis temology across their practice. These findings can be interpreted analyzi ng Mahoneys (1995a, 1995b) assumptions, as well as the available literature supporting Ma honey. The constructivist worldview assumes complexity and interdependency of human experi ences and social systems. Therapies guided by constructivist epistemology are committed to appreciation of complexity, and in-depth processing of client emotions and experi ences (Nagae & Nedate, 2001; Vasco, 1994; Viney, 1994; Winter & Watson, 1999), and they tend to have higher levels of self-exploration, attendance to emotions, openness and tolerance in therapists (Neimeyer & Aksoy, 2005). Various prominent psychotherapists, such as Albert Ellis (1992a, 1999), Donald Meichenbaum (1993), Aaron Tim Back (2002; Bloch, 2004), and Michael Mahoney (1991), had suggested their increasing levels of constructivism implicitly in their descriptions of their own professional development across time, with prac tices becoming more eclectic and complex in relation to their work with their clients. At cer tain times, they explicitly identified their change processes as reflecting an epistemic shift a nd an increasing commitme nt to constructivist epistemology (Ellis, 1990, 1995; Meichenbaum, 1990; Mahoney, 2001). Studies conducted on therapis ts career developments also have recounted change processes that indicated the de velopment of characteristics acro ss years that might parallel increasing commitment to constructivist epis temology (Rnnestad & Skovholt, 2003). Increased practice and experience in the field translated to therapists increasi ng likelihood to reject

PAGE 89

89 precisely defined realities and embrace complexity and flexibility in the ways they understood and reached out to their clients. The current st udy indicates that psychotherapists also perceive this trend of increasing commit ment to constructivist epistemology within themselves. Rationalist and constructivi st epistemologies are largely complementary and their differences reflect upon the way therapy is conceived and conducted (Lyddon, 1988; Mahoney & Gabriel, 1987; Mahoney & Lyddon, 1988). Rationalist epistemologies tend to assume a stable, single, universal reality and therapists commitme nt to rationalist epistemology translates into their practice with an aim to corre ct the clients faulty cogniti ons of reality through a relatively straightforward approach (Nagae & Nedate, 200 1; Vasco, 1994; Viney, 1994; Winter & Watson, 1999). Higher levels of rationalist commitments we re also linked to lower levels of selfexploration, openness, and tolerance in therapists (Neimeyer & Aksoy, 2005). Career development studies have indicated that therapists tend to reject precisely defined realities, and embrace complexity and flexibility in the ways they conceptualized and conducted therapy over the course of their developmen t as professional pract itioners (Rnnestad & Skovholt, 2003). These changes are consistent with a greater alignment with constructivist commitments. We might expect that therapis ts increasing commitment to constructivist epistemologies across the course of their deve lopment would be associated with corresponding decreases in complementary epistemologies such as rationalism. Hence, the finding of perceived weakening in therapists rationa list commitments is consistent with overall increase in constructivist leanings in the current study. The current study reveals that la y psychotherapists also percei ve this trend of increasing commitment to constructivist epistemology within themselves. When therapists reflected on their current and initial experiences, they observed an increase in their constructivist commitments

PAGE 90

90 and a decrease in their rationalist commitments. Next, we inves tigated the degree to which cohort effects underlie epistemic changes of the therapists and the field. Cohort Effect on Perceived Changes on Epistemic Leanin gs Existing literature agrees that the field is shifting in its epistemi c commitments (Mahoney, 1995a, 1995b) and the current study pr ovides support for this clai m from the perspective of practicing psychotherapists. Changes in the field and the changes of its members are reciprocal. The change in the field impacts its existing me mbers as well as those who enter the field recently, while the existing members change processes further impacts the field. As Farber et al. (2005) noted, the changes in the field impacts therap ists such that those w ho enter the field at a certain time might be different than others who have entered the field at an earlier era. Therapists entering the field recently might differ from seasoned therapis ts in their motivations or aspirations (Farber et al., 2005). Similarly the epistemic commitments of those therapists who entered the field recently might be different than their seasoned colleagues as a part of the epistemic change of the field of psychotherapy. In fact, it can be suggested that the epistemic journey of the field with its increasingly postmodernist perspective can be a reflection of the recent cohorts greater commitment to constructivism and postmodernism. At the same time, a review of studies on caree r development of practi tioners suggested that individual change processes of th e members of the field are system atic in nature, are independent from the cohort to which practitioners bel ong to or their experience level (Rnnestad & Skovholt, 2003), and include themes of increasin g commitment to constructivist epistemology. In other words, from the perspective of career development theories, the fields epistemic journey might be a reflection of the therapists individua l change processes. It is also possible that such individual change processes are subject to cohort effects such that certain groups of

PAGE 91

91 practitioners who entered the fiel d at a certain era might have a different epistemic journey due to the nature of the field at that time. Given the lack of empirical l iterature on this topi c, the current study aimed to provide an initial understanding of the complex dynamics unde rlying the fields and therapists epistemic shift. The current study explored to what extent the perceived epis temic shifts can be attributed to cohort effect facilitated by th e more recent infusion of post-modern therapists to the field versus the perceived individual change processes of psychotherapists across time. Within the limits of the current study, we focused our attenti on to two specific areas that might shed light on the proposed question. First, we examined whet her or not different cohort groups predicted differences in the levels of th erapists initial levels of cons tructivist commitments. If cohort effects were strong, this might suggest that the overall shift in the field towards greater constructivism was due to the more infusion of ne w therapists into the field, who carried with them greater constructivist commitments. Relate dly, we examined the data to see whether the different cohort groups predicted the ways in whic h therapists changed in their epistemic shifts, in order to understand the degr ee to which the entry year to profession colors the epistemic change processes of therapists (did older, or younger therapists change more, for example?). The results failed to suggest sign ificant cohort effects either fo r therapists in itial epistemic commitments or for their epistemology change scores. Therapists initial commitment to constructivism, as they construed it, has been similar across the ye ars of entry to the field. Hence our data indicates that the fi elds increasing commitment to c onstructivist epistemology cannot be explained via the influx of those therapists with post-mode rn tendencies and/or trainings. Therapists initial commitment to rationalism has also been sim ilar across years suggesting that

PAGE 92

92 therapists epistemic commitments at the time that they have entered the field cannot be differentiated by the time in which they have entered the field. Data also failed to support if therapists year of entry to the field colored their epistemic journey. For the group of therapists in this study, therapists change in their epistemic commitments was independent from the era in wh ich they have been trained and entered the profession. The results failed to support the notion that cohort effects might underlie epistemic change processes of therapists and of the field. Overall the obtained results may imply that therapists individual processes play a dominant role in therapis ts epistemic journey rather than the cohort effects. This is consistent with our review of the career development literature, where greater constructivist commitment appeared to be a part of pract itioners professional change pr ocesses. For instance, Rnnestad and Skovholt (2003) suggested that therapists career development involved increased conceptualization of knowledge as a construction and decreased use of precisely defined realities in understanding clients, which are not only consis tent with constructivist perspective, but also indicative of increasing commitment to construc tivist epistemology across the therapists course of practice. Theoretical and Stylistic Change Constructions of Psychotherapists Change concerning ther apists is not limited to their personal epistemo logies but includes professional attributes as well. When they re flected on their initial and current experiences, therapists revealed change in certain professi onal aspects such as theoretical plurality and therapy style. Theoretical Change Theoretical change acro ss practic e is considered a widespread experience for contemporary psychotherapists (DeAngelis, 2006, p. 59). This trend was also evident in the current study.

PAGE 93

93 Overall, therapists perceived st atistically significant and mode stly robust increases in their commitments to cognitive, constructivist, and femi nist-multicultural therapies. There were also significant increases in behavioral and decreases in commitment to systemic-family therapies, although these changes were failed to be robust, as suggested by th eir low effect size indices. When therapists were asked to identify one theo retical orientation as their primary orientation, a similar trend has emerged where commitments to cognitive, narrative-cons tructivist, feministmulticultural and integrationist perspectives strengthened over time. These results are consistent with the current trends where cognitive, constructi vist, multicultural, and integrationist theories are more prevalent for therapists as their main base (Norcross et al., 2002). The most notable change in the realm of theo retical orientation is the fields increasing openness to theoretical integra tion and technical eclecticism (G oldfried, 2001a; Norcross et al., 2002; Norcross, 2005). One of the aims of the present study was to investigate whether psychotherapists perceive such a theoretical shift within themselves. We specifically hypothesized increasing levels of perceived theoretical plurality as therapists developed across time. Results consistently supported this hypothe sis. Therapists report ed statistically and clinically significant increases in the variety of theoretical orientations that they employed in their practice. Rnnestad and Skovholt (2003) provided an explanation for therapists theoretical shift that mostly entails integration of a number of theoretical orientations. Increasing practice in psychotherapy enhances the congruity between th erapists personality a nd their the ways in which they conduct therapy. Therapists changing th eir theoretical orientati on can be an indicator of such an increased integration and congr uency. Rnnestad and Skovholt (2003) further suggested that as therapists theo retical adherence shifte d, their therapy style may shift in certain

PAGE 94

94 ways. Next, we summarize what the current study revealed about therapists perceived change experiences in the ways in which they conduct therapy. Stylistic Change Preliminary evidence suggesting the change in therapy style across the years of practice was provided by Castaeiras et al .s (2006) study where expert a nd beginner therapists showed differences in certain aspects of their therapy styles. Therapist professional development studies (Jennings & Skovholt, 1999; Martin et al ., 1989; Rnnestad & S kovholt, 2003; Skovholt & Jennings, 2004) and personal narrat ives of seasoned therapists (Goldfrie d, 2001a) also supported the assumption that therapists styles might change with experience. The aim of the present study was to investigate whether psychotherapists perceive such stylistic shifts within themselves and to provide further support for the existing literature. We specifically hypothesized increasing ly higher levels of perceived expressive and engagement scores, and lower levels of percei ved operative and attentional scor es as therapists became more experienced. In other words, we expected therapists to perceive themselves to have increased in their (a) expressing emotions to their clients, (b) commitment to therapy and clients, (c) spontaneity in the way of implementing interven tion, and (d) range of attention when gathering information from clients. Results supported three of the four hypotheses. Therapists reported increases in their expressive and decreases in their operative and attentional dimensi ons of therapy styles. In other words, across the course of thei r practice therapists perceived statistically significant and robust increases in their emotional closeness and expr essiveness to their clients, increases in the spontaneity with which they conducted therapy and increases in the ra nge of attention and activity in gathering information. Results failed to indicate any ch ange in therapists degree of

PAGE 95

95 commitment to therapy and engagement with c lients, i.e. engagement dimension of therapy styles. The obtained results were mostly consistent with the literature. Castaeiras et al.s (2006) study on differences between expe rt and beginner therapists in therapy style, therapist professional development studies (Jennings & S kovholt, 1999; Martin et al., 1989; Rnnestad & Skovholt, 2003; Skovholt & Jenni ngs, 2004), and personal narratives of seasoned therapists (Goldfried, 2001a) concluded that therapists become more emoti onally expressive, operatively spontaneous, and broader in their therapeutic attention across the course of their practice. Castaeiras et al. (2006) found th at expert therapists who were identified with cognitive orientation were more emotionally closed to wards their clients compared to beginners. Additionally, Jennings & Skovholt (1999; Skovho lt & Jennings, 2004) described master therapists as having strong emotional skills such as emotional receptiveness, ability to attend to self and others emotions and r ecognition of the ways in which their own emotions impact their work. These findings supported the findings noting that therapists perceived their emotional expressiveness to strengthen over th e course of their practice. Castaeiras et al. (2006) found th at expert integrative therap ists were more spontaneous in implementing interventions compared to be ginners. Likewise, Rnnestad and Skovholt (2003) suggested that as therapists matured, they grad ually developed an internally-based flexible professional functioning. This inferred flexibil ity across professional development was aligned with the findings that expert therapists were more spontaneous in implementing interventions. The narrations of 16 experienced psychotherapists also described their process of breaking free from their original teachings and developing inte grative, expansive, pliable ways of being and doing in their therapeutic work (Goldfried, 2001a). Overall, the results of our study support the

PAGE 96

96 broader literature regarding therapists increasing spontane ity over the course of their professional development and practice. Castaeiras et al. (2006) found that beginning integrative an d psychoanalytic therapists endorsed a significantly narrower focus and search for a specific realm of knowledge than their expert counterparts. Experienced therapists tended to conceptua lize their clients at a broader level and in a more inclusive manner (Martin et al., 1989). The internally-based flexible professional functioning of expert therapists was also aligned with therapists being more broadly focused and open-minded while listening to client material In their narrations, practitioners also reflected on their professional change processes where they have increased in flexibility, and broadened their understanding and a ppreciation of client concerns (Goldfried, 2001a). Overall, the finding of therapists increasing ra nge of attention in information gathering across their practice is consistent with the literature. Yet, it is im portant to note the low reliability rates obtained for the current and initial attent iveness scores since these rates raise questions regarding the validity and interpreta tion of the obtained findings. We expected therapists to report increased commitment to therapy and to their clients across their practice, yet the data failed to support our expectations of increased engagement scores across years. One plausible explanati on may be the relatively high initial ratings of engagement dimension of therapy style. Within the possible range of 6 to 42, participants average engagement-now score was 27.49 and engagement-then score was 28.40. Although there was potential for them to score higher, no other dimensions of therapy style in the study has passed the 65 to 67 % rating figure that was achie ved by the engagement scores. In other words, the datas failure to indicate any increase in engagement dimension of therapy style might stem from the fact that therapists perceived themselves highly committed to therapy and engaged with

PAGE 97

97 their clients starting the beginning of their careers, leaving less of a room for growth or increase on this domain. The ceiling effect may also explain the reduction on the average of the engagement score from then to now, although this di fference failed to be clin ically significant. If therapists had hit the maximum of their care a nd concern for their client s starting their careers, they might experience a slight decline in thei r engagement level across the course of their practice. Castaeiras et al.s (2006) study may also aid our understandi ng of the datas failure to support our hypothesis regarding increased therapis t engagement across practice. Specifically, Castaeiras et al.s (2006) study indicated that differences acro ss experience levels emerged for the dimension of engagement only for those therap ists who were identified as integrationist, but not for psychoanalytic or cognitive therapists. In our analyses, we investigated the change experiences of all participated therapists without controlling for their theoretical commitment, and that might have masked the therapy style ch anges for therapists with specific theoretical commitments. Post-hoc analyses were utili zed to investigate if differences across experience levels emerge for the dimension of engagement only fo r those therapists with certain theoretical orientation. Data confirmed the interaction between theoretical commitments and time on therapists levels of engagement. For therapists that identify their current theoretical commitment as cognitive and integrative, engagement levels have declined across their practice while no significant changes appear for therapists with other theoretical commitments. For therapists that identified their initial theoretical orientation as behavioral, humanistic-exi stentialist-gestalt, and integrative, engagement levels have declined acro ss their practice. For therapists that identified their initial theoretical orientation as narrative/co nstructivist, their engagement levels seemed to

PAGE 98

98 increase across their practice. Possible explana tions of these effects were drawn from the literature. Overall, findings supported the explanation that therapists stylistic changes may be moderated by their theoretical commitments (Castaeiras et al ., 2006), masking the engagement changes when combining responses of therapists with different theoretical commitments. The obtained results revealed that the therapy style changes happen in a complicated fashion, where different theoretical orientations currently held or held in the past, may impact perceived changes in therapy styles in different ways. While Castaeiras et al. found that expert level integrationist th erapists had higher levels of engagement scores than beginners our findings indicate that therapists who were initially or currently identified their theoretical orientation as integrative perceived themselves to have decreasing levels of engagement across years. The difference might be a result of the methodological differences between the two studies. First, the two studies differ in the ways in which therapists theoretical commitments were determined. Castaeiras et al. assigned theoretical orientation to the therapists who par ticipated based on their de scriptions of how they conduct therapy; on the other hand, in the curr ent study, it was the participants themselves (rather than the researchers) who identified their main theoretical commitments with no descriptions of how they conduc t therapy or what these orient ations that th ey selected particularly mean to them. Second, the two st udies differed in the number of theoretical orientations that were included in the analyses. Castaeiras et al. grouped theoretical orientation into 3 orientations; on the other hand, the current study expanded the options to 7 orientations that might have captured the complexity of the interaction in-depth. Thir d, the two studies differ in their comparison groups and conducted analyses. Castaeiras et al. compared expert

PAGE 99

99 therapists therapy style to beginner level therapists therapy st yle, where beginner was defined as therapists with up to 5 years of experience and experts as therapists with 15 years of experience or more. However, the current study co mpared the same therapists ratings of their initial and current therapy style that included an average of 20 y ears of experience (ranging from 1 year to 52 years). Decreasing levels of engagement that were found for therapists who were initially committed to behavioral, humanistic, integrat ive and currently committed to cognitive and integrative therapies was mostly inconsistent with the literature. But this finding may be explained with the literature of therapist distress and burnout. Conducting psychotherapy can be a distressing endeavor due to various sources of distress ranging from economic uncertainty to working with complex issues where it is diffi cult to define success (Kramen-Kahn & Hansen, 1998). Conducting therapy has been recognized among factors contribut ing to the burnout (Kestnbaum, 1984; Grosch & Olsen, 1994) that has been defined as to fail, wear out, or become exhausted by making excessive demands on ener gy, strength or resour ces (Freudenberger, 1974, p. 159). Depersonalization that refers to uncaring and un feeling attitudes towards others, especially clients was identif ied among the central features of burnout (Maslach, Jackson, & Leiter, 1996). The reduced commitment to therapy and clients may be related to an increase in therapists depersonalization experience that may follow the taxing years of practice. It is important to note that pr evious research on burnout has failed to demonstrate a direct relation between burnout experien ce and theoretical orientati on (Raquepaw & Miller, 1989). Yet researchers argue that certain ther apeutic approaches can be contri buting to the therapists levels of stress through their demands a nd effectiveness (Horner, 1993) Similarly, our findings of decreased levels of engagement for therapis ts with initial commitments to behavioral,

PAGE 100

100 humanistic, integrative therapy, and current commitments to cogni tive and integrative therapy might be a result of the distress and minor experien ces of burnout for partic ipated therapists. The hypothesis of the study that predicted incr easing levels of engagement across practice was supported only for the therapists who were iden tified their initial theo retical orientation as narrative/constructivist. Those therapists were th e only group of therapists in the study that perceived their commitment to therapy and client s increasing across the y ears of their practice. The nature of narrative-construc tivist therapies can be explored to understand this outcome. Constructivist therapies refrain fr om one-way construction of the et iology and cure of the client concerns, they promote experiential as well as cognitive growth, and they value a highly humanized relationship with clie nts that is subjective, personal and emotional (Mahoney & Gabriel, 1987; Mahoney, Lyddon & Alford, 1989). Th ese qualities can buffer against the distress of conducting therapy and can facili tate therapists commitment to therapy and their levels of engagement with their clients as they have been seasoned in their practice (F reudenberger, 1974; Norcross, 2000). Overall, our results concur with Castaeira s et al.s (2006) study and therapist career development studies that therapists become skillful in communicating their emotions, relax in their style and become more spontaneous in the wa y they operate as therapists and broaden their attentional focus in collecting data as they season in the profession and gain expertise. Change in therapists levels of engagement was more complex for therapists such that their theoretical orientations colored their change experiences. For therapists curre ntly identified with cognitive and integrative orientations, and initially identi fied with behavioral, humanistic-existentialistgestalt and integrative orientati ons, engagement levels reportedly declined across their practice.

PAGE 101

101 Our initial hypothesis of increasing engagement across practice held true only for those therapists who were initially identified with narrative/constructivist orientation. Association between Epistemic and Pr ofessional Change Constructions Epistem ology has been associated with certain schools of thought and theoretical orientations (Lyddon, 1989a; Lyddon & Adamson, 1992; Neimeyer et al., 1993; Neimeyer & Morton, 1997; Schacht & Black, 1985). Epistemology has also been associated with the ways in which therapists conducted therapy (Nagae & Nedate, 2001; Vasco, 1994; Viney, 1994; Winter & Watson, 1999), including the therapy style dimens ions of expressive, engagement, operative, and attentional (Neimeyer & Saferstein, 2006). The literature indicated that epistemic, th eoretical and stylistic commitments were associated. The current study indi cated that therapists epistemi c, theoretical, and stylistic commitments were perceived to change across the course of their practice. Given that change of any sort can facilitate other cha nges (Stricker, 2001, p. 79), we in tended to explore if epistemic change accounts for or aligns with therapists theoretical and stylisti c change experiences. We hypothesized that increases in therapists cons tructivist commitments would predict (1) greater changes in thei r theoretical orientati on throughout their career; (2 ) greater adherence to theoretical integration and eclecticism; and (3) therapy styles marked by higher levels of expressiveness, client engageme nt, attentional focus and operative spontaneity. Since the data failed to indicate engagement diff erences across the years of practi ce, we excluded this variable from the analyses. Results were mostly consiste nt with our expectati ons. After accounting for demographic variables and initia l standings, therapists increasing commitment to constructivist epistemology predicted high ratings for theoretical orientation change scale, as well as higher levels of theoretical plural ity, higher levels of emotiona l expressiveness and operative

PAGE 102

102 spontaneity in conducting therapy and broader focus in gathering in formation in therapy in their current practice. Although no specific predictions were made, th e ways in which changes in rationalist commitments predict therapists professional standings were also investigated. Results suggested that therapists increasing commitment to ra tionalist epistemology pr edicted lower ratings on theoretical orientation change scale, lower le vels of emotional expr essiveness and operative spontaneity and narrower focus in information ga thering. Rationalist change scores accounted for the variance in these variables even after the co nstructivist change scores were entered into analyses, suggesting that, taken together, therapis ts epistemic journeys better explained the ways in which therapists ended up on their theoretical and stylistic dimensions than did either epistemic orientation alone. Overall, epistemological change processes pred icted where therapists have reached in their theoretical and stylistic commitments even after accounting for their initial commitments. These results are consistent with the literature. The fi ndings are explored in depth, first for theoretical and next for stylistic commitments of therapists. Epistemic and Theoretical Change Epistem ology has been associated with theore tical orientation. Not only certain epistemic commitments were conceptually tied to certain theoretical orientati ons (Lyddon, 1991), but also epistemic commitments accounted for therapists theoretical orientation preferences (Lyddon, 1989a; Lyddon & Adamson, 1992; Neimeyer et al., 1993; Neimeyer & Morton, 1997; Schacht & Black, 1985). The results of th e current study supported and exte nded the relationship between theoretical orientation and epistemology by indicati ng that as therapists have perceived greater commitment to constructivism across the course of their practice, they indicated higher levels of theoretical orientation change and high er levels of theoretical plurality.

PAGE 103

103 Those therapists, who shift in their epistemic journey towards increased constructivism tended to experience more change in their theore tical commitments and they were more likely to integrate a variety of theoretical orientations in their conceptualizations. Constructivist metatheory recognizes the complexity of human processes (Mahoney & Gabriel, 1987). Similarly, higher levels of constructivist co mmitments predicted hi gher levels of selfexploration, openness, and tolerance in therapists (Neimeyer & Aksoy, 2005). Therapists becoming increasingl y constructivist might mean in creasing appreciation of the complexity of human processes, increasing tole rance for the complexity and increasing openness to integrate different perspectives on their part Such changes, then, would be consistent with their openness to change the ways in which they have framed their work and to integrate a variety of theoretical orientat ions in their therapeutic work. As therapists constructivist commitments grow stronger, their openness for sampling different theoreti cal orientations and for integrating different orient ations might grow stronger. It is significant to note that the current st udy establishes an associa tion between the fields two significant trends, namely its increasi ng commitment to constructivist epistemology (Mahoney, 1995a, 1995b) and theore tical integration (Goldfrie d, 2001a; Norcross et al., 2002; Norcross, 2005). Although it is be yond the scope of this project to attain causality to this interaction, it is most likely that a dialectical relationship exists between these trends. As therapists embraces the complexity human change processes, they might utilize complementary orientations in junction to facilitate clients change processes. The c onstructivist mindset would allow therapists to combine various orientations in idiosyncratic ways. Increasing theoretical plurality, in return, might lead to increased appreciation of dive rsity and complexity of involved processes, and hence may solidify therapists constructivist commitments.

PAGE 104

104 On the other hand, participants who shifted in their epistemic jour ney towards increasing rationalism tended to experience less theoretical orientation change. The nature of rationalistic epistemology can be defined as relatively determined, definitive, and confident in understanding and helping clients (Mahoney & Gabriel, 1987) Similarly, higher levels of rationalist commitments predicted lower leve ls of self-exploration and ope nness in therapists (Neimeyer & Aksoy, 2005). Hence, therapists with increa sing rationalist commitments might be less compelled to explore other theoreti cal orientations and change thei r theoretical commitments. It is also important to note that th e data indicated a decrease in rationalist epistemology in general which would translate to further increase in pr actitioners theoretical change experiences. Rationalism change experience did not account for the degree to which therapists have integrated different theoretical orientations. Fo r our participants, changes in their rationalistic commitments did not translate to their tendency to integrate a number of theoretical orientations. Considering the nature of the rationalist epistemology, one might expect to find decreasing plurality with increasingly higher levels of com mitment to rationalism. The failure of the data to indicate such might be a result of other influences dominating the field. For instance, increasing valuing for and occurrence of th eoretical integration might have outweighed the possible impact of rationalist epistemology despite the nature of rationalist epistemology might conflict with the use of a variety of lenses in conceptualizing therapy. Epistemic and Stylistic Change Epistem ology has been associated with thera py style. Therapists conducting rationalist and constructivist therapies differed in the way they set the direction of the therapy, related to client, and conceptualized and worked through clients emotional distress, relapse and regression (Nagae & Nedate, 2001; Vasco, 1994; Viney, 1994; Winter & Watson, 1999). Moreover,

PAGE 105

105 therapists with different epistemic commitments appeared to have diffe rent styles in their therapeutic closeness, focus, engagement, and spontaneity (Neimeyer & Saferstein, 2006). The results of the current study supported a nd extended the relationship between therapy style and epistemology by indicati ng that therapists ep istemic journey predicted their current stylistic standings. As therapists have perceive d greater commitment to constructivism across the course of their practice, they indicated higher levels of emoti onal expressiveness with clients, higher levels of spontaneity in conducting ther apy and broader focus in gathering information. Moreover, perceived decrease in their commitment to rationalism across the course of their practice accounted for additional variance in predicting higher levels of expressiveness and spontaneity and broader focus. These findings are consistent with the liter ature investigating th e relationship between epistemology and therapy style. Expressive, operative, and attentional dimensions of therapy style have been associated ther apists epistemic commitments. Neimeyer and Saferstein (2006) established that higher c onstructivist commitments related to higher levels of expressive (i.e. increased emotional openness and closeness to clie nts), lower levels of ope rative (i.e. increased operative spontaneity in conducting therapy) and lower levels of a ttentional (i.e. broader range of attention in therapeutic information gathering). Other studies further supporte d the link between epistemology and therapy style. With respect to expressive dimension, Viney (1994) suggested that therapists conduc ting constructivist cognitive therapies tended to acknowledge their clients negative emotions more compared to rationalist cognitive therapists. Moreover, Winter and Watson (1999) suggested that constructivist therapists might tend to be more communicative of unconditional positive regard to their clients than rationalist therapists. With respect to operative dimension, Vasco (1994)

PAGE 106

106 established that more the therapists are committe d to constructivist epistemology, less they lean on therapeutic structure and direction. Overall, our data extended the translation of epistemology into practice by suggesting that therapists epistemic journey in the form of increasing commitment to constructivism and decreasing commitment to rationalism would account for where therapists fi nalized their journey on expressive, operative, and attentional dimensions of therapy style. Discussion of how our findings are supported by the literature may be strengthened by utilizing the literature associat ing therapists personal characteristics with their epistemic commitments where higher levels of constructivist commitments pr edicted higher levels of selfexploration, attending to emotions, ambiguity tolerance and openness in therapists, and yet higher rationalism scores predicted lower leve ls of these characteris tics (Neimeyer & Aksoy, 2005). Therapists personal characteristics may f acilitate therapists change processes. For instance, increasingly constructivist therapists may tend to have strengthened commitment to self-understanding as well as attend ance to their emotional processes, which might facilitate their emotional expressiveness in the session and em otional closeness to their clients as well. Similarly, those who are more incr easingly open to and tolerant of ambiguity may be more likely to welcome a broad attention to variety of areas and concerns in their information gathering processes and may operate w ith increasing spontaneity in their therapeutic work. Therapists increasing commitment to constructivism and decreasing commitment to rationalism, then, may translate to higher levels of expressive, operative, and attentional through facilitating individual change proc esses that might relate to stylistic commitments (and future studies can explore this). Overa ll, the finding that increased constructivism predicts emotional expressiveness, spontaneity and range of atten tion positively across the course of therapists

PAGE 107

107 practice seems to be consistent with the personal characteristics that mirrors the assumptions of constructivist epistemologies. It is important to note that when both episte mologies were entered into the analyses, the results were more robust and so mewhat different than the re sults of analyses with only constructivist epistemol ogy. For instance, after including rati onalist commitment change score, constructivist commitment change score lost some of its power to account for the variance in the professional variables of intere st. For theoretical change inde x, the change was substantial enough for the constructivism-change score to lo se its statistical si gnificance. Moreover, rationalist-change journey of therapists seemed to be a better predictor of operative and attentional dimensions of therapy style than th eir constructivist-journey. Decrease in rationalist commitment across therapists cour se of practice predic ted the increase in s pontaneity and range of focus much strongly than increase in constructivist commitment did. Our focus on the distinction betw een constructivist and rationa list epistemologies aimed to enhance our understandings of the ways in which epistemological change accounted for professional commitments. As Mahoney (1995b) s uggested, our interest was on the potential contribution that rationali st-constructivist contra st may offer to emerging theory and research relating the cognitive sciences and clinical se rvices (p. 9). Complementary ways of acquiring and evaluating knowledge and understanding th e world are equally valuable (Lyddon, 1989b), and as it is shown in this st udy, the rationalist-constr uctivist contrast serv es us with a better understanding of how epistemic worldview relates to theoretical and stylistic commitments. Limitations In this section, we noted som e significan t sampling, instrumental, procedural and methodological limitations of this study that might have hindered the exte rnal validity of the

PAGE 108

108 findings. First, the obtained data might have been provided by a biased sample and its generalizability must be questioned. Those who volunteered to participate in this study might have been different from non-volunteers in the ch aracteristics of interest as indicated by the behavioral research (Rosenthal & Rosnow, 1991). Furthermore, the collec ting data via Internet through online survey may have widened the gap between those who volunteered to participate and those who did not. However, research failed to find difference in part icipant responses when compared to online data collection methods to paper-pencil methods (Gosling et al., 2004). We cannot determine the representativeness of our population as a sample due to the information restrictions as we ll as the snowballing that might have happened through invited professionals forwarding the in vitation email to other colleague s. Yet, our population that was mainly composed of practitioner psychologists has a strong resemblance to the demographic make-up of the members of the American Psyc hological Association (APA) that identified themselves as practitioners (http://research.apa.o rg/prac_profile_12-7-07.pdf, 2007). In 2007, APA members reported to be approximately 57.8% female and 42.2% male, and similarly 59.5% of the population of the current study was fe male and 40.5% of the sample was male. APA members mean age was reported as 50.4 ( SD = 10.7), and in the current study, the mean age of participants was 50.36 ( SD = 11.7), which is again comparable. Ethnicities in the current study were Caucasian, 88.6% (vs. 93.3% of APA) Hispanic, 3.6% (vs. 2.7%), AfricanAmerican/Black, 2.4% (vs. 1.3%), Asian-America n, 1.2% (vs. 1.8%), and multiracial, 1.2% (vs. 0.6%). Such similarities in the demographic composition of a part of the sample (i.e. psychologists) and obtained population is encouragi ng with respect to exte rnal validity of the obtained findings.

PAGE 109

109 Generalizability of the findings was hamper ed by the self-report na ture of the present study. Self-reports are subject to distortion and social desirab ility. The postmodern zeitgeist might prompt therapists to provide answers in line with the constructiv ist viewpoint even though they might not have internalized this standpoint or transferred their assumptions to therapy room. Moreover, self-reports may not correlate well wi th the participants actual behavior or experience (Rosenthal & Rosnow, 19 91). It is important to consider that what therapists claim they do in therapy sett ing might be quite different from what they actually do. The personal narrations of certain well-known therapists could f acilitate our understandi ng in this matter. For instance, Albert Ellis noted repeatedly that he was committed to constructivist epistemology and his therapy was constructivist in nature. Yet other researchers such as Mahoney and Meichenbaum (see Zeig, 1992) had s uggested that a closer inspec tion to the basic assumptions and operations of REBT, and Ellis s himself, indicated the contrar y. The variables of interest in the current study such as epistemic commitment, theoretical orientation and therapy style are subject to such misconstructions where se lf-reports do not correlate with behavior. The current study asks participants to provi de self-reports for not only their current experiences but also for their experiences that took place during the time frame that they have first started practice afte r graduation from their highest degr ee. Hence the limitations of selfreport studies might have been further compli cated by memory biases. The literature on cognitive psychology, specifically on recall, indicated that our memo ry is far from impartial and subject to bias (Schacter, 1999) Certain facts can be construe d as years move on and more experience is gained. Hence, it must be clear to our reader that this study is based on the constructions of professional prac titioners as they had recalled themselves to be in their

PAGE 110

110 professional start point and as of today, and caution must be exerted while interpreting the obtained findings to not to equate these findi ngs as the reality of the practitioners. Another significant methodological limitation of the study is the number and nature of the measures employed to collect th e data regarding the variables of interest. Our understanding of how therapists epistemic journeys parallel th eir professional journey could be improved through employing additional measures or indicators of therapy style and theoretical orientation as well as measures of other professional variables. Providing an operational definition for the theoretical orientations cited on the survey would also further th e depth in which we interpreted the findings. Such engagements would also enhan ce the validity and viabil ity of the findings. Another limiting factor to the current study is its efforts to approximate a longitudinal research question through a cross-sectional research design. A lthough collecting data regarding the times that practitioners first started thei r professional journey pr ovides us with a quasilongitudinal data, the present study was far from detailing practitioners journey, which threatens its validity. Moreover, we have da ta regarding the two positions across therapists practice with little or no information regarding the trajectories that took place between thei r initial and current experiences. Ideally, the inquiries posed in this study would be answered by longitudinal studies with multiple data collection points. The logistical difficulties and limitations associated with the longitudinal studies did not allow us to conduct a longitudinal study where we would be able to track psychotherapists from the beginning of their practice for year s. Such studies are needed in the future to deepen our unde rstanding of practitioners epis temic and professional journey. It is also important to note that the obtained findings are simply associations between the variables of interest and do not imply causal relationships. For in stance, perceived decrease in therapists rationalist commitment was associated with increase in their theoretical change

PAGE 111

111 experiences; however we cannot claim that change in therapists epistemologies cause them to have increasing experiences of theoretical change Obtained results only suggest relationship, not necessarily causality. Significance and Directions for Future Research Despite the apparent lim itations detailed above, the present study is an important addition to the current literature on epistemology and psyc hotherapist experiences for a variety of reasons. In this section, first we highlight the contributions of this study to the field and then we explore the directions that future research can pursue following the lead of this study. The current study is the first study investigating therapists epistemic journey. Our findings present empirical support for th e claims of Mahoney (1995a, 1995b) and extend the literature on epistemology as participated therapists pe rceived themselves to become increasingly constructivist and decreasingly ra tionalist across the course of their practice. The current study also presents a preliminary empirical expl oration for the dynamics underlying therapists epistemic shifts. Specifically, it suggests that therapists career development trajectories, rather than their year of entry to th e profession, color their epistemic journey. Moreover, it provides the first empirical argument against the claim that the fields increasing commitment to constructivism is a reflection of the infusion of therapists with stronger constructivist commitments. This study also extends our understandi ng of the ways in which therapists epistemic journey is related to their professional experiences, sp ecifically their theoretical and stylistic commitments. As Meichenbaum (1993) suggested, the stor y on which the theory and practice of psychotherapy has been based continues to unfold and to change (p. 204) Field continues to rely increasingly constructivist principles, cultura l values and theoretical integration (Goldfried,

PAGE 112

112 2001a; Norcross et al., 2002; Norcross, 2005; Norcross, Hedges, & Prochaska, 2002). Recognizing the ways in which our understanding of the world, clinical practice and change processes are linked to one another would be beneficial given the continuing change that the field as well as its members experience. This study also supports the claims of Mahoney (1995b) who suggested focusing on the ways in which rationalist-constructivist contrast may be useful for clinical work and studies. Constructivism and rationalism presents comp lementary ways of acquiring and evaluating knowledge and understanding the world, and none of these worldviews provides the correct or best frame of reference. They simply suggest different forms of understanding, inquiry and theory. (Lyddon, 1989b, p. 446). Togeth er they extend our u nderstanding of the complexities of human experience (M ahoney & Lyddon, 1988, p. 223). Our findings in general exemplify how th e rationalist-constr uctivist contrast would extend our knowledge when employed together and it encourag es researchers to make use of such epistemological contrasts sensibly. The present study also contribu tes to the literatu re through opening up a fertile area of research to investigate various dimensions of therapists episte mic change processes. To begin with; future research can extend our understand ing by studying impacts and/or correlates of therapists changing epistemologies. As this study is focused on the association between epistemological, theoretical and stylistic change experiences; future studies can explore how change in epistemological commitments is associat ed with change in othe r sets of professional characteristics. Therapists epistemic commitments were not only associated with their professional qualities but also with certain pers onal qualities such as self-exploration, openness and tolerance (Neimeyer & Aksoy, 2005). Future research can also invest igate how therapists

PAGE 113

113 epistemic journey interacts with their personal qualities which may also be moderating and/or mediating the ways in which epistemic and professional journeys interact. Most importantly, future studies can investigate further imp lications of the link between therapists epistemic journey and their profes sional experiences. Kramen-Kahn and Hansen (1998) suggested that therapists perceived their change proce sses among the rewards of their work. The current study can also be continued by exploring how these changes in therapists epistemic, theoretical and stylistic commitments tr anslate to therapists sa tisfaction, and perhaps, effectiveness of their work. Future research can investigate how epistemic and professional changes of therapists are perceived by their cl ients and facilitated thei r change processes. This study also partially validated the expect ations that therapis ts career development processes play a signific ant role in their episte mic journey. It is known that therapists personal and professional lives are impacted by their c onducting psychotherapy in multiple and complex ways. Yet, more research is needed to understand the underlying dyna mics of therapists epistemic journeys. Future research can also explore which individual processes facilitated therapists epistemic and professional change. Na rrations of certain psychotherapists (such as Goldfried, 2001a) highlighted why therapists change and what aspects of their personal life and career have impacted their developmental process. Studies can investigate if therapists epistemic journey interacts with such persona l accounts for reasons of change. Conclusion In conclusion, the presen t study examined the percei ved epistem ic changes of psychotherapists, the impact of cohort on these change processe s and the ways in which such processes relate to therapists professional stan dings in theoretical or ientation and style of conducting psychotherapy. Results of the study suggested that therapis ts perceive that they have

PAGE 114

114 changed in their epistemic, theoretical and stylistic commitments across their professional journey. Therapists reported that they have b ecome increasingly constructivist and decreasingly rationalist in their epistemic commitment, increa singly pluralist in their theoretical commitment and increasingly expressive, spontaneous, and attentive to a broad spectrum of information in their therapeutic styles. Results of the study also suggested that cohort effects did not account for the levels of therapists initial epistemic commitments or epistemic change experiences. Moreover, results of the study re vealed that therapists increa sing commitment to constructivist epistemologies and decreasing commitment to ra tionalist epistemology toge ther were perceived to be associated with their curr ent theoretical and stylistic comm itments. Epistemological change processes predicted where therapists have reache d in their theoretical and stylistic commitments even after accounting for their initial commitments. The current study is a significant contribution to the field gi ven that it was the first study empirically investigating the epistemic change pr ocesses of therapists. It extended the developing literature on epistemology as a factor relating to psychothe rapists professional change. Additional and ideally, longitudinal work is needed to clarify the nature and correlates of therapists epistemic journeys. It also opens up a fertile area of re search to extend our understanding of practitioners epistemic ch ange processes, which may increase our effectiveness in dealing with the ch anges that our prof ession generates.

PAGE 115

115 APPENDIX A THERAPIST ATTITUDE QUESTIONNAIRE -SHORT FORM (TAQ-SF) Please rate the following items along the followi ng 5-point scale. In considering yourself NOW, we are interested in how you currently view yourself and your professional practice today. In considering yourself THEN, we are interested in how you view yourself when you first started practicing fo llowing the completion of your graduate training. 1 2 3 4 5 Strongly Moderately Neither agree M oderately Strongly disagree disagree nor disagree agree agree NOW THEN 1. Reality is singular, stable a nd external to human experience. 1 2 3 4 5 1 2 3 4 5 2. Knowledge is determined to be valid by logic and reason. 1 2 3 4 5 1 2 3 4 5 3. Learning involves the contiguous or contingent chaining of discrete events. 1 2 3 4 5 1 2 3 4 5 4. Mental representations of r eality involve accurate, explicit and extensive copies of the external world, which are encoded in memory. 1 2 3 4 5 1 2 3 4 5 5. It is best for psychotherapist s to focus treatment on clients current problems and the elim ination or control of these problems. 1 2 3 4 5 1 2 3 4 5 6. Disturbed affect comes from irrational, invalid, distorted or/and unrealistic thinking. 1 2 3 4 5 1 2 3 4 5 7. Clients resistance to change reflects a lack of motivation, ambivalence or motivated avoidance and such resistance to change is an impediment to therapy, which the psychotherapist works to overcome. 1 2 3 4 5 1 2 3 4 5 8. Reality is relative. Realities reflect individual or collective constructions of order to ones experiences. 1 2 3 4 5 1 2 3 4 5 9. Learning involves the refi nement and transformation (assimilation and accommodation) of mental representation. 1 2 3 4 5 1 2 3 4 5 10. Cognition, behavior and affect are interdependent expressions of holistic system ic processes. The three are functionally and structur ally inseparable. 1 2 3 4 5 1 2 3 4 5

PAGE 116

116 11. Intense emotions have a diso rganizing effect on behavior. This disorganization may be f unctional in that it initiates a reorganization so that more viable adaptive constructions can be formed to meet the environmental demands. 1 2 3 4 5 1 2 3 4 5 12. Psychotherapists should encourage emotional experience, expression, and exploration. 1 2 3 4 5 1 2 3 4 5 13. Clinical problems are current or recurrent discrepancies between our external environm ental challenges and internal adaptive capacities. Problems can become powerful opportunities for learning. 1 2 3 4 5 1 2 3 4 5 14. Awareness or insight is one of many strategies for improvement, however, emotional and/or behavioral enactments are also very important. 1 2 3 4 5 1 2 3 4 5 15. Therapists relationship with clients is best conceptualized as a professional helping relationship, which entails the service and delivery of technical, in structional information or guidance. 1 2 3 4 5 1 2 3 4 5 16. Psychotherapists relationshi p with clients can best be conceptualized as a unique social exchange, which provides the clients a safe supportive c ontext to explore and develop relationships with them selves and the world. 1 2 3 4 5 1 2 3 4 5

PAGE 117

117 APPENDIX B THEORETICAL ORIENTATION RATINGS Directions: Below you will find a list of theoretical or ientations. You can list a variety of orientations. Please rate yourself along the provided scale iden tifying the extent to which the given theoretical orientation is and w as a part of your clinical practice. In considering yourself NOW, we are interested in how you currently view yourself and your professional practice today. In considering yourself THEN, we are interested in how you view yourself when you first started practicing fo llowing the completion of your graduate training. Not a Part 1 2 3 4 5 A Significant Part of My Therapy of My Therapy NOW THEN 1 Cognitive 1 2 3 4 5 1 2 3 4 5 2 Behavioral 1 2 3 4 5 1 2 3 4 5 3 Humanistic Existential Gestalt 1 2 3 4 5 1 2 3 4 5 4 Narrative/constructivist 1 2 3 4 5 1 2 3 4 5 5 Systemic Family 1 2 3 4 5 1 2 3 4 5 6 Psychodynamic 1 2 3 4 5 1 2 3 4 5 7 Feminist Multicultural 1 2 3 4 5 1 2 3 4 5 8 If you would have to choose only one theoretical orientation as your main base, which one would that be? Drop Down Menu Saying Please Select 1. Cognitive 2. Behavioral 3. Humanistic Existential Gestalt 4. Narrative/constructivist 5. Systemic Family 6. Psychodynamic 7. Feminist Multicultural 8. Integrationist Drop Down Menu Saying Please Select 1. Cognitive 2. Behavioral 3. Humanistic Existential Gestalt 4. Narrative/constructivist 5. Systemic Family 6. Psychodynamic 7. Feminist Multicultural 8. Integrationist 9 When you consider your ther apeutic orientation across time, to what extent do you see that orientation has having remained the same, or changed? Same 1 2 3 4 5 Changed

PAGE 118

118 APPENDIX C PERSONAL STYLE OF THE THERAPIST (PST-Q) Directions : Please rate the following items along the following 7-point scal e. In considering yourself NOW, we are interested in how you currently view yourself and your professional practice today. In considering yourself THEN, we are interested in how you view yourself when you first started practicing following the completion of your graduate training. Total Disagreement 1 2 3 4 5 6 7 Total Agreement represents total disagreement with the statement and means total agreement. NOW THEN 1. I tend to be open-minded and receptive in listening rather than narrow-minded and restrictive. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 2. I try to get patients to adjust to the regular format of my work. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 3. As a therapist I prefer to indicate to patients what they should do in each session. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 4. I keep a low profile of involvement with patients in order to be more objective. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 5. I find changes in the setting quite exciting. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 6. The emotions the patient arouses in me are key to the course of the treatment. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 7. Im more inclined to accompany the patient in exploring than to point out the steps to follow. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 8. I avoid communicating through gestures or deeply emotional expressions. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 9. I tend to demand strict compliance with schedules. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 10. I place little value on planned treatments. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 11. Expressing emotions is a powerful tool leading to changes. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 12. Many important changes that occur during treatment require the therapist to respond without expressing much emotion. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 13. I dont think about patients outside sessions. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 14. Changing offices has a negative impact on treatment. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 15. Real changes take place during highly emot ional sessions. 1 2 3 4 5 6 7 1 2 3 4 5 6 7

PAGE 119

119 16. I believe I am a therapist with a flexible setting. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 17. I find it useful to reveal something personal about myself during sessions. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 18. I like to feel surprised by what each patient brings to the session without having preconceived notions. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 19. I often attend patients outside the office. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 20. The best intervention in a treatment occurs spontaneously. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 21. Whatever happens to my patients has little influence on my own life. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 22. My intervention is mostly directive. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 23. I think quite a lot about my job even in my spare time. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 24. I avoid revealing my emotions to my patients. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 25. I can plan an entire treatment from the very outset. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 26. Keeping emotional distance from patients favors change. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 27. I never change how long a session lasts, unless absolutely necessary. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 28. If something bothers me during a session I can express it. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 29. Emotional closeness with patients is essential to bring about therapeutic change. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 30. I prefer to know in advance what things I should pay attention to in sessions. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 31. I prefer treatments where everything is programmed. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 32. I like working with patients who have clearly focused problems. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 33. I can give my entire attention to everything that takes place during sessions. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 34. I think about patients problems even after sessions. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 35. Im quite flexible with schedules. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 36. Right from the beginning of the session I allow my attention to float. 1 2 3 4 5 6 7 1 2 3 4 5 6 7

PAGE 120

120 APPENDIX D DEMOGRAPHIC INFORMATION Please tell us a little about yourse lf. This information will be used only to describe the sam ple as a group. 1. Gender: Male Female 2. Age: 3. Ethnic background: White/Caucasian, Black/A frican-American, Hispanic/Latino/a Black, Hispanic/Latino/a White, Asian-Amer ican-Pacific Islander, American Indian /Native-American, Multi-racial, Other __________ 4. Name of your highest degree: BA/BS, MA/MS, MSW, PsyD, PhD, EdD, Other__________ 5. Years of college and higher education in total: 6. The year you obtained your highest degree: 7. Total number of years you spent engaging in clinical practice: 8. Specialty area: Psychologist, Mental Health Counselor, Marriage a nd Family therapist, Social worker, Psychiatrist, Other ___________. 9. Primary job responsibility: Practice/Clinical work, Research Academic, Administrative, Other ___________ 10. Primary employment setting: Private practice, University academic department, University service delivery department, Hospital, Mental health care, School setting, Research setting, Community Center, Other _____________ 11. Number of clients you see weekly on average. Please count each group you work with as 1 client. 12. Country you live in: Drop Down Menu: List of Countries

PAGE 121

121 LIST OF REFERENCES Am erican Psychological Association Website (2008). 2007 psychology practitioner profile. Retrieved January 2, 2008, from http: //research.apa.org/prac_profile_12-7-07.pdf. Arthur, A. R. (2000). The personality and c ognitive-epistemological traits of cognitive behavioral and psychoanalytic psychotherapists. British Journal of Medical Psychology, 73, 243-257. Babbage, D. R., & Ronan, K. R. (2000). Philosophical worldview and personality factors in traditional and social scientists: Studying the world in our own image. Personality and Individual Differences, 28 405-420. Beck, A. T. (2002, June). Emoti onal arousal in cognitive therapy. Beck Institute Newsletter, 7 Retrieved April 15, 2007, from http://www.beckinstitute.org/InfoID/78/RedirectPath/Add1/FolderID/168/SessionID/%7 B002A9969-B2FE-49A9-B0EC34BEF53B311B %7D/InfoGroup/Main/InfoType/ Article/PageVars/Library/InfoManage/Zoom.htm. Beck, A. T. (n.d.). Retrieved April 15, 2007. Aaron T. Beck writes in: Early response to CT, and current success. Cognitive Therapy Today, Beck Institutes Blog. Retrieved April 15, 2007, from http://cttoday.org/?p=91. Beitel, M., Ferrer E., Cecero, J.J. (2004). Psychological mindedness and cognitive style. Journal of Clinical Psychology, 60 567-582. Berzonsky, M. D. (1994). Individual differences in self-construction: The role of constructivist epistemological assumptions. Journal of Construc tivist Psychology, 7 263-281. Bloch, S. (2004) An interview with Aaron (Tim) Beck. Retreived April 15, 2007, from http://www.beckinstitute.org/Library/InfoManage/Zoom.asp?InfoID=304&RedirectPath= Add1&FolderID=208&SessionID={CA5E7FE1-9C4B-4AEA-978E-5EADA 0B35B0A}&InfoGroup=Main&InfoType=Article&SP=2. Botella, L., & Gallifa, J. (1995) A constructivist approach to the development of personal epistemic assumptions and worldviews. Journal of Constructi vist Psychology, 8, 1-18. Brown, L. S. (2005). Dont be a sheep: How this eldest daughter became a feminist therapist. Journal of Clinical Psychology, 61 949-956. Castaeiras, C., Garca, F., Lo Bianco, J., Fern ndez-Alvarez, H. (2006) Modulating effect of experience and theoretical-techni cal orientation on the person al style of the therapist. Psychotherapy Research, 16 595-603. Cohen, J. (1992). A power primer. Psychological Bulletin, 112 155-159.

PAGE 122

122 DeAngelis, T. (2006). Finding focus. Monitor on Psychology, 37 59-61. DiGuiseppe, R., & Linscott, J. (1993). Philo sophical differences among cognitive behavioral therapists: Rationalism, constructivism, or both? Journal of Cognitive Psychotherapy: An International Quarterly, 7 117-130. Eagle, M. N. (2001). Reflections of a psychoana lytic therapist. In Goldfried, M. R. (Ed.), How therapists change: Personal and professional reflections (p. 37-53). Washington, DC: American Psychological Association. Ellis, A. (1990). Is rational-emotive thera py (RET) rationalist or constructivist? Journal of Rational-Emotive & Cognitive-Behavior Therapy, 8 169-193. Ellis, A. (1992a). Discussion by Albert Ellis, Ph.D. In Zeig, J. K. (Ed), The Evolution of psychotherapy: the second conference New York: Brunner/Mazel. Ellis, A. (1992b). My early experiences in developing the practice of psychology. Professional Psychology: Research and Practice, 23 7-10. Ellis, A. (1993). Constructivism and rational-emotive therapy: A critique of Richard Wesslers critique. Psychotherapy, 30 531-532. Ellis, A. (1995). Reflections on rational-e motive therapy. In M. J. Mahoney (Ed), Cognitive and constructive psychotherapies: Theory, research, and practice (pp. 69-73). New York: Springer. Ellis, A. (1999). Why rational-emotive therapy to rational emotive behavior therapy? Psychotherapy, 36 154-159. Farber, B. A. (1983). The effects of psychot herapeutic practice upon psychotherapists. Psychotherapy Theory, Research and Practice, 20 174-182. Farber, B. A., Manevich, I., Metzger, J., & Saypol, E. (2005). Choosing psychotherapy as a career: Why did we cross that road? Journal of Clinical Psychology, 61 1009-1031. Fernndez-lvarez, H., Garca, F ., Lo Bianco, J. L., & Corbella Santoma, S. (2003). Assessment questionnaire on the personal st yle of the therapist PST-Q. Clinical Psychology and Psychotherapy, 10, 116 125. Frankel, Z., & Levitt, H. M. (2006). Postmodern strategies for working with resistance: problem resolution or self-revolution? Journal of Constructivist Psychology, 19 219-250. Freudenberger, H. J. (1977). Burn-out: Occ upational hazard of the child care worker. Child Care Quarterly, 6 90-99. Germer, C. K., Efran, J. S., & Overton, W. F. (1982). The Organisicm-Mechanism Paradigm Inventory: Toward the measurement of meta physical assumptions. Paper presented at the 53rd Annual Meeting of the Eastern Psychological Association, Baltimore, MD.

PAGE 123

123 Goldfried, M. R. (Ed.). (2001a). How therapists change: Personal and professional reflections Washington, DC: American Psychological Association. Goldfried, M. R. (2001b). Conclusion: A perspective on how therapists change. In Goldfried, M. R. (Ed.), How therapists change: Personal and professional reflections (p. 315-330). Washington, DC: American Psychological Association. Gosling, S. D., Vazire, S., Srivastava, S., & John, O. P. (2004). Should we trust web-based studies? A comparative analysis of six preco nceptions about Internet questionnaires. American Psychologist, 59, 93-103. Greenberg, L. S. (2001). My cha nge process: From certainty through chaos to complexity. In Goldfried, M. R. (Ed.), How therapists change: Personal and professional reflections (p. 247-270). Washington, DC: American Psychological Association. Grosch, W. N. & Olsen, D. C. (1994). When Helping Starts to Hurt. A New Look at Burnout Among Psychotherapists. New York: W. W. Norton. Horner, A. J. (1993). Occupational hazards and ch aracterological vulnerability: The problem of "burnout." American Journal of Psychoanalysis, 53 137-142. Hoyt, M. F. (2005). Why I became a (brief) psychotherapist? Journal of Clinical Psychology, 61 983-989. Jennings, L., & Skovholt, T.M. (1999). The cognitive, emotional, and relational characteristics of master therapists. Journal of Counseling Psychology, 46 3-11. Johnson, J. A., Germer, C. K., Efran, J. S., & Over ton, W. F. (1998). Personality as the basis for theoretical predilections. Journal of Personality and Social Psychology, 55 824-835. Kestnbaum, J. D. (1984). Expectations for therapeutic growth: One factor in burnout. Social Casework, 65, 374-377. Kivlighan, D. M., & Quigley, S. T. (1991). Di mensions used by experienced and novice group therapists to conceptu alize group processes. Journal of Counseling Psychology, 38, 415 423. Kramen-Kahn, B., & Hansen, N. D. (1998). Rafting the rapids: Occupational hazards, rewards, and coping strategies of psychotherapists. Professional Psychology: Research and Practice, 29 130-134. Kramer, D. A., Kahlbaugh, P. E. & Goldston, R. B. (1992). A measure of paradigm beliefs about the social world. Journal of Gerontology: Psychological Sciences 47, 180-189. Lyddon, W. J. (1988). Information-processing and c onstructivist models of cognitive therapy: A philosophical divergence. The Journal of Mind and Behavior, 9 137166.

PAGE 124

124 Lyddon, W. J. (1989a). Personal epistemo logy and preference for counseling Journal of Counseling Psychology, 36, 423-429. Lyddon, W. J. (1989b). Root metaphor theory: A philosophical framework for counseling and psychotherapy. Journal of Counseling & Development, 67 442-448. Lyddon, W. J. (1990). Firstand second-order change: Implications for rationalist and constructivist cogni tive therapies. Journal of Counseling & Development, 69 122-127. Lyddon, W. J. (1991). Epistemic style: Imp lications for cognitive psychotherapy. Psychotherapy, 28, 588-597. Lyddon, W. J., & Adamson, L. E. (1992). Worldv iew and counseling preference: An analogue study. Journal of Counseling and Development, 71 41-47. Mahoney, M. J. (1988). Constructive metatheo ry: II. Implications for Psychotherapy. International Journal of Pe rsonal Construct Psychology, 1, 299-315. Mahoney, M. J. (1991). Human change processes: The scien tific foundations of psychotherapy. New York: Basic. Mahoney, M. J. (Ed). (1995a). Cognitive and constructive psychot herapies: Theory, research, and practice New York: Springer. Mahoney, M. J. (1995b). Theoretical developm ents in the cognitive psychotherapies. In Mahoney, M. J. (Ed), Cognitive and constructive psychot herapies: Theory, research, and practice (pp. 3-19). New York: Springer. Mahoney, M. J. (1995c). The Psychological Demands of Being a Constructive Psychotherapist. In R. A. Neimeyer & M. J. Mahoney (Eds.), Constructivism in psychotherapy (pp. 385399). Washington, DC: American Psychological Association. Mahoney, M. J. (2001). Behaviorism, cognitivism, and constructivism: Reflections on people and patterns in my intellectual deve lopment. In Goldfried, M. R. (Ed.), How therapists change: Personal and professional reflections (pp. 183-200). Washington, DC: American Psychological Association. Mahoney, M. J., & Gabriel, T. J. (1987). Psychotherapy and the cognitive sciences: An evolving alliance. Journal of Cognitive Therapy: An International Quarterly, 1 39-59. Mahoney, M. J., & Lyddon, W. J. (1988). Recent developments in cognitive approaches to counseling and psychotherapy. The Counseling Psychologist, 16 190-234. Mahoney, M. J., Lyddon, W. J., & Alford, D. J. (1989). An evaluation of rational-emotive theory of psychotherapy. In M. E. Bernard & R. DiGiuseppe (Eds.), Inside Rational-Emotive Therapy. A Critical Appraisal of the Theory and Therapy of Albert Ellis. (pp. 69-94). San Diego, CA: Academic Press.

PAGE 125

125 Martin, J., Slemon, A. G., Hiebert, B., Hallberg, E. T., & Cummings, A. L. (1989). Conceptualizations of novice and experienced counselors. Journal of Counseling Psychology, 36, 395. Maslach, C., Jackson, S.E. & Leiter. M. (1996). MBI Manual (3rd ed.). Palo Alto, CA: Consulting Psychologists Press. McCann, I. L., & Pearlman, L. A. (1990). Vi carious traumatization: A framework for understanding the psychological eff ects of working with victims. Journal of Traumatic Stress, 3, 131-149. Meichenbaum, D. (1990). Evolution of cognitive behavior therapy: Origins, tenets and clinical examples. In J. Zeig (Ed.), The evolution of psychotherapy (pp. 96-115). New York: Brunner/Mazel. Meichenbaum, D. (1993). Changi ng conceptions of cognitive behavior modification: Retrospect and prospect. Journal of Consulting and Clinical Psychology, 61 202-204. Myers, R. (1990). Classical and modern regr ession with applications (2nd ed.). Boston: Duxbury Press. Nagae, N., & Nedate, K. (2001). Comparison of constructive cognitive and rationalist cognitive psychotherapies for students with social anxiety. Constructivism in the Human Sciences, 6, 41-49. Neimeyer, G. J., & Aksoy, G. (2005). Epistemol ogy and psychotherapists: Clarifying the link among epistemic style, experience, and therap ist characteristics. Unpublished manuscript, University of Florida. Neimeyer, G. J., & Morton, R. J. (1997). Personal epistemologies and pr eferences for rationalist versus constructivi st psychotherapies. Journal of Constructi vist Psychology, 10 109-123. Neimeyer, G. J., Prichard, S., Lyddon, W. J., & She rrard, P. A. D. (1993). The role of epistemic style in counseling pref erence and orientation. Journal of Counseling and Development, 71, 515-523. Neimeyer, G. J., & Saferstein, J. (2003). Personal epistemologies and psychotherapists preferences. Unpublished manuscrip t, University of Florida. Neimeyer, G. J., & Saferstein, J. (2006). The re lationship between therapists epistemology and their therapy style, working alliance, a nd use of specific interventions. Unpublished manuscript, University of Florida. Neimeyer, R. A. (1993). Constructivism and the cognitive psychotherapies: Some conceptual and strategic contrasts. Journal of Cognitive Psychotherapy, 7 159-172.

PAGE 126

126 Neimeyer, R. A. (1995). Constructivist psychotherapies: Features, foundations, and future directions. In R. A. Neimeyer & M. J. Mahoney (Eds.), Constructivism in Psychotherapy (pp. 11-38). Washington, DC: Amer ican Psychological Association. Neimeyer, R. A. (2005). The construction of change: Personal reflectio ns on the therapeutic process. Constructivism in the Human Sciences, 10 77 98. Norcross, J. C. (2000). Psychotherapist self -care: Practitioner-test ed, research-informed strategies. Professional Psychology: Re search and Practice, 31 710-713. Norcross, J. C. (2005). A primer on psychothera py integration. In J.C. Norcross & M.R. Goldfried (Eds.), Handbook of psychotherapy integration (2nd ed.) New York: Oxford University Press. Norcross, J. C., Hedges, M., & Prochaska, J. O. (2002). The face of 2010: A Delphi Poll on the future of psychotherapy. Professional Psychology: Re search and Practice, 33 316-322. Norcross, J.C., Karpiak, C.P., & Lister, K. M. (2 005). Whats an integrationist? A study of selfidentified integrative and (occasionally) eclectic psychologists. Journal of Clinical Psychology, 61, 1587. Orlinsky, D. E. (1999). The master therapist: Ideal character or cl inical fiction? Comments and questions on Jennings and Skovholt's "The Cognitive, Emotional, and Relational Characteristics of Master Therapists". Journal of Counseling Psychology, 46 12-15. Orlinsky, D. E., Rnnestad, M. H., Ambuehl, H., Willutzki, W., Botermans, J-F., Cierpka, M., Davis, J., & Davis, M. (1999). Psychotherap ists assessments of their development at different career levels. Psychotherapy, 36 (3), 203. Padesky, C. A. (2002). Mind and men introduction fo r the Festschrift in honor of Aaron T. Beck, M.D. Beck Institute Newsletter, 6 Retrieved April 15, 2007, from http://www.beckinstitute.org/InfoID/132/RedirectPath/Add1/FolderID/174/SessionID/%7 B002A9969-B2FE-49A9B0EC34BEF53B311B%7D/InfoGroup/Main/InfoT ype/Article/PageVar s/Library/InfoMa nage/Zoom.htm Pepper, S. C. (1942). World hypotheses. Berkeley, CA: University of California Press. Pepper, S. C. (1967). Concept and quality: A world hypothesis. LaSalle, IL: Open Court. Radeke, J. T., & Mahoney, M. J. (2000). Compari ng the personal lives of psychotherapists and research psychologists. Professional Psychology: Re search and Practice, 31 82-84. Raquepaw J. M., & Miller, R. S. (1989). Psyc hological burnout: A componential analysis. Professional Psychology: Re search and Practices, 20 32-36.

PAGE 127

127 Rnnestad, M. H., & Skovholt, T. M. (2001). Le arning arenas for professional development: Retrospective accounts of se nior psychotherapists. Professional Psychology: Research and Practice, 32 181. Rnnestad, M. H., & Skovholt, T. M. (2003). Th e journey of the counselor and therapist: Research findings and perspectives on professional development. Journal of Career Development, 30, 5-44. Rosenthal, R., & Rosnow, R.L. (1991). Essentials of behavioral research: Methods and data analyses (2nd Edition). Boston: McGraw-Hill. Royce, J. R. (1964). The encapsulated man: An interdis ciplinary essay on the search for meaning. Princeton, NJ: Van Nostrand. Royce, J. R., & Mos, L. P. (1980). Psycho-epistemological profile manual. Edmonton, Canada: University of Alberta Press. Royce, J. R., & Powell, A. (1983). Theory of personality and individual differences: Factors, systems, processes Englewood Cliffs, NJ: Prentice-Hall. Schacht, T. E., & Black, D. A. (1985). Epis temological commitments of behavioral and psychoanalytic therapists. Professional Psychology: Research and Practice, 16 316-323. Schacter, D. L. (1999). The seven sins of memory: Insights from psychology and cognitive neuroscience. American Psychologist, 54 182-203. Skovholt, T. M. & Jennings, L. (Eds.) (2004). Master therapists: Explor ing expertise in therapy and counseling. Boston: Allyn & Bacon. Skovholt, T. M. & Rnnestad, M. H. (l992). Them es in therapist and counselor development. Journal of Counseling and Development, 70 505. Skovholt, T. M., & Rnnestad, M. H. (2003). The hope and promise of career life-span counselor and therapist development. Journal of Career Development, 30, 1-3. Stricker, G. (2001). How I learned to abandon certainty and embrace change. In Goldfried, M. R. (Ed.), How therapists change: Personal and professional reflections (p. 67-81). Washington, DC: American Psychological Association. Vasco, B. (1994). Correlates of constr uctivism among Portuguese therapists. Journal of Constructivist Psychology, 7 1-16. Viney, L. L. (1994). Sequences of emotional distress expressed by clients and acknowledged by therapists: Are they associated w ith some therapists than others? British Journal of Clinical Psychology, 33 469-81.

PAGE 128

128 Winter, D. A., & Watson, S. (1999). Persona l construct psychothe rapy and the cognitive therapies: Different in theory but ca n they be differentiated in practice? Journal of Constructivist Psychology, 12 1-22. Zeig, J. K. (1992). The Evolution of psychotherapy: The second conference New York: Brunner/Mazel.

PAGE 129

129 BIOGRAPHICAL SKETCH I was born in Ankara, Turkey, in 1981. In 1995 my fa mily moved to Istanbul, Turkey. I attended the Bogazici Univer sity in Istanbul, double-majoring in guidance and psychological counseling and psychology programs, as an unde rgraduate. In 2003, I graduated, ranking first in the Department of Education. I joined the Department of Psychology at th e University of Flor ida as a counseling psychology graduate student in August 2003. I co mpleted my Master of Science degree in December 2005. I completed my Doctor of Philosophy degree in August 2008.