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TMatch: Client/Therapist Matching
Based on Epistemological Styles

General Description

Epistemology is a term from philosophy that refers to how people know what is true. In psychology, your "empistemological style" is your personal style or system for deciding whether ideas or statements are valid or true, that is, how you learn about the world and justify what you believe. This might also be called your "preferred way of knowing about the world." For TMatch, I used the system that divides these ways of knowing into three types:

Relevance to Psychotherapy

An obvious question is what this has to do with psychotherapy. Here is an example. Suppose the therapist suggests that a problem may have a particular cause that the client hadn't considered before. The therapist isn't sure, this is just a suggestion. How are the client and the therapist going to decide whether this suggestion is accurate, and what then should be done about the problem? Using the Rational style, they would try to think about it logically. Does it match other things they think are true about the client? Is it logically consistent with other ideas they think are true? A "Rationalist" therapist would try to help the client solve the problem by having the client change his or her way of thinking. Using the Empirical style, the client and therapist would try to use their senses (sight, sound, etc.) to make observations to test it. For instance, they could say "if this is true, then tomorrow such-and-such will happen". In other words, they would be like scientists, doing experiments to test ideas. To try to make problems better, an "Empirical" therapist might have the client practice different behaviors. Using the metaphorical style, the therapist and client would see how much validity the suggestion seemed to have from an artistic or metaphorical standpoint. For instance, they might say that it seemed true because it seemed to be artistically correct and just feels right. This would be sort of like seeing a movie that you felt spoke a deep truth to you. Using this method, the client and therapist might not believe that there are "truths," but instead equally valid opinions about things. A "Metaphorical" therapist might not see "problems" as necessarily negative, but instead as aspects of the client's life blocking his or her attempts to adapt and adjust to the world.

Importance for Matching

Epistemological style may be important in therapy because different styles between the client and therapist could cause discomfort and conflict, hinder the client being helped, and lead to the client giving up on therapy. For example, suppose the therapist suggests a cause for a problem, and the client is trying to use a Metaphorical style to decide whether the therapist is correct, while the therapist is using an Empirical style and trying to get the client to see that the that suggestion is true by saying something like "see how your behavior is consistent with what I am suggesting." The client might be frustrated because the therapist doesn't understand that the suggestion is lacking in symbolic truth, and doesn't feel right artistically, while the therapist might think that the client is just being resistant to looking at the truth as shown in his or her actions.

Testing Epistemological Styles in TMatch

This particular way of catergorizing epistemological style is associated with a special test devised by Royce and Mos, called the the Psycho-Epistemological Profile (PEP). The PEP questionnaire contains 90 questions, and produces a rating of preferences on each of the three styles. 90 questions was much too long to be incorporated into the client and therapist questionnaires in TMatch. Using factor analysis, Royce and Mos created a shortened version of the PEP, which they call the "Revised Experimental Form VI," which has only 41 questions, with 16 questions assessing Rationalism, 16 questions assessing Metaphorism, and 8 questions assessing Empiricsm (Royce & Mos, 1980, pp. 82-86). This was still too long for the questionnaires. The goal was to have an instrument that would fit on one page (one computer screen).This goal was accomplished by reducing the number of questions to 20 by selecting the questions that had the highest factor loadings on each of the three factors. The end result was 8 Metaphorism questions, 7 Rationalism questions, and 5 Empiricism questions.

Matching Clients to Therapists

The original idea was to give therapists this test, ask clients to rate their ideal therapists using the same test, and then match accordingly. However, when this was tried on friends (called "pilot testing"), all clients answered according to how they themselves felt. In other words, their only preference, if they had one at all, was for therapists who had the same epistemological styles that they had. Because of this result during pilot testing, the attempt to match by preference for epistemological styles was changed to the one attempt in TMatch to match by similarity instead.

How Well Did This Work?

There was no evidence from the study of TMatch that matching by similarity of epistemological style using this system was helpful. This study tried to determine whether clients liked the epistemological styles of their therapists more when they were more similar to their own. However, this determination was extremely hindered by the problem of having clients understand clearly what epistemological styles are. It seemed therapists had a lot of difficulty understanding these concepts also. People don't think about this area of their lives much, if at all. The original goal of matching according to clients' preferences for the epistemological style of their therapist is still my dream for matching. To do this would require a method of describing epistemological styles in a way that clients could understand, and a way to match this to therapists' tendencies. If such a method could be found, it would be very interesting to try matching by this method.


For more information, or to give feedback, email Kenneth Frankel, Ph.D.

References

Royce, J. R. & Mos, L. P. (1980). Manual: Psycho-Epistemological Profile. Edmonton, Alberta, Canada: University of Alberta, Edmonton, Center for Advanced Study in Theoretical Psychology.

Vincent, N., & LeBow, M. (1995). Treatment preference and acceptability: Epistemology and locus of control. Journal of Constructivist Psychology, 8, 81-96.