Contemporary Family Therapy

, Volume 33, Issue 4, pp 364–383 | Cite as

Therapist Use-of-Self Orientations Questionnaire: A Reliability and Validity Study

  • Stephen A. Anderson
  • Jessica Sanderson
  • Iva Košutić
Original Paper


This article describes the development of the Therapist Use-of-Self Orientation Questionnaire (TUSO-Q), an instrument designed to measure therapists’ use-of-self orientations while working with clients. A total of 373 therapists participated in this study. Exploratory factor analysis in the structural equation modeling context revealed three different therapist use-of-self orientations: Transpersonal, Contextual, and Instrumental. The final model provided an excellent fit to the data. TUSO-Q scores exhibited satisfactory evidence of internal consistency reliability and construct validity. Implications for the scale’s use in clinical research and training are discussed.


Self of therapist Instrument Reliability and validity Therapist training 


  1. Anderson, S. A., & Holmes, S. (2007). Personal mythologies: A framework for dealing with therapeutic and supervisory impasses. In S. Krippner, M. Bova, & L. Gray (Eds.), Healing stories: The use of narrative in counseling and psychotherapy (pp. 126–139). San Juan: Puente Publications.Google Scholar
  2. Aponte, H. J. (1994). How personal can training get? Journal of Marital and Family Therapy, 20, 3–15.CrossRefGoogle Scholar
  3. Aponte, H. J., Powell, F. D., Brooks, S., Watson, M. F., Litzke, C., Lawless, J., et al. (2009). Training the person of the therapist in an academic setting. Journal of Marital and Family Therapy, 35, 381–394.PubMedCrossRefGoogle Scholar
  4. Aponte, H. J., & Winter, J. E. (2000). The person and practice of the therapist: Treatment and training. In M. Baldwin (Ed.), The use of self in therapy (2nd ed.). New York: Haworth.Google Scholar
  5. Asparouhov, T., & Muthén, B. (2009). Exploratory structural equation modeling. Structural Equation Modeling, 16(3), 397–438.CrossRefGoogle Scholar
  6. Bachelor, A., & Horvath, A. O. (1999). The therapeutic relationship. In M. A. Hubble, B. L. Duncan, & S. D. Miller (Eds.), The heart and soul of change: What works in therapy (pp. 133–178). Washington: American Psychological Association.CrossRefGoogle Scholar
  7. Baldwin, M. (1987). Interview with Carl Rogers on the use of self in therapy. Journal of Psychotherapy and the Family, 3(1), 45–52.CrossRefGoogle Scholar
  8. Bennett-Levy, J. (2006). Therapist skills: A cognitive model of their acquisition and refinement. Behavioral and Cognitive Psychotherapy, 34, 57–78.CrossRefGoogle Scholar
  9. Beutler, L. E., Malik, M. L., Alimohamed, S., Harwood, T. M., Talebi, H., et al. (2004). Therapist variables. In M. J. Lambert (Ed.), Bergin and Garfield’s handbook of psychotherapy and behavior change (pp. 227–306). New York: Wiley.Google Scholar
  10. Blow, A. J., Sprenkle, D. H., & Davis, S. D. (2007). Is who delivers the treatment more important than the treatment itself? The role of the therapist in common factors. Journal of Marital and Family Therapy, 33, 298–317.PubMedCrossRefGoogle Scholar
  11. Bowen, M. (1978). Family therapy in clinical practice. New York: Aronson.Google Scholar
  12. Braverman, S. (1984). Family of origin as a training resource for family therapists. The Clinical Supervisor, 2(2), 37–47.CrossRefGoogle Scholar
  13. Brown, T. (2006). Confirmatory factor analysis for applied research. New York: The Guilford Press.Google Scholar
  14. Brown, K. W., Ryan, R. M., & Kreswell, J. D. (2007). Mindfulness: Theoretical foundations and evidence for its salutary effects. Psychological Inquiry, 18, 211–237.CrossRefGoogle Scholar
  15. Coleman, D. (2004). Theoretical evaluation self-test (TEST): A preliminary validation study. Social Work Research, 28, 117–128.Google Scholar
  16. Cortina, J. (1993). What is coefficient alpha? An examination of theory and applications. Journal of Applied Psychology, 78(1), 98–104.CrossRefGoogle Scholar
  17. Cowley, A. S., & Adams, R. S. (2000). On Satir’s use of self. Journal of Couples Therapy, 9(3/4), 51–68.CrossRefGoogle Scholar
  18. DeCarlo, L. T. (1997). On the meaning and use of kurtosis. Psychological Methods, 2(3), 292–307.CrossRefGoogle Scholar
  19. Fabrigar, L. R., Wegener, D. T., MacCallum, R. C., & Strahan, E. J. (1999). Evaluating the use of factor analysis in psychological research. Psychological Methods, 4, 281–290.CrossRefGoogle Scholar
  20. Field, N. (1996). Breakdown and breakthrough. London: Routledge.Google Scholar
  21. Freud, S. (1910). The future prospects of psycho-analytic therapy (Standard ed., Vol. 11, pp. 139–152). London: Hogarth Press.Google Scholar
  22. Garcia, M., Košutić, I., McDowell, T., & Anderson, S. (2009). A critical supervision framework: Critical consciousness within supervisory systems of difference. Journal of Feminist Family Therapy, 21, 18–38.CrossRefGoogle Scholar
  23. Gehart, D. R., & McCollum, E. E. (2007). Engaging suffering: Towards a mindful re-visioning of family therapy practice. Journal of Marital and Family Therapy, 33, 214–226.PubMedCrossRefGoogle Scholar
  24. Grunebaum, H. (2006). On wisdom. Family Process, 45, 117–132.PubMedCrossRefGoogle Scholar
  25. Haarhoff, B. A. (2007). The importance of identifying and understanding therapist schema in cognitive therapy training and supervision. New Zealand Journal of Psychology, 35, 126–131.Google Scholar
  26. Haber, R. (1990). From handicap to handy capable: Training systemic therapists in use of self. Family Process, 29, 375–384.PubMedCrossRefGoogle Scholar
  27. Haley, J. (1976). Problem solving therapy. San Francisco: Jossey Bass.Google Scholar
  28. Horvath, A. O., & Symonds, B. D. (1991). Relation between working alliance and outcome in psychotherapy: A meta analysis. Journal of Counseling Psychology, 38, 139–149.CrossRefGoogle Scholar
  29. Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55.CrossRefGoogle Scholar
  30. Jankowski, P. J., & Vaughn, M. (2009). Differentiation of self and spirituality: Empirical explorations. Counseling and Values, 53, 82–96.Google Scholar
  31. Kline, R. B. (2005). Principles and practice of structural equation modeling (2nd ed.). NY: The Guilford Press.Google Scholar
  32. Kottler, J. A. (2003). On being a therapist (3rd ed.). San Francisco, CA: Jossey-Bass.Google Scholar
  33. Lambert, M. J. (2004). Bergin and Garfield’s handbook of psychotherapy and behavior change (5th ed.). New York: Wiley.Google Scholar
  34. Leach, M. M., Stoltenberg, C. D., McNeill, B. W., & Eichenfield, G. A. (1997). Self-efficacy and counselor development: Testing the integrated developmental model. Counselor Education and Supervision, 37, 115–124.Google Scholar
  35. Leahy, R. (2009). Resistance: An emotional schema (EST) therapy approach. In S. Gregoris (Ed.), Cognitive behavior therapy: A guide for the practicing clinician (Vol. 2, pp. 187–204). New York: Routledge/Taylor & Francis.Google Scholar
  36. Looney, S. W. (1995). How to use tests for univariate normality to assess multivariate normality. The American Statistician, 49(1), 64–70.CrossRefGoogle Scholar
  37. Mahrer, A. R. (1996). The complete guide to experiential psychotherapy. New York: Wiley.Google Scholar
  38. Mallinckrodt, B. (1993). Session impact, working alliance, and treatment outcome in brief counseling. Journal of Counseling Psychology, 40, 25–32.CrossRefGoogle Scholar
  39. Marsh, H. W., Muthén, B., Asparouhov, T., Lüdtke, O., Robitzsch, A., Morin, A. J. S., et al. (2009). Exploratory structural equation modeling, integrating CFA and EFA: Application to students’ evaluations of university teaching. Structural Equation Modeling, 16(3), 439–476.CrossRefGoogle Scholar
  40. Mascaro, N., Rosen, D. H., & Morey, L. C. (2004). The development, construct validity, and clinical utility of the spiritual meaning scale. Personality and Individual Differences, 37, 845–860.CrossRefGoogle Scholar
  41. Maslow, A. H. (1968). Toward a psychology of being (2nd ed.). New York: Van Nostrand Reinhold.Google Scholar
  42. McGeorge, C. R., Carlson, T. S., Erickson, M. J., & Guttormson, H. E. (2007). Creating and evaluating a feminist-informed social justice couple and family therapy training model. Journal of Feminist Family Therapy, 18(3), 1–38.CrossRefGoogle Scholar
  43. McGoldrick, M. (1982). Through the looking glass: Supervision of a trainee’s trigger family. In R. Whiffen & J. Byng-Hall (Eds.), Family therapy supervision: Recent developments in practice. London: Academic Press.Google Scholar
  44. Michalski, D., Mulvey, T., & Kohout, J. (2010). 2008 APA survey of psychology health service providers. Retrieved March 3, 2011, from
  45. Mutchler, M., & Anderson, S. A. (2010). Therapist personal agency: A model for examining the training context. Journal of Marital and Family Therapy, 36(4), 511–525.PubMedCrossRefGoogle Scholar
  46. Muthén, L. K., & Muthén, B. O. (2007). Mplus statistical analysis with latent variables: User’s guide. Los Angeles, CA: Muthén & Muthén.Google Scholar
  47. Northey, W. F. (2002). Characteristics and clinical practices of marriage and family therapists: A national survey. Journal of Marital and Family Therapy, 28, 487–494.PubMedCrossRefGoogle Scholar
  48. Ponterotto, J. G., Gretchen, D., Utsey, S. O., Rieger, B. P., & Austin, R. (2002). A revision of the multicultural counseling awareness scale. Journal of Multicultural Counseling and Development, 30, 153–180.Google Scholar
  49. Raykov, T. (2009). Evaluation of scale reliability for unidimensional measures using latent variable modeling. Measurement and Evaluation in Counseling and Development, 42(3), 223–232.CrossRefGoogle Scholar
  50. Rivett, M., & Street, E. (2001). Connections and themes of spirituality in family therapy. Family Process, 40, 459–467.PubMedCrossRefGoogle Scholar
  51. Rober, P. (1999). The therapist’s inner conversation in family therapy practice: Some ideas about the self of the therapist, therapeutic impasse, and the process of reflection. Family Process, 38(2), 209–228.PubMedCrossRefGoogle Scholar
  52. Roote, K. H., Jankowski, P. J., & Sandage, S. J. (2009). Bowen Family Systems and spirituality: Exploring the relationship between triangulation and religious questing. Contemporary Family Therapy, 32(2), 89–101.Google Scholar
  53. Rowan, J., & Jacobs, M. (2002). The therapist’s use of self. Maidenhead, Great Britain: Open University Press.Google Scholar
  54. Satir, V. (1983). Conjoint family therapy. Palo Alto, CA: Science and Behavior Books.Google Scholar
  55. Satir, V. (1987). The therapist story. Journal of Psychotherapy and the Family, 3(1), 17–25.CrossRefGoogle Scholar
  56. Sedgwick, D. (1994). The wounded healer: Countertransference from a Jungian perspective. London: Routledge.CrossRefGoogle Scholar
  57. Simon, G. M. (2006). The heart of the matter: A proposal for placing the self of the therapist at the center of family therapy research and training. Family Process, 45, 331–344.PubMedCrossRefGoogle Scholar
  58. Simon, G. M. (2007). The heart of the matter: Continuing the conversation. Journal of Family Therapy, 29, 100–1003.CrossRefGoogle Scholar
  59. Sprenkle, D. H., & Blow, A. J. (2007). The role of the therapist as the bridge between common factors and therapeutic change: More complex than congruency with a worldview. Journal of Family Therapy, 29, 109–113.CrossRefGoogle Scholar
  60. Timm, T. M., & Blow, A. J. (1999). Self-of-the-therapist work: A balance between removing restraints and identifying resources. Contemporary Family Therapy, 21, 331–351.CrossRefGoogle Scholar
  61. Titelman, P. (1987). The therapist’s own family: Toward the differentiation of self. Northvale, NJ: Aronson.Google Scholar
  62. Whitaker, C. A., & Bumberry, W. M. (1988). Dancing with the family: A symbolic-experiential approach. New York: Brunner/Mazel, Inc.Google Scholar
  63. White, M., & Epston, D. (1990). Narrative means to therapeutic ends. New York: W. W. Norton.Google Scholar
  64. Wosket, V. (1999). The therapeutic use of self. New York: Brunner/Routledge.Google Scholar
  65. Yates, A. (1987). Multivariate exploratory data analysis: A perspective on exploratory factor analysis. Albany: State University of New York Press.Google Scholar
  66. Young, J. E., & Brown, G. (2003). Young schema questionnaire. New York: Cognitive Therapy Center, NY.Google Scholar
  67. Yuan, K. H., & Bentler, P. M. (2000). Three likelihood-based methods for mean and covariance structure analysis with nonnormal missing data. Sociological Methodology, 30(1), 165–200.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Stephen A. Anderson
    • 1
  • Jessica Sanderson
    • 1
  • Iva Košutić
    • 2
  1. 1.Human Development and Family Studies, Marriage and Family Therapy Program, Center for Applied Research in Human DevelopmentUniversity of ConnecticutStorrsUSA
  2. 2.Human Development and Family StudiesUniversity of ConnecticutStorrsUSA

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