Fuzzy Measurements, Consensual and Empathic Validation of the Active Observations of Multiple Observers of the Same Psychotherapeutic Event

摘要

This presentation uses fuzzy logic to develop a method to simultaneously measure the ratings of the patient''s global assessment of functioning (GAF), by both the therapist and patient in psychotherapy. Most therapy sessions in the mental health field use the GAF score for documentation for insurance purposes. The patient''s and therapist''s views pertain to multiple observers of the same event. In contrast to strict binary (0 or 1; or true or false) assignments, fuzzy measurements are uniquely dimensional. Using a new framework called plurimonism, we mathematically formulate the problem of empathy. This self-reflective mathematical model entails four components of the empathic process involving two observers. They are: (1) the self, (2) the self''s other, (3) the other and (4) the other''s-self. It measures the degree of accuracy of the therapist- observer''s empathy, as well as conscious and unconscious processes involved in the patient observer''s idealization and the therapist- observer''s confidence in clinical psychotherapy. Ratings are obtained from both patient and therapist from four different points of view. The plural views of the patient''s GAF are from: (1) the therapist''s view (TGAF), (2) the patient''s view (PGAF); (3) the therapist empathic view (TEGAF), which represents the therapist''s estimate of PGAF; and (4) the patient''s empathic estimate of the TGAF. The global assessment of functioning (GAF) scale is the standard dimensional 100 point-scale measure used in psychiatry for recording a patient''s functioning. The patient''s estimate of the therapist''s degree of accuracy as well as the therapist''s confidence in his or her empathic accuracy is also represented. Three formulae are presented which describe the degree of the therapist''s empathic accuracy, the patient''s overidealization/under-idealization, and the therapist''s overconfidence/under-confidence. The concept of empathy is here restricted to mean the degree to which one observer can -take the point of view of another observer when both are observing the same thing