Facilitative Interpersonal Skills (FIS)

Facilitative Interpersonal Skills Rating Scale (Timothy Anderson & Candace Patterson)

Ratings for each item are made on a 5 point Likert-type scale. The rating scale ranges from Not Characteristic (“1") to Extremely Characteristic (“5"). More elaborate descriptions of each rating level are provided to help identify the correct rating level... In rating a response, instances of an “average” level of a helping behavior would merit a rating of 3.

1. Verbal Fluency. This item is a rating of the extent to which the participant is verbally capable and at-ease in communicating. The response is delivered in a relaxed manner and without significant signs of anxiety (e.g., broken speech, extended and awkward pauses, and clarity in communication). However, the content of what is said is not rated, but rather how it is spoken. 

1. The participant has great difficulty verbalizing a response (e.g., obviously anxious, sounds shaky or timid), reflecting a clear avoidance or anxiety. The participant may lack confidence and is clearly uncertain or even difficult to follow.
2. Fluency is disrupted by the participant’s anxiety and avoidance of verbal expression. The respondent may be obviously anxious and struggling to formulate a response. At times, the communication may be choppy, even halting. [Note: In some rare instances a response could represent an avoidance of the interpersonal situation through anxious rambling. It would need to be clear that the participant’s ramblings are the result of anxiety over communicating with another]. 
3. A moderate level of verbal fluency indicates that the participant's response is conversational and mostly easy to follow. 
4. The response is fluent, and there is little that is difficult to follow. 
5. The participant is at great ease and communicates ideas with no anxiety, reflecting a desire to "approach" the other. The verbal quality of the response may have a "melodic," rhythmical quality and is easy to follow; the response is fluent. 

2. Hope & Positive Expectations. This item rates expressions of hope, optimism, and positive expectations for change. Staats (1989, 2001) defines hope as the interaction between wishes and expectations. The interpersonal skills needed for hope involve facilitating a) personal agency and b) building the pathways needed for attaining desired goals and expectations (Steed, 2002). Hope is related to persuasiveness and collaboration in the sense that hope and positive expectations are often built through offering a rationale, friendliness, and enthusiasm. As defined here, hope focuses more on building client agency for actions that will facilitate meeting the client’s goals whereas persuasion is based more on a plausible explanation (which may or may not include hope).

1. The participant's response is hopeless or is even pessimistic. For example, the participant may address only issues or concerns beyond the control of the other or subtly suggests that the other cannot change or improve his/her problems.
2. The participant responds with some hopelessness, including subtle expressions of feeling unable to help the client. 
3. The response is ordinary OR the optimism of the response is not discernable. There may be some hopefulness expressed, but with little confidence or reason for being hopeful. 
4. A general sense of optimism about the client’s situation is detected. Specifically, the participant's response is directed toward building the client’s agency OR facilitating the building of pathways to meet the client’s goals. 
5. The participant's response expresses clear hope about the client’s future and/or positive expectations about therapeutic work. In addition, for a response to be coded as a “5” there needs to be an allusion to building the client’s agency as well as how the client might participate or do something that will help move toward his/her desired goals (i.e., pathways). 

3. Persuasiveness. Persuasiveness is the capacity to induce the other to accept a view that may be different from his or her own view. It involves that ability to convey a clear, organized understanding about the meaning of the other’s source of distress. Persuasiveness implies an ability to communicate what Jerome Frank called a “believable myth.” This capacity implies that the persuasive therapist must be convincing in communicating this belief-system.

Rating Notes: For rating purposes, the response does not necessarily need to convey an entire world view, but a point of view that is implied to be at least slightly different from the client in the video clip. High ratings require that the participant provide a clear belief in a point of view or rationale. It is necessary that the rationale be relevant to the other’s problems and at least somewhat novel to the other’s experience. For this item, the rater should disregard personal beliefs about the validity of the participant's rationale, but instead rate the extent to which the participant might persuade another (i.e., ability to "sell" their rationale). 

1. The participant’s response is unorganized, incoherent, and difficult to follow. The participant may also not know what to say. 
2. The participant is unpersuasive. Unpersuasive responses may be characterized by either a) a rationale that lacks credibility and there is little reason to believe that it could be convincing. It is important here to try to be aware of your personal biases in judging credibility. As a rule, you can accept most explanations offered as being credible unless there is a clear logical flaw in the process of explaining their particular belief. b) a response that is expressed with a lack of confidence, lethargy, or uncertainty by the respondent will be low in persuasiveness. Even responses that don’t contain a rationale may be coded as low in persuasiveness. 
3. The participant’s response conveys little sense of persuasiveness. 
4. The participant speaks persuasively. The rationale may be more implicit and it is even possible that the rationale, though present, may be unclear, superficial, or marginally relevant to the other’s problems. 
5. The participant is highly persuasive. Persuasive persons may speak with great confidence, certainty, and authority. Advice may or may not be given, but the participant must offer some rationale or re-framing of the other's experience. 

4. Emotional Expression. This item rates the energy and emotion in the participant's response. This item rates the extent to which the participant’s response is delivered with effective expressions of emotion. 

1. The participant speaks with little or no affect and may be dull or boring (e.g., speaking in a near monotone voice and without intensity).
2. The participant may display some sense of interest or curiosity, but the response is not emotionally engaging. Prosody is somewhat less than typical to casual conversation. 
3. The participant has prosody, but it is the amount of emotion that one might find in ordinary conversation. 
4. The participant is emotionally expressive at a moderate level. There is more emotion than found in ordinary speech, but it is not as focused in its delivery as the maximum rating of 5. 
5. There is affect and prosody in the participant's voice. The response is delivered in a highly emotional and engaging manner. The primary criterion is that the vocal expression conveys emotion. There may be a more focused delivery of emotional intonations to emphasize meanings that influence other processes (e.g. persuasion). The participant may even be somewhat provocative or challenging in delivering an emotion-based response toward the client in the video clip. However, a "5" should not be rated if the affect is primarily demeaning or hostile toward the other (in which case a "3" would be the maximum rating possible). 

5. Warmth, Acceptance, & Understanding. This item is a rating of the ability of the participant to care for and accept the other. Therapist behaviors/attitudes that might indicate an absence of acceptance and understanding include: a judgmental attitude, condescension, rudeness, disapproval, guilt-induction, exasperation, or annoyance. Often it will be necessary to avoid rating what the participant is doing (e.g., giving advice), but rate how it is being done. Note that accepting does not necessarily mean approval, but rather a caring attitude and determination to help the other.

1. The participant has an obvious lack of respect, acceptance, or warmth for the other (e.g., clearly pejorative comments, judgmental attitude, condescension, disapproval, guilt induction, blaming the other). 
2.  The participant conveys a subtle lack of respect, acceptance, or concern of the other (e.g., sarcasm, exasperation, annoyance). 
3. There is an "ordinary" level of courtesy and warmth in the response OR the participant's opinion of the other may not be clearly discernable from the response. 
4. The participant’s response is genuinely nonjudgmental and gently explores the other's thoughts, feelings, alternatives for dealing with future situations, etc. The participant appears concerned for and respectful of the client. 
5. The participant expresses clear and obvious warmth, concern and acceptance. The participant may, for example, make a compassionate attempt to relate to the other’s experience. 

6. Empathy. The capacity to respond with an expressed understanding of the subjective experience of the client. The response must also convey an accurate understanding of the thoughts and emotions expressed in the video clip. Therefore, it is especially important that the rater have an accurate understanding of the client’s experiences in the video clips. 

1. Participant clearly distorts the other's experience. That is, the participant misidentifies a significant component of the other's complaints, beliefs, emotions, etc. Give a rating of 1 if the response indicates a clear disregard of the other’s experience.
2. Participant does not communicate an awareness or understanding of the other’s experience, and/or there are minor distortions of the other’s experience. Some aspects of the participant's response may be irrelevant to the other's concerns (when clearly not an attempt to change the other's focus). 
3. Participant is generally accurate about the other's experience but only perceives the more obvious aspects of the other's experience or concerns. 
4. Participant comments accurately on the other's experience but not to the extent required to receive a “5" rating. The distinction between the 4 and 5 ratings are matters of intensity. 
5. Participant alludes to the client's experience so that it is clear that he/she has not only listened, but obtained an exceptional comprehension of what the other is experiencing. In order to receive a "5" the participant must infer something about the other's experience that is not explicitly stated by the other but is clearly identifiable in the client’s nonverbal expression. 

7. Alliance Bond Capacity. This item rates the participant's capacity to provide a collaborative environment, one in which there is recognition of the need to work with the client jointly on problems.

1. The participant actively undermines a mutual collaboration. The participant may respond in a way that is over-involved or reactive (e.g., moralistic lecturing, "preaching" to the other, assuming all responsibility). The rupture may also involve withdrawal or under-involvement in the participant’s response (e.g., putting all the responsibility for change on the other).
2. The participant may slightly undermine the building of a collaborative atmosphere, although it may be unintentional or superficial. 
3. The participant neither undermines nor attempts to enhance a collaborative effort. 
4. Some effort to collaborate is made but not as strong as a “5” (e.g., subtle invitations to engage in working with the client). 
5. Specific actions on the part of the participant help create a collaborative atmosphere. There should be a sense that the participant is attempting to work with the other to create a "we-ness" that is implied in the participant's behavior (e.g., participant checks with the other by asking questions about the "fit" of interpretations, conclusions, goals, etc.). 

8. Alliance Rupture-Repair Responsiveness. Background: Each client in video clips is expressing an interpersonal issue that involves the patient-therapist relationship. Each video clip places the participant in the middle of alliance rupture episodes. Further, these rupture episodes take place at different locations within the interpersonal circle, which requires interpersonal flexibility for the therapist. The interpersonal problem with the client-therapist relationship threatens the development of the alliance.

This item rates the extent to which the therapist appears responsive to the interpersonal issue. In some cases, the problem is clearly stated as when Suzie angrily berates the therapist for being ineffective. In other cases, the problem is more implicit such as when Lauren idealizes the therapist to the extent of leaving herself overly vulnerable to disappointment. 

1. Participant reacts to the interpersonal tension in a way that is nonproductive or in a way that likely exacerbates the rupture (e.g., responding negatively to a hostile client; responding to a controlling client with counter-control). Low scores also may be given when the participant fails to respond to the interpersonal issue involved in a way that indicates that the participant is avoiding the interpersonal issue or the relationship altogether. 
2. Participant addresses an issue to discuss that it is tangentially related to the interpersonal issue presented, but directs the discussion away from the present relationship situation. 
3. There may be more casual recognition of the interpersonal situation, but the response does not draw for further discussion of the issue or the relationship. 
4. Participant recognizes the other’s interpersonal issue, and may discuss this further in more general terms (or discuss some secondary element of the other=s issue or the relationship). 
5. Participant makes attempts repair the interpersonal issue by engaging the client in a direct discussion of the immediate moment-to-moment interaction. This may include how specific relational messages are being expressed by the client in the video clip. Optimal responses will include attempts to not only allude to the interpersonal tension, but make some attempt to repair that interpersonal issue. 

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Anderson, T., Ogles, B. M., Patterson, C. L., Lambert, M. J., & Vermeersch, D. A. (2009). Therapist effects: Facilitative interpersonal skills as a predictor of therapist success. Journal of Clinical Psychology, 65(7), 755-768.

• Study. 
• Things that didn't matter: therapist age, therapist gender, percentage of working time conducting treatment, therapist theoretical orientation. 
• Facilitative interpersonal skills (FIS) was found to be "a significant predictor of outcome." (Older therapists tended to have greater FIS skills.) 
• FIS measured through the Facilitative Intepersonal Skills (FIS) Performance Task.

Anderson, T., & Patterson, C. Facilitative Interpersonal Skill Task and Rating Method.

• FIS = common factors
• The FIS approach is not to minimize the effect of techniques, however, but to elevate their importance by recognizing that techniques are on par with relationship variables and the other common factors. The FIS assumes that techniques are of great importance, but that there are a variety of techniques that helpers can use. 
• Interpersonal skills are the learned emotional and interpersonal patterns of behavior that allow some people to be more effective at navigating through difficult and complex interpersonal situations.
• FIS: 1) perceiving, understanding, and sending a wide range of interpersonal messages and 2) persuading others who have personal problems to apply proposed solutions to their problems and abandon maladaptive patterns.
• Anderson, T., Crowley, M. E., Himawan, L., Holberg, J., Uhlin, B. (2013). A Controlled Study of Therapist Facilitative Interpersonal Skills and Training Status on Alliance and Outcome. (current revise and resubmit status): Those therapists with high facilitative interpersonal skills had higher client outcomes and higher client- and therapist-rated working alliance than did therapists with low facilitative interpersonal skills. Importantly, the high facilitative doctoral students from non-helping disciplines were just as effective as were the high facilitative clinical psychology doctoral students.