Development and Validation of the Barriers to Using Immediacy Scale (BUIS)

• Published in: Journal of counseling psychology 2023-10, Vol.70 (5), p.571-583
• Main Authors: Hillman, Justin W., Gerstenblith, Judith A., Jankauskaite, Greta, Mohr, Jonathan J., Hill, Clara E.
• Format: Article
• Language: English
• Subjects: Attachment Behavior; Attachment Style; Barriers; Communication; Confirmatory factor analysis; Exploratory factor analysis; Factor Analysis; Factor Structure; Female; Human; Interpersonal communication; Male; Measures; Psychometrics; Psychotherapeutic Processes; Resistance (Psychology); Self Efficacy; Skills; Test Construction; Test Validity; Therapeutic alliances; Therapist Trainees; Therapists; Trainees; Treatment methods; Undergraduate students
• ISSN: 0022-0167; 1939-2168
• DOI: 10.1037/cou0000685

Immediacy is a skill therapists use to process the therapeutic relationship in the here and now. Although immediacy has been shown to enhance the therapeutic process, therapists are often reluctant to use it (Hill et al., 2018). In three studies, we developed and tested a measure to assess reasons that therapists avoid using this skill: the Barriers to Using Immediacy Scale (BUIS). In Study 1, 185 North American therapist trainees completed the 45-item pilot measure. Exploratory factor analysis supported a four-factor structure (Concerns About Client Reactions, Concerns About Therapist Reactions, Negative Beliefs About Immediacy, Lack of Skills for Using Immediacy). In Study 2, with an international sample of 352 therapist trainees and professionals, confirmatory factor analyses supported the original four correlated factors model, as well as alternative models. In Study 3, 89 undergraduate students in a helping skills class completed the BUIS at three points during the semester. Students' total barriers and barriers due to a lack of skills decreased, but other perceived barriers did not decrease after training. Across all three studies, predicted correlations of BUIS scores were found with measures of self-efficacy for using immediacy, adherence to different theoretical orientations, communication style, and attachment style. Incremental validity was supported by the association of BUIS scores with measures of open communication and attachment style, after accounting for self-efficacy for immediacy. Limitations and future directions are discussed. Public Significance Statement We provide preliminary evidence of strong psychometric properties for the Barriers to Using Immediacy Scale. The Barriers to Using Immediacy Scale could be used to help therapists and therapist trainees understand what gets in the way of using immediacy, as well as to track the success of training programs designed to reduce these barriers.