TABLE 3.

Validation of Model of Therapeutic Effectiveness

	Correct, %a
Domains and Themes	Domain Categorization	Item Categorization
A: Personal growth and self-care
1. Maintain a balanced life	100	100
2. Work at self-awareness	100	96.9
3. Acknowledge/work through our own fears	100	96.9
4. Acknowledge your own feelings of vulnerability or helplessness	100	98.4
5. Debrief with colleagues	100	93.8
6. Value professional development	NA	NA
B: Therapeutic approaches
7. Clarify and name sources of distress	100	95.3
8. Problem-solve	100	100
9. Educate, inform client	98.4	93.8
10. Debunk myths	100	98.4
11. Reinforce client strengths and positive ways of coping	100	92.2
12. Provide techniques (eg, mindfulness, Therapeutic Touch)	100	98.4
13. Advocate for client with the care team	98.4	92.2
14. Foster positive relationships between client and family	100	78.1
15. Elicit client needs	98.4	96.9
16. Probe for feelings underlying events and circumstances	98.4	92.2
17. Help client identify what they can and cannot control	100	93.8
18. Help client understand by mirroring and reflection	98.4	85.9
19. Use silence to encourage client expression	98.4	82.8
20. Explore image and metaphor	100	95.3
21. Offer comfort through touch	87.3	67.2
22. Acknowledge spiritual distress	98.4	81.3
C: Creation of a safe space
23. Provide privacy	100	98.4
24. Provide calming environment	100	89.1
25. Assure confidentiality	NA	NA
AB: Therapeutic humility
26. Do not avoid emotion	100	100
27. Tolerate clinical ambiguity	100	93.8
28. Be able to explore difficult topics	96.9	96.9
29. Accept and honor client as expert	81.3	76.6
30. Be a catalyst for therapeutic change	93.8	90.6
31. Trust in the process	89.1	89.1
32. “Sit with” client emotional distress	92.2	87.5
33. Avoid urge to have to fix	92.2	92.2
34. Model healthy processing of emotion	93.8	93.8
BC: Therapeutic pacing
35. Listen attentively	95.3	95.3
36. Hold or ground client	85.7	82.8
37. Keep client in the here and now	87.5	87.5
38. Maintain slow pace—do not rush therapy	89.1	87.5
39. Encourage client to talk about fear and distress	85.9	85.9
40. Normalize and validate client experience and distress	85.9	85.9
41. Use skillful tentativeness	90.6	90.6
AC: Therapeutic presence
42. Being compassionate and empathetic	95.3	93.8
43. Being respectful and nonjudgmental	95.3	92.2
44. Being genuine and authentic	93.8	92.20
45. Being trustworthy	93.8	93.8
46. Being fully present	95.3	90.6
47. Valuing intrinsic worth of client	90.6	89.1
48. Being mindful of boundaries	76.6	76.6
49. Being emotionally resilient	85.9	85.9

Abbreviation: NA, not applicable.

^aNote that correct item categorization indicates concurrence with the primary or hybrid domain item placement, and correct domain categorization indicates that, although there is disagreement with the actual item placement, there is agreement with the overall domain placement.