This study adds a phase-by-phase perspective to the well-known, and thoroughly analysed on a moment-by-moment basis, case of Lisa. The aim is to see whether this phase-by-phase analysis adds anything valuable to the understanding of the processes of change in this case and the therapeutic processes in general. In this good-outcome case study, a team of raters integrated the temporal sequencing phase component of the Paradigmatic Complementarity Metamodel (PCM) with a moment-by-moment tracking method-the Developmental Analysis of Psychotherapy Process Method (DAPP)-to analyse what occurred along the process that could explain the phase transitions and consolidations observed and how the therapist facilitated them. We illustrate and explain the therapeutic progression with therapeutic interactions from the dyad. The results suggest that Lisa evolved in accordance with the sequence of phases proposed by the PCM until phase 4 (out of 7). However, only phase 2 gains show evidence of structural consolidation. The sequence of phases proposed by the PCM seems to represent a natural progression for patients throughout the therapeutic process, and the consideration of a phase-by-phase map in analysing and thinking of therapeutic cases may be a valuable tool regarding clinical decision making.
As narrativas são frequentemente consideradas o meio por excelência de reconhecimento e reorganização da experiência interna dos pacientes. Neste estudo procurou‑se diferenciar e identificar potenciais marcadores narrativos de capacidade de processamento e, ao quantificá‑los em diferentes momentos do processo terapêutico, verificar se existia evidência a favor da proposta de sequencialização do trabalho terapêutico do Meta‑modelo de Complementaridade Paradigmática, em termos de estratégias gerais. Foram definidos, reconhecidos e analisados processos narrativos a nível molecular (a partir da revisão de literatura) e a nível molar (a partir da teoria do meta‑modelo supra‑referido). Em ambos os casos, enfatizou‑se as formas e capacidades de processamento da informação em detrimento dos conteúdos narrados. Os resultados evidenciaram diferenciação e movimentação entre as fases consideradas para processos moleculares e molares, e nestes últimos reconheceu‑se um padrão de progressão narrativa de acordo com a sequencialidade proposta pelo modelo, para as fases em estudo.DOI: http://dx.doi.org/10.17575/rpsicol.v25i1.284
Feature heterogeneity and diagnostic overlap occur regularly among patients in clinical settings. In interpersonal reconstructive therapy (IRT), a case formulation focused on patterns learned in close attachment relationships guides intervention choices. This study illustrates how IRT formulation and treatment proceed, and how it may also fail when there is not close adherence to underlying principles. Don is a music professor in his 40's with a significant trauma history and complex diagnostic profile that includes many hospitalizations and suicide attempts. He qualified for several diagnostic and statistical manual of mental disorders personality disorders via formal diagnostic interviews (obsessive-compulsive, avoidant, passive-aggressive, narcissistic), as well as major depression, generalized anxiety, and substance abuse. Don's formulation demonstrates how self-destruction can function as a "gift of love" to internalized representations of important caregivers. Data from work with patients like Don confirm the usefulness of Benjamin's IRT lens for navigating comorbidity, as well as the importance of underlying principles of change.
In this article, we discuss the process of terminating psychotherapy based on an integrative perspective-the paradigmatic complementarity metamodel (PCM). One of the research fronts in PCM is the temporal sequence of phases structuring strategic objectives. The temporal sequencing of the therapeutic work in terms of phases, stages, or steps is believed to be a general principle of change among different theoretical orientations, both of an integrative and nonintegrative nature (Vasco, 2006;Vasco et al., 2018). According to the PCM, the therapeutic process unfolds as the client and therapist progress along 7 phases regarding the implementation of strategic objectives. In this article, we address termination and its implications at different phases of therapy considering the PCM. Some vignettes are used as illustrations.
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