On Analytic Process

Abstract

An innovative methodology is presented for identifying and assessing change process in psychoanalytic treatments. Using the Psychotherapy Process Q-set (PQS), a panel of experienced psychoanalysts developed a prototype of an ideal psychoanalytic hour. This prototype was then applied to verbatim transcripts of three archived treatment samples: psychoanalyses, long-term analytic therapies, and brief psychodynamic therapies. The degree to which these treatments fostered an analytic process as represented by the prototype was measured quantitatively. Analytic process was significantly more present in psychoanalyses than in the long-term analytic therapies, which, in turn fostered significantly more analytic process than did brief psychodynamic therapies. The study demonstrates that, given descriptive language that does not represent a particular theoretical perspective, analysts can agree on a definition of analytic process, and that analytic process can be operationalized and quantitatively assessed. A second study demonstrates that despite consensus on its definition, there is not just one proper analytic process; rather, there are change processes unique to each dyad. Two quantitative case studies illustrate how each analytic pair has a unique interaction pattern linked to treatment progress. These dyad-unique “interaction structures” are recurrent, mutually influencing patterns of interaction, the experience, recognition, and comprehension of which appear to be a fundamental component of therapeutic action. A bipersonal model is described that attempts to bridge theories of therapeutic action that focus on insight and self-understanding and those that emphasize the patient's experience of the therapist.

Uncovering Interaction Structures in a Brief Psychodynamic Psychotherapy

“…The results found demonstrate that in this therapeutic modality, the patient and therapist establish repetitive patterns of interaction and relationship, as in the example of what happens in long-term psychotherapies (Jones et al, 1993;Jones & Price, 1998;Pole & Jones, 1998) and in psychoanalysis (Ablon & Jones, 2005). Hence, independently of the frequency or duration of the psychotherapy, the set of the studies undertaken in this line of investigation shows that each therapeutic pair interacts repeatedly in different ways over the course of a single treatment.…”

“…The construct, which integrates other concepts such as that of enactment, intersubjectivity and role-responsiveness is operationalized empirically through the repeated application of the PQS to the sessions of a psychotherapy (Jones, 2000). The interaction structures are an essential part of the process and contribute to facilitating or impeding the therapeutic process (Ablon & Jones, 2005).…”

“…Through the application of Q type factor analysis procedures to the codifications of the therapeutic process undertaken using the PQS, various single and multiple case studies have identified interaction structures in long-term psychodynamic psychotherapies (Jones, Ghannam, Nigg, & Dyer, 1993;Jones & Price, 1998;Pole & Jones, 1998) and also in psychoanalysis (Ablon & Jones, 2005). Generally speaking, these revealed a limited number of factors (between 3 and 5), including both patterns which are unique to the specified dyad and patterns which are repeated in various cases (Goodman, Edwards, & Chung, 2014).…”

Simulation modeling analysis of sequential relations among therapeutic alliance, symptoms, and adherence to child-centered play therapy between a child with autism spectrum disorder and two therapists

“…Due to the limitations of randomized controlled trials (Duncan, 2002; Goodman, 2010; Westen, Novotny, & Thompson-Brenner, 2004), some psychotherapy researchers are turning to single-case designs to explore questions of the treatment process and its effectiveness (Iwakabe & Gazzola, 2009). Psychotherapy researchers use such designs to explore which interventions work for individual patients at the level of a single case in the hope that these single cases can be gradually aggregated to enhance practice-based knowledge (Ablon & Jones, 1999, 2005; Iwakabe & Gazzola, 2009; Jones, 1993, 2000; Jones, Ghannam, Nigg, & Dyer, 1993).…”

Psicoterapia de Crianças: Desenvolvimento da Versão em Português do Child Psychotherapy Q-Set

“…O uso do CPQ em novas investigações poderá possibilitar a identificação das estruturas de interação terapeutapaciente ao longo do tratamento (Jones, 2000) e a relação de tais estruturas com os resultados (Ablon & Jones, 2005;Goodman, Edwards, & Chung, 2014;Jones, 2000). Explorar diferenças no processo terapêutico entre pacientes, terapeutas, mudanças nos itens ao longo do tempo de um tratamento, mudanças nos itens como função do resultado, o grau de adesão aos protótipos ou modelos teóricos, as mudanças nessa adesão ao longo de uma psicoterapia são possibilidades oferecidas pelo instrumento com potencial de contribuir para a ampliação do conhecimento acerca dos processos envolvidos na psicoterapia de crianças.…”