Psychotherapy process in the National Institute of Mental Health Treatment of Depression Collaborative Research Program.

Abstract

This study examined psychotherapy process in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Transcripts of brief interpersonal and cognitive-behavioral therapies were rated using the Psychotherapy Process Q Set (PQS), an instrument designed to provide a standard language for describing therapy process. Results demonstrated that there were important areas of overlap and key differences in the process of the treatments. There were important differences in therapist stance, activity, and technique that were consistent with theoretical prescription, but patient characteristics within sessions were quite similar. Patient in-session characteristics as measured by the PQS were related to outcome across the treatment samples. These findings are linked to theoretical models, which may help explain the role of nonspecific factors associated with nondifferential treatment outcome in brief therapy.

Investigation of the Phase Model of Psychotherapy Across Therapeutic Orientations: Are Different Approaches Actually All That Different?

“…A study of particular interest to the current endeavor is Albon and colleagues' analysis of psychotherapy process which attempted to assess the stance and interactions of the patients and therapists in each session (Albon and Jones, 1999). Their findings indicate that therapists of different orientations exhibited a focus on different techniques during the psychotherapy process.…”

Elaboração da versão em português do Psychotherapy Process Q-Set

“…Usando o coeficiente de correlação de Pearson, foi então avaliada a concordância entre as duplas de avaliadores, tendo como parâmetro de fidedignidade interavaliadores coeficientes maiores ou iguais a 0,50, critério adotado em outros trabalhos com o PQS 34,38,42,[51][52][53] .…”

“…De fato, diversas pesquisas têm demonstrado que a aliança terapêutica é um importante preditor de resultados terapêuticos em diferentes psicoterapias [31][32][33] . Não há ainda, no entanto, estudos suficientes para esclarecer como tais fatores, específicos ou comuns, contribuem para a mudança em psicoterapia 34 .…”

“…Foi baseado nesses estudos que Jones 13,35 formulou o construto "estruturas de interação" (aspectos manifestos, comportamentais e emocionais da transferência e contratransferência) e desenvolveu uma teoria de ação terapêutica (da psicanálise e psicoterapia psicanalítica) que conjuga os efeitos do insight e do relacionamento paciente/ terapeuta sobre os resultados do tratamento. Além dos estudos causais, o PQS tem sido utilizado para comparar o processo terapêutico de diferentes psicoterapias 34,36,37 , identificar os fatores do processo que melhor predizem os resultados terapêuticos 30,38 , investigar diferenças entre fases de tratamento 39,40 , examinar o processo de formulação das hipóteses clínicas dos psicoterapeutas 41 , determinar protótipos de diferentes tratamentos psicanalíticos e psicoterápicos 42,43 , entre outras aplicações descritas na literatura.…”

Therapists' thoughts on therapy: Clinicians' perceptions of the therapy processes that distinguish schema, cognitive behavioural and psychodynamic approaches

“…Another fundamental assumption of CBT is that patients can access all the necessary information for change (Abrams & Abrams, 1997). Therapists take an active stance during therapy to guide the interaction, challenge negative cognitions, and encourage the patient to develop new ways of behaving (Ablon & Jones, 1999;Osatuke, Glick, Stiles, Greenberg, Shapiro, & Barkham, 2005). Practical exercises are often set between sessions to change cognitions and behaviour (Foreman, 2011).…”