Working through: In-session processes that promote between-session thoughts and activities.

Abstract

This study examined whether clients' ratings of the working alliance as well as their perception of cognitive-behavioral (CB) and psychodynamic-interpersonal (PI) techniques (delivered by therapists who used both) were associated with clients' intersession processes (i.e., their thoughts about therapy and therapeutic activity between sessions). Seventy-five clients who were currently in therapy at a large university counseling center participated in the current study. Multilevel regression analyses demonstrated that alliance and clients' perceptions of their therapists' use of PI techniques were positively associated with clients' general thoughts about therapy between sessions. Also, stronger alliances were associated with more therapeutic activities between sessions and more positive (and less negative) thoughts about therapy between sessions. In addition, clients at later sessions who described their therapists as using more PI techniques also reported engaging in more therapeutic activities between sessions (after controlling for the variance in the other variables, such as use of CB techniques). Clients' perceptions of their therapists' use of CB techniques in the most recent session were not related to thinking about therapy or therapeutic activities after controlling for the variance in the other variables.

The Intersession Process in Psychotherapy for Anorexia Nervosa: Characteristics and Relation to Outcome

“…In this very first stage, therapists do not intend to promote change, in contrast to the brief interventions evaluated in the Owen et al. () study. Additionally, applying therapeutic learning in the study of Owen et al.…”

“…Patients were more preoccupied with therapy contents in emotive and problem solving contexts compared to relaxed dreaming–drowsy contexts. This is something one would expect because psychotherapy generally encourages patients to use in‐session experiences to deal with difficult situations outside of therapy and develop new ways of relating and coping (Owen, Quirk, Hilsenroth, & Rodolfa, ). The difference between levels of the ISP according to contexts was also found in a previous study (Zeeck et al., ).…”

Interpersonal differentiation within depression diagnosis: Relating interpersonal subgroups to symptom load and the quality of the early therapeutic alliance

“…Targeted patient recruitment within predefined interpersonal classes may allow finer-grained analyses of sufficiently sized interpersonal subgroups. Future studies may differentiate between patient and therapist effects and consider the differential development of the therapeutic alliance over time to better explain the complex process-outcome relationships in therapy of depression (Barber, Khalsa, & Sharpless, 2010;Owen, Quirk, Hilsenroth, & Rodolfa, 2012). We expect that a better understanding of the role of interpersonal characteristics and processes will support custom-tailoring psychotherapy of depression and 438 M. Grosse Holtforth et al may contribute to better therapy outcomes (Norcross & Wampold, 2011).…”

Cognitive Behavioral and Psychodynamic Therapies: Points of Intersection and Divergence

“…However, the use of homework from a psychodynamic orientation is much less direct, systematic, or central to the treatment, and may be even be viewed by some as interfering. Some psychodynamic theorists would suggest that in longer-term treatment, the patient is already thinking about the last session and planning for the next, consciously or unconsciously (Owen, Quirk, & Hilsenroth, 2012). Implementing directive activities may disrupt this process or potentially contaminate the therapeutic relationship and transference reactions of patients.…”