Symposium sobre resultados en investigación y proceso de psicoterapia presentado en el Congreso Mundial de Psicoterapia celebrado en Lucerna, Suiza, entre los días 16 y 19 de julio. Este congreso fue organizado por la International Federation for Psychotherapy (IFP).
Este symposium corresponde a distintas investigaciones desarrolladas por investigadores españoles.
Psychotherapy research: advances in outcome and process research with cognitive and psychoanalytic psychotherapy
Alejandro Avila Espada1, Isabel Caro Gabalda2, Luis Botella García Del Cid3, Luis Ángel Saul Gutiérrez4. 1Universidad Complutense (Madrid, SPAIN) 2Universidad de Valencia (Valencia, SPAIN) 3Universitat Ramon Llull (Barcelona, SPAIN) 4Universidad Nacional de Educación a Distancia (Madrid, SPAIN)
Chair: Alejandro Ávila-Espada
Objectives: To depict a portrait of the last two decades of research in psychotherapy processes performed conjointly by Spanish and other countries researchers from a variety of theoretical frames (Cognitive, Psychoanalytic, Integrative)
Methods: Qualitative and quantitative strategies have been used for the study of the interplay between outcome and process along several cases depicted in depth. In the first part special attention is paid to predictors of good and poor outcome. In the second we have worked with the assimilation model, focusing on setbacks in the process of assimilation in a good outcome case. In the third one, with a woman who consulted because of her depressive symptoms and eating disorder monitoring the changes in self-concept. Last, with the whole treatment of the Publicist, including all the main dimensions considered essential in psychoanalytic psychotherapy process. Whole Results and Conclusions: Poor and good treatment outcome can be predicted with accuracy. Measures of the structure of the construct system (including cognitive conflicts) can be used also to establish the evolution across therapy of changes in the patient levels of psychological distress. APES setbacks could be used to yield a deeper description of the process of change involving affective, cognitive and behavioural levels. Finally new models for change processes can be established to improve research and practice in psychoanalytic psychotherapy, cognitive therapy and integrative psychotherapy.
Title: Outcome and Process in Cognitive Integrative Psychotherapy
Presenting author: Luis Botella, Diana Beriain, Lydia Lossa, Yolanda García, Judit Lecue, Ariadna Pijuan & Sergi Corbella (U. Ramon Llull, Barcelona, Spain)
Content: This summarizes and reviews the main results of a series of studies conducted during the last ten years at the Blanquerna Psychotherapy Unit (Ramon Llull University, Barcelona) regarding the outcome and process of cognitive integrative psychotherapy and the interplay between outcome and process. Special attention is paid to predictors of good and poor outcome, differential therapeutic processes between clients with different complaints and different attachment styles, the influence of therapist’s differential effects on differential client’s outcome and process, and the role of therapist’s emotional self-regulation in the therapeutic process. Research results are connected to implications for psychotherapeutic practice.
Title: The assimilation model: the irregular process of assimilation
Presenting author: Isabel Caro Gabalda (University of Valencia, Spain) & William B. Stiles (Miami University, Ohio, USA)
Content: The assimilation model, through the Assimilation of Problematic Experiences Scale (APES) describes the process of change at different stages: 0.Warded-off; 1.Unwanted Thoughts; 2.Emergence; 3.Clarification; 4.Insight; 5.Application; 6.Problem Solution; 7.Mastery. Each advance along this scale could be considered as assimilation progress. However, in the context of cognitive psychotherapies it has been found that this process is not an smooth one but it shows noticeable setbacks. A setback could be defined as a return from a higher stage to a lower stage of the APES, i.e., a client could reach, after a therapeutic discussion, an APES stage of 4 (Insight), however, when the topic is discussed again, the client could “return” to lower APES stages, perhaps to APES stage 2 (Emergence). This study focuses on setbacks in the process of assimilation in a good outcome case: Gabriel, treated with linguistic therapy of evaluation. Gabriel’setbacks (more than 100) in his process of assimilation will be considered in light of several alternative explanations. Most frequently, setbacks appeared to be due to the therapist working at a higher APES stage that the patient would alone (zone of proximal development concept), or to a therapeutic strategy reflecting cognitive therapy work (balance metaphor) or to other reasons for switching among multiple strands of the problem. Paper discussion will emphasize how setbacks could be used to yield a deeper description of the process of change involving the affective, cognitive and behavioural aspects that the assimilation model depicts.
Title: Monitoring the change of personal meanings across the therapy process using the Repertory Grid Technique: A case study
Presenting author: Luis Ángel Saul (UNED, Spain); Guillem Feixas (U. Barcelona, Barcelona, Spain); Maria de los Angeles Lopez-Gonzalez (UNED)
Content: This work presents a clinical case of Ana, a woman who consulted because of her depressive symptoms and eating disorder. Her personal meanings were assessed using the Repertory Grid Technique (Kelly, 1955). With this method her personal constructs about herself and others were explored. Further applications of the same grid (inter, end and follow-up of therapy) permitted to monitor changes in his self-concept and view of others, in diverse measures of the structure of the construct system (including cognitive conflicts), and also to relate those measures and their evolution across therapy to changes in his levels of psychological distress.
Title: A Model of Change Processes developed for Psychoanalytic Psychotherapy. Integrating Qualitative & Quantitative Methods in single case research
Presenting author: Alejandro Ávila-Espada (U. Complutense, Madrid, Spain); Merce MItjavilia García (U. A. Barcelona, Barcelona, Spain)
Content: An international team of researchers have worked along a decade (1997-2008) in the Salamanca-Barcelona-Madrid Project on Psychotherapy Process Research (SMBP; Ávila-Espada, Vidal-Didier et al., 1998a; Ávila-Espada, Gutierrez, Mitjavila & Poch, 2002). This project, an study conducting single case research (The Publicist), along the main phases of complete treatment (up to 200 recorded sessions), have given us the opportunity to adquire a better knowledge on the main dimensions of the therapeutic process in psychoanalytic psychotherapy, through the content analysis of sessions and with qualitative data using a variety of procedures. Crossing all the studied dimensions we have developed a comprehensive model of change observed in the studied case, considering both the contributions of the therapist and the patient to change. Results are discussed in the light of the new methodological possibilities offered by this kind of approach to improve research in psychoanalytic psychotherapy.