Evaluation of a Therapeutic Concept Diagram

Abstract

Documentation used in psychotherapy for quality assurance can be useful, but also time consuming and inflexible. In the process of behavior analysis, therapy planning and conducting therapy, a large amount of clinical data have to be structured and organized. We present an economical documentation method that contains information about the most important causes of problem behavior and expectations about how much certain therapy components will achieve the therapist and client therapy aims. This documentation method can assist therapy planning, serve as a communicative tool for colleagues and supervisors, serve as an educational tool for clients, and be utilized as a self-reflective therapy discourse (quality assurance). The paper describes and pilots the use of a transtheoretical, graphic approach, the therapeutic concept diagram, for the above-mentioned aspects of quality assurance. Four experienced analytic therapists and six experienced cognitive-behavioral therapists documented therapeutic concept diagrams for five clients each. These 50 recorded therapeutic concept diagrams are described. In general, the diagrams were rated as useful for documentation and treatment planning. Ratings of the diagrams as a communicative tool and for a self-reflective therapy discourse were heterogenic, with analytical therapists tending to benefit more. The discussion focuses on application settings and limitations and highlights the heuristic value of assessing idiographic hypotheses.