Psychodynamic Factor as Predictor of Outcome in the Treatment of a Psychosomatic Spectrum Patient

Abstract

To investigate through the prototype methodology as well as the interaction structures methodology which are the factors involved in the psychotherapeutic progress in the treatment of a patient with chronic diseases and somatic symptoms. 62 of the total 120 videotaped sessions were analysed by independent judges using the Psychotherapy Process Q-Set. The interaction structures as well as the extent to which each session conformed to the ideal psychodynamic, cognitive behavioural therapy (CBT) and reflective function prototypes were evaluated through multiple regression analysis, in order to test which factors were able to predict therapeutic progress. The psychotherapeutic process was characterized by moderate adherence to both psychodynamic and CBT prototypes and by greater adherence to the reflective function prototype. The therapeutic progress was better predicted by the adherence to the psychodynamic prototype. Both the psychodynamic technique and the reflective function were prominent factors in this case. Mentalization has been considered a “common factor” among different psychotherapeutic approaches, and our results highlight the importance of considering it along with specific technical aspects. Examining elements of the therapeutic process focusing on the complex interaction among these different aspects can provide helpful new insights into the process factors associated with a favourable outcome.