Therapeutic Atmosphere in Psychotherapy Sessions.

Marte L Siegel,Eva M Gullestad Binder,Kenneth L Critchfield,Per A Høglend,Randi Ulberg,Hanne Sofie J Dahl,Nikolai O Czajkowski

doi:10.3390/ijerph17114105

Abstract

There is uncertainty concerning what the active ingredients in psychotherapy are. The First Experimental Study of Transference interpretations (FEST) was a randomized controlled trial of the effects of transference work (TW) in psychodynamic psychotherapy. Women with low quality of object relations (QOR) showed a large positive effect of transference work, while men with high QOR showed a slight negative effect. The present study aimed to expand the knowledge from the FEST by investigating the therapeutic atmosphere with Structural Analysis of Social Behavior (SASB). Two-way ANOVAs were conducted to investigate differences between SASB cluster scores between subgroups. The therapeutic atmosphere was characterized by Protect–Trust, Affirm–Disclose and Control–Submit. Multilevel modeling was used to assess the relationship between a therapist variable and outcomes for men and women. Contrary to expectations, no significant differences in therapeutic atmosphere between subgroups (with or without TW in women with low QOR and men with high QOR) were observed using the process measure SASB.

Highlights

What characterizes the in-session psychotherapeutic environment that promotes improved mental health? It is well established that psychotherapy is effective for many people who seek psychological treatment [1,2,3]
What characterizes the therapeutic environment in these therapies? Examining the process between therapist and patients in sessions may shed light on the atmosphere in therapy which may contribute to the understanding of outcomes. Based on these results from First Experimental Study of Transference interpretations (FEST), we aim to investigate what characterizes the therapeutic atmosphere in good outcome psychodynamic therapy across time with and without transference work (TW) in men with high quality of object relations (QOR)
When patient gender was combined with the moderator QOR, a strong effect emerged: women with low QOR showed a large positive effect of transference work and men with high QOR showed a negative effect of transference work [32]

Summary

Introduction

What characterizes the in-session psychotherapeutic environment that promotes improved mental health? It is well established that psychotherapy is effective for many people who seek psychological treatment [1,2,3]. The elements that constitute psychotherapy can be divided into common factors and specific techniques. The term “common factors” refers to shared aspects of all effective treatments including alliance, empathy, expectations, cultural adaptation, and therapist differences [5]. Of these components, an alliance between therapist and patient is the most researched [3]. A specific technique in psychotherapy can be understood as a defined tool or method used by a therapist to promote effective therapy or positive change in the patient [6], in addition to the common factors

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Conclusion