Abstract
Psychotherapy is an important approach for the treatment of psychiatric disorders. Apart from treating disorders as such, psychotherapy aims at increasing patients' well-being. The Therapeutic Cycles Model (TCM) is a process-oriented theoretical model that makes predictions about the psychotherapeutic progress based on verbatim content. The model helps to identify therapeutic factors on a language level. The present study aims at analyzing transcripts of group therapy sessions with forensic psychiatric patients using the rationale of the TCM. Furthermore, the relationship between linguistic features of psychotherapy sessions and patients' well-being before and after therapy are investigated. In order to identify therapeutic factors, a group psychotherapy with nine drug addicted forensic psychiatric patients was videotaped and transcripts of N = 16 sessions were analyzed. Process-oriented measures were rated by the patients, their therapists, and an external observer. Patients' self-reported well-being before therapy was negatively related to Connecting (indicating emotional insight), and the frequency of therapeutic cycles, which are both thought of as key moments in therapy. Well-being of forensic patients is not necessarily a helpful precursor for insightful and productive events in therapy to occur. The findings help to better understand psychotherapeutic micro-processes throughout forensic therapies, and their relationship with patients' well-being. Implications for research and the forensic practice are discussed.
Highlights
The psychotherapeutic treatment of offenders and forensic patients is effective [1,2,3]
Micro-processes in psychotherapy and change agents in offender treatment are in the center of ongoing psychotherapy processoutcome research [4]
Using the rationale of the Therapeutic Cycles Model (TCM), the present study aims at analyzing transcripts of group therapy sessions with forensic psychiatric patients diagnosed with substance use disorders
Summary
The psychotherapeutic treatment of offenders and forensic patients is effective [1,2,3]. It is not entirely clear which psychotherapeutic processes promote behavioral change. Micro-processes in psychotherapy and change agents in offender treatment are in the center of ongoing psychotherapy processoutcome research [4]. A very broad and prominent model that summarizes empirical factors at play in psychotherapy is the Generic Model of Psychotherapy [5]. Six aspects of psychotherapy are outlined: therapeutic contract, therapeutic operations, therapeutic bond, participant self-relatedness, insession impacts, and temporal patterns. In-session impacts describe what happens in a therapy session, i.e. emotional reactions, or insight
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