Mechanisms Of Change In Psychotherapy Research Articles

Psychotherapists collect data during routine clinical work that can contribute to knowledge about mechanisms of change in psychotherapy.

Therapists providing psychological treatments routinely pose and test hypotheses about mechanisms of change, including mechanisms of change in cognitive therapy for depression. When they use systematic, objective, and scientific methods to do these tasks, clinicians can simultaneously provide quality care and contribute to the field's understanding of the mechanisms of therapeutic action. This article presents evidence supporting these assertions and offers examples of data collected in routine clinical practice that answer important questions about the process of change in cognitive therapy for depression.

Identifying mechanisms of change in psychotherapy: Mediators of treatment outcome

AbstractWe know that psychotherapy works, but the processes and mechanisms underlying therapeutic change are still largely unknown. The study of mediators and moderators of change in psychotherapy is one way to improve our understanding of mechanisms operating in psychotherapy. Consensus is slowly building on how to define both mediators and moderators of change, while there is still a controversy on strategic issues, e.g., criteria for demonstrating causality. The rationales for mediator research are discussed, as well as some of the major obstacles inherent in this research area. Finally, we present some strategic considerations for future research. Copyright © 2007 John Wiley & Sons, Ltd.

Psychotherapy for patients with borderline personality disorder: Focusing on the mechanisms of change

A major development in the field of psychotherapy research is the growing recognition of the need for evidence on the mechanisms of change in psychotherapy. The empirical evidence that psychotherapy has a positive and significant effect must be amplified with data on the mechanisms of action in the various psychotherapies. This special issue is devoted to the articulation of putative mechanisms of change in the psychotherapy of patients with borderline personality disorder by leading researchers in this field.

Reexamining Psychotherapeutic Action Through the Lens of Trauma

Work with survivors of childhood trauma sheds light on the enigmatic subject of just how psychotherapy produces change. The focus of this paper is the observation that there are two fundamental change mechanisms in psychotherapy, catharsis and internalization . Each one has a different time course and different clinical characteristics including the role played by the therapeutic relationship. Catharsis is triggered by the presence of the empathically attuned therapist, while internalization is driven by the therapist's slightly aloof stance of expectancy and the patient's need for connection. Each mechanism has a different childhood origin. Taken together, these two mechanisms are sufficient to explain therapeutic gains in other forms of psychotherapy and with other pathologies.

Linking in-session change to overall outcome in short-term cognitive therapy.

To better understand the mechanisms of change in psychotherapy, it is important to validate suboutcome measures that represent intermediate links between more molecular in-session changes and ultimate outcome. The present study involved the collection of pre- and postsession ratings from 53 patients in a 20-session protocol of cognitive therapy, which yielded 5 suboutcome measures: Anxiety Shift, Depression Shift, Cognitive Shift, Optimism Shift, and Therapeutic Alliance. From a series of regression analyses of repeated measures with a generalized estimating equations approach, results regarding the predictive relationship of these variables to a number of patient and therapist-rated outcome criterion variables indicated that change in cognition and quality of the therapeutic alliance were the strongest predictors.

La relevancia de la flexibilidad psicológica en el contexto del cáncer: una revisión de la literatura

La flexibilidad psicológica ha sido relacionada con diversos indicadores positivos en individuos con problemas de salud mental y enfermedades crónicas, y ha sido identificada como un importante mecanismo de cambio psicoterapéutico. Sin embargo, la atención prestada a la flexibilidad psicológica en la psicooncología ha sido limitada, a pesar de su potencial relación con el distrés relacionado con el cáncer. El objetivo de la presente revisión descriptiva fue reunir los estudios que han examinado la asociación entre la flexibilidad psicológica y distintos indicadores de bienestar en pacientes con cáncer, o evaluado el impacto de intervenciones destinadas a incrementar el nivel de flexibilidad psicológica en pacientes con cáncer. A pesar del bajo número de estudios, los resultados demuestran de forma consistente que la flexibilidad psicológica está asociada a altos niveles de bienestar en pacientes con cáncer, incluso en presencia de deterioro físico. Para finalizar, se presentan algunas implicaciones para la práctica clínica en psico-oncología.