Innovative Moments Research Articles

A Dialogical Self Approach to Self-Innovation and Narrative Continuity in Retirement From Elite Sport

This case study aims to uncover the processes of narrative change in retirement from elite sport. Using Dialogical Self Theory, we examined resistance to retirement and narrative work in a recently retired, Swiss, male elite athlete from an individual sport. Two narrative interviews at 3-months and 1-year post retirement were analyzed using a holistic-content analysis, and an analysis of multivoicedness and innovative moments. We identified 39 I-positions and key innovative moments which were exceptions to the athlete’s problematic narrative and supported athletic retirement. Importantly, results demonstrate that the participant’s self-innovation began proactively before retirement, was necessitated by dialogue and supported by the introduction of a new future-oriented position, the position I-as-healing. Innovation continued after retirement and the position I-as self-reflective allowed the athlete to observe changes to his self-concept and restore continuity. Based on our findings, athletes should be supported in accessing a variety of I-positions to enable rich inner dialogue before they approach retirement from elite sport. Reflective practices which encourage meta-positions and help trace continuity far into their futures may also be advantageous. Practical considerations for the identification of I-positions in personal narratives during transitions are discussed.

Tracking narrative change in post-intervention focus groups for teachers: an exploratory study

ABSTRACT Reliable and systematic qualitative methodologies to assess participants’ change after group interventions are scarce. This study outlines a methodolo5gical approach to use in focus groups, allowing the elicitation and coding of participants’ change talk after a group intervention. A Change Elicitation Script for Focus Groups was developed and its viability for evoking participants’ discussion around change was tested. Following a self-compassion intervention for teachers, participants’ dialogue was examined in three focus groups following a simplified version of Innovative Moments Coding System for groups. Results suggest that the Change Elicitation Script for Focus Groups effectively prompted participants’ discussion around change. The Innovative Moments Coding System for groups allowed to reliably identify, delimit, and categorize Innovative Moments throughout these dialogues. Although preliminary, this study puts forward a mixed-method methodology, applicable to the retrospective analysis of the process of change in post-intervention focus groups, from educational to clinical settings.

Reliability of the innovative moments coding system for groups and the association between markers of change and outcomes.

Reliability of the innovative moments coding system for groups and the association between markers of change and outcomes.

Physiological synchronization and innovative moments in psychotherapy: A single-case study of micro-process.

Interpersonal synchronization is increasingly studied as a biomarker of empathy, therapeutic alliance, and treatment outcome. However, most studies average data over sessions, leaving associations between synchrony and actual interactions largely unexplored. We aim to showcase a novel approach examining synchronization during specific micro-processes: Innovative Moments (IM) as markers of exceptions to clients' problematic patterns of meaning. Electrodermal activity was recorded over 15 sessions of a psychodynamic psychotherapy single case. Moment-to-moment patient-therapist synchrony was calculated using the Adaptive Matching Interpolated Correlations (AMICo) algorithm. The Innovative Moments Coding System was utilized to identify IMs within session transcripts with precise timing. Monte-Carlo permutation tests were conducted to examine the association between physiological synchrony and IM Levels of increasing complexity (Levels 1-3). Higher-than-random synchronization emerged during Level 3 IMs (p = 0.046; d = 0.21) but not in lower Levels. Post-hoc qualitative analyses linked high synchrony to sub-processes of Level 3 IMs, such as positive contrasts and attributions for change. Our findings show it is possible to link moment-by-moment physiological co-regulation to theoretically identified meaning-making processes. While generalization of these observations is undue, this work demonstrates a robust and promising application of a multimodal approach to investigating psychotherapy, providing insights into both the clinical case and the theoretical model adopted.

Standing upright against trauma and hardship: Checklists of innovative moments of social and psychological resistance

Trauma represents a profound and emotionally intense experience within the human condition. Beyond its evident impacts on both the physiological and psychological dimensions of an individual, this complex phenomenon encapsulates moments of resistance and strength in the face of adversity. From a narrative standpoint, individuals invariably manifest unique responses to trauma, which necessitate a close and nuanced examination for recognition and comprehension. This article proposes a framework for the systematic collection and organisation of diverse responses to trauma through a checklist of innovative moments of social and psychological resistance, contributing to a greater comprehension of this intricate phenomenon.

Supplemental Material for Reliability of the Innovative Moments Coding System for Groups and the Association Between Markers of Change and Outcomes

Supplemental Material for Reliability of the Innovative Moments Coding System for Groups and the Association Between Markers of Change and Outcomes

Therapeutic Improvement in Single-Session Therapy: Innovative Moments as Change Markers.

The growing demand for mental health services, exacerbated by long waiting lists and high psychotherapy dropout rates, highlights the urgent need for brief and effective approaches. The aim of this study was to analyse the presence and impact of change markers in online narrative single-session therapy (NSST) and a change interview 1 month later. The change markers were coded in the NSST and the interview via the innovative moments (IMs) coding system. This coding system allows the identification of IMs (i.e., change markers), differentiating them into three levels of complexity (from lower complexity, Level 1, to the highest complexity, Level 3). Good and poor outcomes were categorized on the basis of the change in presession distress to the distress reported 1 month later at the change interview. Previous research has associated IMs with therapy outcomes, mostly with Level 2 and 3 IMs. In this study, more IMs emerged in the NSSTs of clients with good outcomes. The Level 3 IMs did not emerge in the NSST and only emerged in the change interview. There was a positive correlation between the decrease in distress and the emergence of Level 3 IMs in the change interview. The pattern of the relationship between the IMs in NSST and those in the change interview suggests that, in good outcome cases, there is a positive evolution in the emergence of change markers. These results demonstrate that IMs are produced in NSST, as occurs in regular psychotherapy, and suggest that the change initiated in a single session is expanded until the change interview for good outcome cases. The clinical implications of this study are discussed.

Shifting between Self-States and Narrative Change—Implicit and Explicit Change Processes in Psychotherapy

This study examined the relationship between implicit and explicit levels of change in psychotherapy—the ability to shift between self-states, measured by the Two Person APES (TPA), a relational extension of the Assimilation of Problematic Experiences Scale (APES), and the emergence of exceptions to the problematic self-narrative, measured by the Innovative Moments Coding System (IMCS). The contribution of each of these dimensions of change to session outcome was also examined. Eighty sessions of eight psychodynamic treatments (10 sessions each) were sampled and coded according to the TPA and the IMCS. Session outcome was measured by the Outcome Rating Scale (ORS). A repeated measures correlation approach was used, revealing a positive association between IMs and client TPA. Also, IMs showed stronger correlations with session outcome compared to TPA. These results indicate that a growing ability to shift between self-states in the implicit level is related to the client’s ability to construct new meanings in the explicit level, and that these explicit changes have stronger correlations with functioning improvement at the session level than implicit processes concerning the renewal of dialogue between self-states.

The Development and Adaptation of the Innovative Moments Coding System for Groups (IMCS-G)

Previous researches have attempted to adapt the Innovative Moments Coding System (IMCS) to the group setting by identifying new IM categories able to detect meaningful interactions between group members. This study aims to develop a further adaptation of the IMCS by tracking the categories emerging from previous group coding schemes and analyzing if other types of IM categories emerged in the transcripts of three counseling groups addressed at underachieving university students. Results showed that seven IM categories (Self-directed, Other-directed, Explicit Mirroring, Prompting Change, Reinforcing Change, Collective, and Voice of Group) emerged in the current study, five of which resulting from the findings of previous researches and two obtained in this study through a data-driven method based on the coders’ agreement. The previous and emerging IM categories were illustrated, and agreement and reliability of the IM categories were calculated. Overall, this study refined and integrated the previous group coding schemes and proposed the development of a new coding system, the Innovative Moments Coding System for Groups (IMCS-G), which showed to be a reliable method that allows the detection of markers of change within the group setting.

Innovative Moments as Markers of Meaningful Change: Introducing the Special Section

This special section contains studies in which innovative moments are used as markers of changes in meaning in psychotherapy. Innovative moments, as an empirical operationalization of the concept of “unique outcomes” from narrative therapy, have been used as a strategy to evaluate changes in meaning in psychotherapy sessions and interviews. Innovative moments are defined as exceptions to the problematic pattern of meaning that is associated with clients’ suffering. The emergence of these change markers indicates that flexibility is occurring in the meaning system. This special section contains five studies. Esposito et al. address innovative moments in group intervention by considering the idea that these events are not just individual but also interactional and collective events. Shimshi et al. study shifts between self-states and their relation to innovative moment production in therapy. These shifts are associated with the production of innovative moments, providing further support for the idea that flexibility and the emergence of these change markers are associated. Leeav et al. analyze the relationship between innovative moment production and the therapeutic alliance in a single case study. Fernandez-Navarro et al. interview therapists to understand whether coding innovative moments in sessions may help therapists become more attuned to these events in practice. Finally, Koustafa et al. analyze the evolution of innovative moments in a small sample of individuals with bulimia nervosa. Together, these studies illustrate the potential of this concept as well the domains in which it may be applicable.

Innovative moments with young patients treated for depression: An analysis of post-therapy interviews.

Innovative moments (IMs) pinpoint new and more adaptative meanings that emerge in clients' discourse during psychotherapy. Studies with adult clients have found a greater proportion of IMs in recovered compared to unchanged cases, but similar studies have yet to be conducted with adolescents. The paper aims (1) to study retrospectively the emergence of IMs in therapy, using a post-therapy interview, in adolescents that underwent psychotherapy for depression, and (2) to characterize the themes present in IMs identified retrospectively in the interviews. Semi-structured post-treatment interviews conducted with 24 adolescents on the experience of taking part in a clinical trial of youth depression, were coded using the Innovative Moments Coding System. After identifying IMs, a thematic analysis identified the prominent themes within them. Higher presence of IMs were found in recovered compared to unchanged cases. Two main themes emerged in the IMs, changes that occurred with therapy and attributions of changes. Recovered cases presented more IMs centred on the self, whereas unchanged cases identified more non-specific changes. This study suggests that it is possible to code IMs, identified retrospectively, based on post-therapy interviews with adolescents. Meaningful differences were found between recovered compared to unchanged cases. Therapeutic recovery was associated with a higher focus on the self and more specificity in clients' representations of the change process.

How does change occur in psychotherapy? Innovative moments predict stronger therapeutic alliance and functional improvement in a psychodynamic case study

Innovative moments (IMs) in psychotherapy contradict or challenge clients’ maladaptive patterns of meaning associated with their suffering. IMs are receiving increased theoretical and empirical attention in psychotherapy research and are associated with symptomatic improvement. However, little is known about possible predictors of IMs and their impact beyond their association with outcomes. A therapeutic alliance (TA) that implies a collaborative bond between clients and therapists might set the stage for the occurrence of IMs. Additionally, the occurrence of IMs could serve as a relational experience within the session that strengthens the TA. Thus, in the present study, we examined the association over time between IMs and (i) TA, and (ii) functioning, in a time-limited case study with a good outcome. Furthermore, this study is one of the first to explore IMs in psychodynamic therapy (PDT). Transcriptions of ten randomly selected sessions of PDT of a 43-year-old male with dysthymia were coded using the innovative moment coding system. Self-report measures of function and TA were collected at each session. Data were analyzed using simulation modeling analysis. Consistent with good-outcome cases in other therapeutic approaches, high-level IMs (H-IMs) increased while low-level IMs (L-IMs) decreased throughout treatment. H-IMs predicted a change in functioning in the following session. Finally, H-IMs were associated with higher TA post-session, and specifically with agreement on treatment tasks. To conclude, moments of change in the client’s pattern of meaning are related to stronger TA and better treatment outcome. If replicated, these findings may provide important insights regarding the unfolding of therapeutic change.

What Can Therapists Learn from Coding Therapy Sessions? Interviewing Clinicians to Explore the Case of Innovative Moments Training

This qualitative study explored eight therapists’ perceptions about how training and research into the Innovative Moment Coding System (IMCS) has influenced their clinical practice. Participants, that worked both as researchers and therapists, were interviewed using a semi-structured script written for the current study. The interviews explored whether or not coding psychotherapy sessions (participants’ research experience with innovative moments; IMs) had impacted their clinical practice. A descriptive–interpretative qualitative approach was used to analyze the video recordings of the interviews. Four themes identified the effects of coding therapy sessions with IMs in therapists’ clinical practice: (1) increasing attention to clients’ change instances, (2) noticing clients’ development, (3) implementing strategies inspired by the IM model, and (4) identifying hindering situations. Results suggested that coding therapy sessions appears to bring benefits to practice, regardless of the participant’s theoretical orientation. We discuss how coding sessions may bring subtle but valuable additions to therapists’ everyday practice offering better attunement to clients’ micro-processes of change. In particular, IMCS categorization of such processes could present a useful form of feedback for therapist’s interventions or deliberate practice, further developing therapists’ sensitivity to the interplay between change and problem narratives (called double listening).

Innovative moments in low-intensity, telephone-based cognitive-behavioral therapy for depression.

Innovative moments (IMs), defined as moments in psychotherapy when patients' problematic patterns change toward more elaborated and adaptive patterns, have been shown to be associated with a clinical change in patients with depression. Thus, far IMs have been studied in face-to-face settings but not in telephone-based cognitive-behavioral therapy (t-CBT). This study investigates whether IMs occur in t-CBT and examines the association between IMs and symptom improvement, and reconceptualization and symptom improvement. The therapy transcripts of n = 10 patients with mild to moderate depression (range: 7-11 sessions, in total 94 sessions) undergoing t-CBT were qualitatively and quantitatively analyzed. Symptom severity (Patient Health Questionnaire-9) and IMs (levels and proportions) were assessed for each therapy session. Hierarchical linear models were used to test the prediction models. The rating of IMs was shown to be feasible and reliable using the Innovative Moments Coding System (IMCS) (84.04% agreement in words coded), which is indicative of the applicability of the concept of IMs in t-CBT. Only reconceptualization IMs were shown to have a predictive value for treatment success (R2 = 0.05, p = 0.01). The results should be interpreted with caution due to the exploratory nature of this study. Due to the telephone setting, it was necessary to adapt the IMCS. Nonetheless, the extent of IMs identified in the low-intensity t-CBT investigated was comparable to IMs in face-to-face therapy. Further studies are needed to clarify the association between IMs and treatment success as a change process, especially for low-intensity treatments.

Innovative Moments and the Process of Change in the Treatment of Bulimia Nervosa

Problematic patient narratives emerging in the process of treatment have been identified as important factors in the maintenance of psychopathology, and their change is associated with desired treatment outcomes. This increased focus in psychotherapy research has triggered the investigation of innovative moments (IMs) as novelties in patient narratives in therapy. This exploratory study aims to investigate the development of IMs throughout treatment in bulimia nervosa (BN) in a sample of good and poor outcome cases, and examine their longitudinal associations with binge and purge frequency change. IMs were coded in sixty sessions across five good outcome and five poor outcome cases in different stages of treatment. Generalized estimating equation analyses indicated that IMs evolved significantly over time, with different trajectories between good and poor outcome groups. High-level IMs showed higher proportion in the good outcome group at the end of treatment indicating that the ability to elaborate on how and why change might occur (as measured by high-level IMs) plays a role in the process of change in BN. Additionally, both low- and high-level IMs predicted symptom decrease in the following session. The study provides a preliminary understanding of important patient narrative processes in psychotherapy for BN and their association with treatment change.

Eliciting reconceptualization innovative moments to foster change in Career Construction Counseling

AbstractThis study tests an add‐on procedure to foster change in Career Construction Counseling by eliciting reconceptualization innovative moments. After the career counseling intervention with 42 participants, 21 participants were allocated to the add‐on procedure, consisting of two additional sessions focused on eliciting reconceptualization innovative moments In turn, participants in the comparison group attended two extra intervention sessions in which the lifetime task was used. Outcome measures assessing vocational behavior and psychological distress were applied at the onset, at the end of counseling and after the two additional sessions. The findings show that Career Construction Counseling was effective, allowing a significant increase in vocational certainty, vocational identity, career decision‐making, and a decrease in psychological distress. After counseling, participants in the add‐on intervention fostering reconceptualization innovative moments revealed greater gains in vocational identity and psychological distress than those in the comparison group. The practical implications of these findings are discussed.

Tracking change in group interventions: a further adaptation of the innovative moments coding system for groups.

In group psychotherapy research, there are few reliable measures for tracking members' change. This study proposes a further adaptation of the Innovative Moment Coding System for Groups (IMCS-G), a reliable method previously developed in one format of group intervention for detecting innovative moments (IMs). IMs are exceptions to the clients' problematic narratives, organized in different levels of complexity in terms of meaning elaboration (Level 1, 2, and 3). IMCS-G consists of 7 categories (Self-Directed, Other-Directed, Explicit Mirroring, 'Prompting change, Reinforcing change, Collective, Voice of Group) organized in two macro-categories: Individual (e.g., change was narrated by a single participant) and Group IMs (e.g., change was co-constructed by more than one participant). Two reliable coders applied the IMCS-G to analyse the transcripts of nine sessions of a counselling group addressed to underachieving university students (N=10) and eight sessions of a brief group psychotherapy targeted to substance abusers (N=8). Agreement and reliability for IMCS-G categories and their Levels were calculated. Consistently with previous studies, a strong agreement and reliability for IMCS-G categories and Levels were found in both group interventions. Furthermore, despite some differences in the frequency of IMCS-G categories and Levels, in both interventions, there was a higher frequency of Self-Directed IMs, a lower frequency of the Explicit Mirroring IMs, and a higher frequency of Level 3 Group IMs in comparision with Level 3 Individual IMs. This study confirmed the reliability of IMCS-G in different group interventions, but it also suggested rooms of improvement for some IMCS-G categories.

MILITARY AND PATRIOTIC EDUCATION OF SCHOOL YOUTH IN THE URAL REGION DURING THE GREAT PATRIOTIC WAR

The paper analyses forms and methods of military and patriotic education of students of secondary schools in the Ural region during the Great Patriotic War. The paper notes that the system of military and patriotic education, which worked effectively during the war years, was based on historical traditions of Russian patriotism, which throughout the centuries-old history of Russia ensured socio-political unity of society in the fight against numerous invaders. The paper shows that the work was aimed at improving military physical training, increasing the level of patriotic consciousness of school youth and attracting them to socially useful work. The paper gives a detailed description of the transformations that have occurred in the military training of schoolchildren, in their agitation and propaganda, labour and socio-patriotic activities. The paper also demonstrates innovative moments in the educational and methodological process caused by the influence of extreme conditions of war. As a result, the paper concludes that the military and patriotic education of the population was the most important core ensuring the military and political, ideological and labour unity of the Soviet society, which managed to defend the sovereignty and independence of its state. The general education school of the Urals has made a significant contribution to the process of attracting school youth to the sphere of socio-political and labour activities aimed at achieving the main goal - saving the Motherland and completely defeating the enemy. The historical experience of military and patriotic work, which ensured public unification during the Great Patriotic War, must be studied in every possible way and used to the maximum in solving modern problems related to the need to destroy the revived Nazism.

Historiography in contemporary Italy

The text traces the development of Italian historiographic research from the second post-war period to the present, establishing the innovative moments and the models that have gradually established themselves that have evolved and enriched. In particular, it was the 1960s and 1970s that developed this transformative trend and to which we are still indebted today, precisely because of the high quality that has characterized national historical research.

Innovative Moments and Case Formulation

At the beginning of the therapeutic process, clients frequently feel immersed in their problems, and demoralized, with a negative perspective of different areas of their lives. The clients´ discourse is specially focused on difficulties and previous ineffective attempts to overcome their problems. Even though positive aspects of the clients’ life continue to exist, such as resources and strengths, they have little visibility in the clients’ speech and, consequently, in the therapist’s assessment and intervention planning. Moreover, most psychotherapy models emphasize a focus on the deficits of the clients, centered on the correction of difficulties as a way to achieve mental health. In this context, we highlight the importance of integrating resources and strengths of the clients’ life in case assessment, clinical formulation, and treatment planning. This information can be collected in the assessment phase, but in order to make it explicit the relevance of this information we created a protocol designed for this purpose (Feedback Initiated Narrative Development Protocol [FIND]). The first component of FIND invites clients to reflect on aspects beyond their problem like their personal strengths, significant values, positive autobiographical episodes, and useful strategies that have been adopted in the past. This interview was largely influenced by narrative therapy and innovative moments research, and it provides information regarding clients’ resources that may be useful to psychotherapists from different approaches. In this paper, we presented a clinical case formulation considering resources evaluated with the FIND protocol.