Fluctuation in the Assimilation of Problematic Experiences: A Case Study of Dynamic Systems Analysis.

Dynamic systems theory suggests that instability can be a key element in the promotion of human change processes. Several studies have confirmed an association between unstable patterns and successful psychotherapeutic outcome. Somewhat similarly, the assimilation model of psychotherapeutic change argues that clinical change occurs through the integration of problematic experiences that initially threaten the stability of the self. This study examined how instability in assimilation levels was related to assimilation progress and change in symptom intensity, within and across sessions, in a good-outcome case of Emotion Focused Therapy. We used the assimilation of problematic experiences scales (APES) to measure assimilation and the outcome-questionnaire (OQ-10) to measure clinical symptom intensity. To assess assimilation instability, we used a fluctuation measure that calculated the amplitude and the frequency of changes in assimilation levels. To analyze the structural relationships between variables we used a dynamic factor model. The results showed that APES level and APES fluctuation tended to increase across treatment, while OQ-10 scores tended to decrease. However, contrary to expectations, the dynamic factor model showed no significant associations between APES fluctuation and OQ-10 scores either within sessions or between adjacent sessions.

Narrative therapy vs. cognitive-behavioral therapy for moderate depression: empirical evidence from a controlled clinical trial.

BACKGROUND: Systematic studies of the efficacy of Narrative Therapy (NT) for depression are sparse. OBJECTIVE: To evaluate the efficacy of individual NT for moderate depression in adults compared to Cognitive-Behavioral Therapy (CBT). METHOD: Sixty-three depressed clients were assigned to either NT or CBT. The Beck Depression Inventory-II (BDI-II) and Outcome Questionnaire-45.2 (OQ-45.2) were used as outcome measures. RESULTS: We found a significant symptomatic reduction in both treatments. Group differences favoring CBT were found on the BDI-II, but not on the OQ-45.2. CONCLUSIONS: Pre- to post-treatment effect sizes for completers in both groups were superior to benchmarked waiting-list control groups.

Positioning microanalysis: studying the self through the exploration of dialogical processes.

Self-multiplicity is a widely recognized phenomenon within psychology. The study of how self-continuity emerges amidst self-multiplicity remains a crucial issue, however. Dialogical approaches are widely viewed as suitable for developing this field of study but they demand coherent methods compatible with their theoretical bases. After reviewing the available methods for the study of the dialogical self, as well as other dialogical methods for the study of psychotherapy, we conclude that we still lack a method which can be used by external observers and is devoted to the systematic tracing of the dialogical dynamics of self-positions as they unfold over time. A new method, positioning microanalysis, is described in detail as a possible way to overcome current limitations in methods focused on the dialogicality inherent in selfhood processes. Positioning microanalysis takes a genetic-developmental perspective on dialogical processes in the self and allows for the depiction of microgenetic movements of self-positions over time and the establishment of more or less stable sequences or patterns of positions. This is illustrated by its application to an emotion-focused therapy session.

A dynamic look at narrative change in psychotherapy: a case study tracking innovative moments and protonarratives using state space grids.

This study aims to further the understanding of how innovative moments (IMs), which are exceptions to a client's problematic self-narrative in the therapy dialogue, progress to the construction of a new self-narrative, leading to successful psychotherapy. The authors' research strategy involved tracking IMs, and the themes expressed therein (or protonarratives), and analysing the dynamic relation between IMs and protonarratives within and across sessions using state space grids in a good-outcome case of constructivist psychotherapy. The concept of protonarrative helped explain how IMs transform a problematic self-narrative into a new, more flexible, self-narrative. The increased flexibility of the new self-narrative was manifested as an increase in the diversity of IM types and of protonarratives. Results suggest that new self-narratives may develop through the elaboration of protonarratives present in IMs, yielding an organizing framework that is more flexible than the problematic self-narrative.