Integrating moment-by-moment and phase-by-phase guiding maps facilitates the understanding of therapeutic processes. Therapists' attunement and responsiveness to patients' assimilation capacities supports therapeutic progress. Being aware of both phase-by-phase and moment-by-moment movements in psychotherapy helps lead to better clinical decisions.

This study adds a phase-by-phase perspective to the well-known, and thoroughly analysed on a moment-by-moment basis, case of Lisa. The aim is to see whether this phase-by-phase analysis adds anything valuable to the understanding of the processes of change in this case and the therapeutic processes in general. In this good-outcome case study, a team of raters integrated the temporal sequencing phase component of the Paradigmatic Complementarity Metamodel (PCM) with a moment-by-moment tracking method-the Developmental Analysis of Psychotherapy Process Method (DAPP)-to analyse what occurred along the process that could explain the phase transitions and consolidations observed and how the therapist facilitated them. We illustrate and explain the therapeutic progression with therapeutic interactions from the dyad. The results suggest that Lisa evolved in accordance with the sequence of phases proposed by the PCM until phase 4 (out of 7). However, only phase 2 gains show evidence of structural consolidation. The sequence of phases proposed by the PCM seems to represent a natural progression for patients throughout the therapeutic process, and the consideration of a phase-by-phase map in analysing and thinking of therapeutic cases may be a valuable tool regarding clinical decision making.

As narrativas são frequentemente consideradas o meio por excelência de reconhecimento e reorganização da experiência interna dos pacientes. Neste estudo procurou­‑se diferenciar e identificar potenciais marcadores narrativos de capacidade de processamento e, ao quantificá­‑los em diferentes momentos do processo terapêutico, verificar se existia evidência a favor da proposta de sequencialização do trabalho terapêutico do Meta­‑modelo de Complementaridade Paradigmática, em termos de estratégias gerais. Foram definidos, reconhecidos e analisados processos narrativos a nível molecular (a partir da revisão de literatura) e a nível molar (a partir da teoria do meta­‑modelo supra­‑referido). Em ambos os casos, enfatizou­‑se as formas e capacidades de processamento da informação em detrimento dos conteúdos narrados. Os resultados evidenciaram diferenciação e movimentação entre as fases consideradas para processos moleculares e molares, e nestes últimos reconheceu­‑se um padrão de progressão narrativa de acordo com a sequencialidade proposta pelo modelo, para as fases em estudo.DOI: http://dx.doi.org/10.17575/rpsicol.v25i1.284

This study adds a phase-by-phase perspective to the case of Susan, with the aim of better understanding the processes of change in this therapeutic case. A team of 3 raters integrated the sequential phases of the Paradigmatic Complementarity Metamodel with a moment-by-moment tracking method-the Developmental Analysis of Psychotherapy Process method-to analyse this therapeutic process and clarify what happened throughout that may explain phase gains and how the therapist facilitated them. The results suggest that Susan evolved in accordance with the sequence of phases proposed by the Paradigmatic Complementarity Metamodel. We illustrate and explain this with therapeutic interactions representative of Susan's development within the evolving therapeutic process. This case study is the third of a series intended to contribute towards the optimization of clinical decisions in therapeutic processes by identifying markers of phase progression and assessing the value of the therapeutic interventions offered.

This article intends to highlight the importance of reflective practice, explore the benefits of integrating moment-by-moment and phase-by-phase guiding principles while thinking through and intervening in our cases, and offer psychotherapists of any persuasion guidelines for a reflective practice based on this integration. Reflective practice includes both careful observation of patient's responses, and the use of such data to consider choices that might lead to greater attunement and more successful therapy. The integration of moment-by-moment and phase-by-phase maps, by allowing coordination between a more micro and a more macro level, similar to the idea of figure and ground, favors therapists' responsiveness, the tracking of progress and/or stuckness in psychotherapy cases-in-progress, and integrative clinical decision-making. The guidelines offered combine addressing the match between the therapist's strategic objectives and the patient's evolving capacities, and observing at each moment, in each therapeutic phase, whether and how the patient is able to make use of the resources that the therapist offers.