Analysing phase progression in Susan's case

Abstract

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.

Tracking and understanding phase progression in Lisa's case

“…Lisa's assimilation capacity of phase 1 (relationship building) remained stable and high, and her assimilation capacity of phases 2 (awareness work), 3 (meaning making work), and 4 increased throughout the process in a sequential order. As in other studies (Conceição, , ; Ferreira et al, ; Ferreira, Vasco, et al, ; Vasco, ), here too, the patient's assimilation capacity evolved sequentially and cumulatively along the process.…”

“…The temporal sequence of phases of the PCM has been studied for the last 16 years with both transversal and longitudinal analyses. Previous studies have systematically (a) supported a temporal sequence of strategic objectives (Conceição, , ; Ferreira, Conceição, & Vasco, ; Ferreira, Vasco, Basseches, Santos, & Ferreira, , ; Vasco, ), (b) shown the potential of this sequence in intervening with personality disorders in long‐term processes (Conceição, ; Gonçalves & Vasco, ; Rodrigues, ), (c) pointed to an increase in the estimated improvements of the patient as he/she progresses along the therapeutic process (Vasco, ), and (d) indicated that the articulation of therapist's work according to client's assimilation capacity may be associated with good outcomes and better alliances at least regarding the task agreement dimension (Conceição, , ).…”

“…This is one of the three good‐outcome case studies where we combined the PCM and the DAPP (the other two are Ferreira et al, ; Ferreira, Vasco, et al, ).…”

“…The studies have also systematically shown that patients' capacities tend to evolve sequentially and cumulatively along the process, and when analysing what the therapist is predominantly promoting at a more macro level, he/she seems to promote mainly one phase and the adjacent phases, and when moving forward tends to give up the work of previous phases in favour of subsequent ones (Conceição, , ; Ferreira et al, , ; Ferreira, Vasco, et al, ; Vasco, ).…”

“…Recent studies have shown qualitative evidence of this phase‐by‐phase temporal sequencing of therapeutic gains with excerpts from the patients' discourse illustrating markers of acquired processing capacities (Ferreira et al, ; Ferreira, Vasco, et al, ; Rodrigues, ; Simões, ).…”