Change is not always linear: The study of nonlinear and discontinuous patterns of change in psychotherapy

Hayes, Adele M.; Laurenceau, Jean-Philippe; Feldman, Greg; Strauss, Jennifer; Cardaciotto, LeeAnn

doi:10.1016/j.cpr.2007.01.008

Cited by 435 publications

(400 citation statements)

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“…Again, in an article that applied dynamic systems to cognitivebehavioral therapy (CBT) processes, Hayes and Strauss (1998) argued that treatment research should study growth curve process in an effort to generate trajectories of change (see also Hayes et al, 2007). The current study follows this call to describe and examine patterns of client change, this time with respect to emotional processing in experiential therapy.…”

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confidence: 96%

“…For a model of emotional processing to be applied and used by researchers and/or clinicians it must be concretized by observable phenomena and accompanied by some form of measurement. Finally, as indicated by Hayes et al (2007), to show its broader clinical relevance, researchers must elaborate a moment-by-moment model of emotional processing in how it relates to the development of therapeutic changes sustained across treatment. In other words, the role of emotional processing must be considered across treatment as well as in the moment and in the session.…”

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confidence: 99%

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Emotional processing in experiential therapy: Why "the only way out is through."

Pascual‐Leone¹,

Greenberg²

2007

Journal of Consulting and Clinical Psychology

293

346

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The purpose of this study was to examine observable moment-by-moment steps in emotional processing as they occurred within productive sessions of experiential therapy. Global distress was identified as an unprocessed emotion with high arousal and low meaningfulness. The investigation consisted of 2 studies as part of a task analysis that examined clients processing distress in live video-recorded therapy sessions. Clients in both studies were adults in experiential therapy for depression and ongoing interpersonal problems. Study 1 was the discovery-oriented phase of task analysis, which intensively examined 6 examples of global distress. The qualitative findings produced a model showing: global distress, fear, shame, and aggressive anger as undifferentiated and insufficiently processed emotions; the articulation of needs and negative self-evaluations as a pivotal step in change; and assertive anger, self-soothing, hurt, and grief as states of advanced processing. Study 2 tested the model using a sample of 34 clients in global distress. A multivariate analysis of variance showed that the model of emotional processing predicted positive in-session effects, and bootstrapping analyses were used to demonstrate that distinct emotions emerged moment by moment in predicted sequential patterns.

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confidence: 96%

mentioning

confidence: 99%

Emotional processing in experiential therapy: Why "the only way out is through."

Pascual‐Leone¹,

Greenberg²

2007

Journal of Consulting and Clinical Psychology

293

346

View full text Add to dashboard Cite

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“…Because these changes occurred before the flooding procedure was started, this can be seen as indicator of an early rapid response in the therapy. 5,13,14 Additionally, marked alternations in brain activity were to be Figure 7. Functions of repeated internet-based self-evaluations (by the use of a therapy process questionnaire or other usual instruments) and of the computer based feedback for patient and therapist.…”

Section: Do Order Transitions In Psychotherapy Correspond To Patternsmentioning

confidence: 99%

“…Specific effects can occur even before the specific treatment components were realized and brought into action in a treatment program. [11][12][13][14][15][16] For example: cognitive restructuring takes place before the beginning of irrational beliefs treatment in cognitive behavioral therapy, or reduction of compulsions before the flooding begins. 3.…”

Section: Treatment Techniques and Technique-specific Factors Of Effecmentioning

confidence: 99%

Complexity and Nonlinear Dynamics in Psychotherapy

Schiepek¹

2009

European Review

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Human life changes with time. It seems therefore obvious that most of the phenomena that psychology and psychotherapy are concerned with are dynamic in nature. For human development processes, human change and learning processes, the dynamics and prognosis of mental disorders, problems manifesting in social systems such as couples, families, teams, or the question of how psychotherapy works, self-organization is ubiquitous. In the context of self-organization, complexity is a quality of changing patterns and patterns of change, produced by nonlinear coupled systems. Anomalies of the linear input-output model of psychotherapyA huge amount of empirical outcome studies and reviews (meta-analyses) supports the evidence that psychotherapy works -its efficacy is comparable to other medical treatments. The usual conception is that it works due to the applied methods of treatment. The input makes the output, and the treatment causes the effect. The specific factors producing the effect should exist within the treatment techniques; everything else is used only to fill in the blanks and is therefore non-specific. Against this background, for the purpose of proving the efficiency of psychotherapies, the execution of randomized controlled trials is regarded as the 'gold standard'. It makes use of experimental designs where treatment systematically varies and confusing variables are to be excluded (e.g. by randomization of patients to treatment modalities). The effect should be attributed to the employed treatment as clearly as possible. To describe this dominating paradigm, Wampold 1 used the term 'medical model', or -since it also dominates in the field of psychology as well and corresponds to the methodological canon of the general linear model -'standard model'.

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“…There is a growing literature on process dynamics in psychotherapy, studying time-varying factors that influence treatment progress and outcome (e.g. Hayes, Laurenceau, Feldman, Strauss, & Cardaciotto, 2007;Mahoney, 1991;Smits, Julian, Rosenfield, & Powers, 2012). While this topic is not new (Gottman & Rushe, 1993), it is gaining momentum with the availability of more sophisticated data analyses, either for the reanalysis of existing data (e.g.…”

Section: Why Do Psychotherapy Researchers Profit From This Methodology?mentioning

confidence: 99%

Time-series panel analysis (TSPA): Multivariate modeling of temporal associations in psychotherapy process.

Ramseyer¹,

Kupper²,

Caspar³

et al. 2014

Journal of Consulting and Clinical Psychology

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Objective: Processes occurring in the course of psychotherapy are characterized by the simple fact that they unfold in time and that the multiple factors engaged in change processes vary highly between individuals (idiographic phenomena). Previous research, however, has neglected the temporal perspective by its traditional focus on static phenomena, which were mainly assessed at the group level (nomothetic phenomena). To support a temporal approach, the authors introduce Time Series Panel Analysis (TSPA), a statistical methodology explicitly focusing on the quantification of temporal, session-to-session, aspects of change in psychotherapy. TSPA-models are initially built at the level of individuals, and are subsequently aggregated at the group level, thus allowing the exploration of prototypical models. Method:TSPA is based on vector autoregression (VAR), an extension of univariate autoregression models to multivariate time-series data. The application of TSPA is demonstrated in a sample of 87 outpatient psychotherapy patients that were monitored by post-session questionnaires.Prototypical mechanisms of change were derived from the aggregation of individual multivariate models of psychotherapy process. In a second step, the associations between mechanisms of change (TSPA) and pre-to-post symptom-change were explored. Results: TSPA allowed identifying a prototypical process pattern, where patient's alliance and self-efficacy were linked by a temporal feedback-loop. Furthermore, therapist's stability over time in both mastery-and clarification interventions was positively associated with better outcome. Conclusions: TSPA is a statistical tool that sheds new light on temporal mechanisms of change. Through this approach, clinicians may gain insight into prototypical patterns of change in psychotherapy. When asked to describe the mechanisms of therapeutic change in a patient, a psychotherapist will likely point to associations between certain factors of the therapist-patient system. These associations occur temporally and in sequence: "When I did X, the patient responded Y". A therapist relies on highly idiographic information, temporal evolution, and the action of multiple factors when evaluating therapy effectiveness. Yet, comparing these properties of therapists' reasoning to the strategies predominant in psychotherapy research (such as outcome research, process research), a stark contrast exists between a therapist's real-life complexity and research-dictated simplicity. This paper aims to show that the viewpoints and interests of the practitioner and the scientist need not be mutually exclusive, and that time-series (i.e. repeated measurements) may capture the dynamics of a psychotherapy process and vastly broaden the analytic and inferential possibilities. We present statistical methodology that accounts for temporal and individual-level information (idiographic perspective) and also generates predictions at a general or group level (nomothetic perspective). In the following application of Time Series P...

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Change is not always linear: The study of nonlinear and discontinuous patterns of change in psychotherapy

Cited by 435 publications

References 59 publications

Emotional processing in experiential therapy: Why "the only way out is through."

Emotional processing in experiential therapy: Why "the only way out is through."

Complexity and Nonlinear Dynamics in Psychotherapy

Time-series panel analysis (TSPA): Multivariate modeling of temporal associations in psychotherapy process.

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