Exploring innovative moments in a brief integrative psychotherapy case study.

Abstract

The present study examined the emergence of innovative moments in a successful case of Brief Integrative Psychotherapy (BIP) based on Hill’s 3-stage model. Hill’s model suggests that optimally therapeutic processes involve exploration (based on client-centered therapy), insight (based on psychoanalytic therapy), and action (based on behavioral therapy). Innovative moments are exceptions to the problematic pattern of meaning that brought the client to therapy. Previous studies showed that their occurrences in the therapeutic conversation were related to symptomatic improvement in different therapeutic models; nevertheless, they have not yet been explored in integrative psychotherapy, and especially psychotherapy that contains explicit psychodynamic components. The aim of the study was too examine the relations between innovative moments, on the one hand, and (a) symptomatic improvement, (b) therapist’s interventions, and (c) client’s subjective experience, session by session, on the other. A 12-session case study of a 27-year-old female client was coded according to the Innovative Moments Coding System. Outcome improvement was measured by the Outcome Questionnaire (OQ-45.2). Therapist’s interventions were coded according to the Helping Skills Scale (HSS). The subjective experience for each session was measured by the Session Evaluation Questionnaire (SEQ). The findings suggest that innovative moments are related to symptomatic change. Exploration and insight interventions were related to the emergence of more elementary innovative moments, whereas action interventions were found to be related to more highly developed innovative moments. Finally, innovative moments were strongly associated with 3 out of the 4 dimensions of client’s subjective experience of the session (depth, smoothness, and positivity). These results should be further explored at a sample level.

Innovative moments and session impact in brief integrative psychotherapy: An exploratory study.

“…Replicating previous results with a case study (Nasim et al, 2018), our study showed significant relations between IMs and three out of four session impact dimensions on the client. According to Stiles and colleagues (1994), the clients’ internal reactions that are captured by the SEQ ratings indicate the interpersonal climate, sense of progress, and consumer satisfaction of the session.…”

“…This exploratory study was the first to identify and explore IMs in eight cases of BIP with clients seeking help for a wide range of psychological problems, thereby widening the scope of a case study design drawn from the same database (Nasim et al, 2018). Our results showed that IMs could be reliably identified in BIP and that their proportion increased while symptomatic measurements decreased along treatments.…”

“…Correlational studies (e.g., Gonçalves et al, 2012; Matos et al, 2009; Mendes et al, 2010) have shown that clinical recovery is associated with a higher presence of Level 2 and 3 IMs. Longitudinal studies (e.g., Gonçalves et al, 2016; Gonçalves, Silva, et al, 2017; Nasim et al, 2018) showed that Levels 2 and 3 (but not Level 1) emerged as predictors of symptomatic improvement, thus reinforcing the crucial importance of this type of IM in the process of change.…”

“…Although the development of this coding system was inspired by the Narrative Therapy tradition (White & Epston, 1990), its application has not been restricted to this therapeutic model. In addition to Narrative Therapy (e.g., Gonçalves et al, 2016), this methodology has been reliably applied to Client-Centered Therapy (Gonçalves et al, 2012), Emotion-Focused Therapy (Mendes et al, 2010), Constructivist Therapy (Alves et al, 2014), Cognitive Behavioral Therapy (Gonçalves, Silva, et al, 2017), and more recently to a Brief Integrative Psychotherapy case study (Nasim et al, 2018). The current article aims to widen the inquiry on IMs in BIP as we will explore the evolution of IM levels throughout therapy and their associations with symptomatic improvement and subjective impact from both client and therapist perspectives.…”

Studying psychotherapy change in narrative terms: The innovative moments method

“…Esposito, Ribeiro, Alves, Gonçalves, & Freda, ) which are setting a new ground for a coding manual for groups. Likewise, replication efforts are being made with bigger samples and different therapeutic models such as Barlow's UP (ongoing study) and psychodynamic therapy (Nasim et al, ).…”