Implementing Dynamic Assessments in Psychotherapy

Abstract

In this article, we organize multimethod, multitimescale data around the interpersonal situation, a conceptual framework that can be used to integrate personality, psychopathology, and psychotherapy constructs in order to guide the assessment of clinical dynamics. We first describe the key variables of the interpersonal situation model and articulate methods for assessing those variables as they manifest (a) across different levels of personality, (b) across situations, and (c) within situations. We next use a case to demonstrate how to assess aspects of the interpersonal situation in a manner that enhances case conceptualization and facilitates the evaluation of clinical hypotheses. We also use this case to highlight challenges and decisions involved in implementing dynamic assessment in psychotherapy. We conclude by outlining areas in need of further exploration toward a more sophisticated approach to clinical practice that involves the routine assessment of dynamic processes.

Structure and correlates of interpersonal problems and sensitivities

“…It would also be interesting for future research to incorporate aspects of an individual’s interpersonal style beyond problems and sensitivities, such as values, efficacies, and strengths (see Locke, ). It would be beneficial to examine how these variables overlap with problems and sensitivities, as well as increment each other in explaining interpersonal functioning in clinical and other contexts (see Dawood & Pincus, ; Hopwood et al, ). In addition to understanding how interpersonal variables relate to psychopathology and functioning, it is also interesting to understand how they can help distinguish individuals with the same form of psychopathology (e.g., Pincus & Wright, ; Thomas et al, ).…”

“…Future work should focus on examining how interpersonal processes play out over time and across different time scales (Hopwood et al, ; Wright & Hopwood, ). Capturing dynamic processes using ecologically valid and temporally sensitive assessments would enable tests of how problems, sensitivities, and other domains of interpersonal functioning interact with one another to produce more or less adaptive outcomes (e.g., Sadikaj, Russell, Moskowitz, & Paris, ).…”

Modeling Heterogeneity in Momentary Interpersonal and Affective Dynamic Processes in Borderline Personality Disorder

“…It is also important to note that the models we estimated here were dynamic across situations , but the micro level dynamic processes that occur within situations escaped our approach (see, e.g., Hopwood, Thomas, et al, in press). It is very likely that additional processes play out within situations that are clinically important.…”

Advancing the Assessment of Dynamic Psychological Processes

“…Although in its early phases, this program of research has the potential to enhance personalization in psychotherapy through dynamic psychological assessment. Finally, Hopwood et al ( IN PRESS ) describe a clinical supervision team that is organized around dynamic assessment and offer a case presentation involving a multimethod assessment that includes self- and informant report questionnaires, narrative methods, daily diaries, and behavioral codes of psychotherapy sessions. The use of the same theoretical model for variable selection across the different assessment modalities provides for a coherent and relatively comprehensive formulation of the patient’s dynamics that leads directly to testable intervention hypotheses.…”