Patient–therapist congruent exchanges engaged with the potential‐to‐experience is associated with better outcome of psychotherapy

Abstract

Background. The concept of potential-to-experience is a major component in psychodynamic theory and assumed to be an important component of psychotherapeutic technique. However, as this assumption has never been empirically tested, the relationship between such interventions and treatment outcome is unclear. The aim of this pilot study is to explore the relationship between patient-therapist congruence of potential-to-experience engaged statements and the outcome of psychodynamic treatments.Methods. Transcripts of 90 sessions from good-and poor-outcome treatments (N = 18) were encoded using the MATRIXa novel content analysis tool of psychodynamic psychotherapy. Based on fixed algorithms, this observer-coding system is designed to identify different types of clinical interventions, including those which focus on the potential-to-experience. Total number of MATRIX codes analysed was 11,125. We compared the total congruence/incongruence ratio of such statements in good and poor treatments. The importance of the congruence/incongruence ratio of the potentialto-experience statements was measured by applying general linear models to classify treatment outcome.Results. The congruence/incongruence ratio of the potential-to-experience engaged statements was significantly higher in good treatments. In the best model for classifying treatment outcome based on the congruence/incongruence ratios of several parameters, the congruence/incongruence ratio of the potential-to-experience engaged statements was the single most important predictor.Discussion. Maintaining the congruence of potential-to-experience engaged statements within the therapeutic session is associated with better clinical outcome. This provides an initial empirical indication to the importance of the potential-to-experience discourse in psychotherapy praxis.

The MATRIX: A deliberate practice approach for clinical supervision in the public sector.

“…It is also multitheoretical (i.e., engulfs the major psychodynamic theories) and language insensitive (i.e., applicable to sessions in any language). The fifth edition of the manual used in the present study is the result of 7 years of ongoing research and has been acknowledged by numerous international, peer-reviewed forums (Bar, Levy & Mendlovic, 2021;Bar, Saad, Slonim-Atzil, et al, 2021;Mendlovic et al, 2015Mendlovic et al, , 2017Mendlovic et al, , 2018.…”

“…Addressing the patient's ability (or inability) to change could emphasize how therapy could become a "playground" for the patient to live out new and previously unimaginable ways of ordering experience (Ogden, 2016). The importance of this component is also empirically supported, as maintaining the patient-therapist congruence around potential statements was found to be the single most important predictor of therapy success (Bar, Saad, Slonim-Atzil, et al, 2021), accounting for 88% of the variance in treatment outcome. Reviewing the session's MATRIX codes allows one to quickly single out such statements along the transcript, and assess the supervisee's ability to immediately echo them.…”

“…However, it is important to note that the patient did not echo the therapist’s reference to the dyad, moving from talking about the relationship to talking about herself again (TDI → PPI). As previously suggested, the congruence between two consecutive codes expresses the immediate way in which the therapist’s intervention was received by the patient (Bar, Saad, Slonim-Atzil, et al, 2021; Mendlovic et al, 2018). In our case, such a sequence might indicate the therapist’s mistiming of this sensitive intervention.…”