Significant Events In Psychotherapy

Part oneObjective:To describe the categories and impact of the significant events identified by patients and paired therapists, and to compare the differences between the patients’and the therapists’perspective on these significant events.Methods:Qualitative significant events design was utilized to understand the psychotherapeutic change process. Individualized problem form, session events form, change interview, video-recordings were used to collect the qualitative data. The content analysis was employed to analyze the qualitative data, and the SPSS18.0was employed to analysis the quantitative data.Results:26patients were participating in291interviews to find992significant events in all sessions. From the patients’view, the top three helpful events were Problem Solution, Personal Contact and Understanding, whereas from the therapists’ view, those were Personal Contact, Self-insight and Problem Solution. The top two hindering events from the patients’view were Misdirection and Unwanted Thoughts; from the therapists’ view, those were Unwanted Thoughts and Negative Therapists Reaction. Among the eight categories helpful events, the patients perceived Problem Solution, Reassurance and Clarification particularly efficacious, while the therapists perceived the Self-insight, Personal Contact and Problem Solution of great efficacious. The correlation of the reported helpful categories of patients and therapists was non-significant (P>0.05). While the correlation of the level of helpfulness between individual categorites in patients and therapists was significant(P<0.05or0..01)Conclusions:Differences in the categories of the significant events were detected in the psychotherapeutic change process between the patients’ view and therapists’ view, though with the agreement on the impact of the significant events during psychotherapeutic process. It suggests a potential difference in the perspectives of patients and therapists towards mechanisms in psychotherapy process; therefore, it is necessary for consideration the patient’s perspectives.Part twoObjective:Helpful factors and hindering factors of the patients were detected and correlations between these factors were explored to establish a "moment-to-moment" psychotherapeutical change model in patients’view. And the principle of psychotherapeutic intervention principle was created on foundation of patient-therapist-patient interaction. A case treating with cognitive behavior therapy(CBT) was used to demonstrate the therapy model and the intervention principle.Methods:Qualitative significant events design was used in23pareied patients and therapists by interviewing them about the therapeutic changes process. Grounded theory was conducted to analyze the qualitative data. Micro-analytic sequential process design was used to create the "moment-to-moment" intervention principle. An example was selected in the23-patient sample as a successful demonstration in this case.Results:1036meaningful units and7categories were detected in23patients. Helpful factors included a safe and professional Therapeutic Relationship, Exploring Together, Problem Solution, Self-insight, and Out-of-session Processing. The hindering factors included Experience Mismatch and Negative Therapist Response. Six categories were reported by the therapists as listed:patients-therapists interaction, including of Relationship, Problem Solution, Explore Together, Self-insight, Out-of-session Processing and Therapists’Characteristics. The case study was formed with12sessions to find29significant events, successfully represent the change model in patients’view and the "moment-to-moment" intervention principle.Conclusion:Safe and professional Therapeutic Relationship, Exploring Together, Problem Solution, Self-insight, and Out-of-session Processing identified by patients were helpful factors of therapeutic change. And the Experience Mismatch and Negative Therapist Response were hinder factors. Principles were listed as follows:the establishment of a safe and professional therapeutic relationship, the cooperation in exploration of the inner side, the problem-solving skills, the improvement in self-sight in patient, the process during the out-of-session, the compatible characteristics of therapists. The study also confirmed the usefulness of significant events design and micro-analytic sequential process design in the research of psychotherapeutic change process.