Phase progression throughout the therapeutic process : longitudinal case studies

Tese de doutoramento, Psicologia (Psicologia Clínica), Universidade de Lisboa, Faculdade de Psicologia, 2016

The purpose of this study was to explore, in specific cases, the value of adding a phase-by-phase perspective to the more common, and essential, moment-by-moment analyses. With this aim, and in order to better understand the therapeutic process and patients’ development throughout it, we gathered a team of researchers to track markers of intermediate sequential gains in each case, and explored the processes of change that favored these intermediate gains. We analyzed three longitudinal case studies in light of the temporal sequencing component of the Paradigmatic Complementarity Metamodel (PCM) and used the Developmental Analysis of the Psychotherapy Process (DAPP) Method to understand moment-by-moment how phase-by-phase changes developed and were co-constructed in each case. The first case study involved analyzing the first year of a 4-year therapy of a female patient complaining of panic and depression. She was accompanied by a male therapist following an integrative approach and familiar with the PCM principles. The second case study involved analyzing a short-term process of a female with depression. She was accompanied by a female therapist following Emotion-Focused Therapy. The third case study involved analyzing a short-term process of a female victim of intimate violence. She was accompanied by a female therapist following Narrative Therapy. In all three cases both patients and therapists tendentiously followed the sequence of phases proposed by the PCM, at least until phase 4 (regulation of responsibility). For each case, we present both the quantitative and qualitative analyses in order to clarify how each process unfolded and what, in each, contributed to the phase transitions and consolidations observed.viii We present the therapeutic principles and models relevant to the study at the beginning of this dissertation, integrate the case studies in the middle, each constituting an article, and explore the implications and limitations of the entire study at the end, providing suggestions for future research.