Publicação
Reconceptualizing the self in psychotherapy for depression: Latest findings and future directions
| Resumo: | Our understanding of psychotherapeutic change is still limited, but we need to move from the question of whether psychotherapy works, and start to move towards the question of how and why change occurs. From a narrative-constructivist point of view, to integrate new meanings into one’s experience is fundamental for successful psychotherapy. According to the innovative moments research, reconceptualization (RC), which is an innovative moment associated with successful therapy, is a type of meta-reflection that helps to re-write one’s story in a more adaptive way. RC is articulated by two components: 1) a contrasting self (CS), i.e., clients’ expression of what is shifting in themselves, and 2) the self-transformation process (STP), i.e., how/why these shifts were possible to achieve. This dissertation aims to study RCs. Specifically, the current work has the objective to clarify previous innovative moments research findings and to study in depth the components that give form to RC (CS and STP). To do so, we conducted three studies in the context of this dissertation. The first study was carried out on a composite sample of clinical cases diagnosed with major depression disorder undergoing narrative therapy (N=10), cognitive-behavioural therapy (N=6), emotion-focused therapy (N=6) and client centred therapy (N=6). Results indicated that RC was a different phenomenon from its components taken separately (i.e., CS and STP) and also was a better predictor of the treatment outcome (pre-post gains). The second study was carried out with a smaller sample (CBT and NT sub-samples) using a longitudinal design. RC during therapy was not only related to recovered cases as the previous study suggests, but also seemed to facilitate symptom reduction along treatment (i.e., lag +1). In this sense, meaning transformation precedes the reduction of depressive symptomatology. The third study portraits the case of Celia and focused on exploring the evolution of new meanings in successful psychotherapy for major depression. Results suggested that meaning integration was an important element during psychotherapy. New meanings present in innovative moments could be aggregated into themes. Furthermore, RC seemed to be a polythematic innovative moment, which integrated new meanings from different themes into a more adaptive meaning framework. This dissertation is a step forward in the research conducted with the innovative moments coding system and contributes to improve our understanding of fruitful therapeutic work. The ultimate goal of this research is to facilitate for psychotherapists and clients the identification of change mechanisms during therapy, which could guide them towards subtle changes in their interactions. Therapists of diverse orientations could easily recognize CS, STP or RC, used them as indicators of the process of change and also try to favour meaning integration. |
|---|---|
| Autores principais: | Fernández-Navarro, Pablo |
| Assunto: | Ciências Sociais::Psicologia |
| Ano: | 2017 |
| País: | Portugal |
| Tipo de documento: | tese de doutoramento |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Universidade do Minho |
| Idioma: | inglês |
| Origem: | RepositóriUM - Universidade do Minho |
| Resumo: | Our understanding of psychotherapeutic change is still limited, but we need to move from the question of whether psychotherapy works, and start to move towards the question of how and why change occurs. From a narrative-constructivist point of view, to integrate new meanings into one’s experience is fundamental for successful psychotherapy. According to the innovative moments research, reconceptualization (RC), which is an innovative moment associated with successful therapy, is a type of meta-reflection that helps to re-write one’s story in a more adaptive way. RC is articulated by two components: 1) a contrasting self (CS), i.e., clients’ expression of what is shifting in themselves, and 2) the self-transformation process (STP), i.e., how/why these shifts were possible to achieve. This dissertation aims to study RCs. Specifically, the current work has the objective to clarify previous innovative moments research findings and to study in depth the components that give form to RC (CS and STP). To do so, we conducted three studies in the context of this dissertation. The first study was carried out on a composite sample of clinical cases diagnosed with major depression disorder undergoing narrative therapy (N=10), cognitive-behavioural therapy (N=6), emotion-focused therapy (N=6) and client centred therapy (N=6). Results indicated that RC was a different phenomenon from its components taken separately (i.e., CS and STP) and also was a better predictor of the treatment outcome (pre-post gains). The second study was carried out with a smaller sample (CBT and NT sub-samples) using a longitudinal design. RC during therapy was not only related to recovered cases as the previous study suggests, but also seemed to facilitate symptom reduction along treatment (i.e., lag +1). In this sense, meaning transformation precedes the reduction of depressive symptomatology. The third study portraits the case of Celia and focused on exploring the evolution of new meanings in successful psychotherapy for major depression. Results suggested that meaning integration was an important element during psychotherapy. New meanings present in innovative moments could be aggregated into themes. Furthermore, RC seemed to be a polythematic innovative moment, which integrated new meanings from different themes into a more adaptive meaning framework. This dissertation is a step forward in the research conducted with the innovative moments coding system and contributes to improve our understanding of fruitful therapeutic work. The ultimate goal of this research is to facilitate for psychotherapists and clients the identification of change mechanisms during therapy, which could guide them towards subtle changes in their interactions. Therapists of diverse orientations could easily recognize CS, STP or RC, used them as indicators of the process of change and also try to favour meaning integration. |
|---|