Publication details
Why did she leave? An evidence-based case study of a dropout in an effective psychotherapy of depression
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| Year of publication | 2017 |
| Type | Appeared in Conference without Proceedings |
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| Description | Aim: The aim of this study was to explore mechanisms of change in relation to outcome in a successful case of psychodynamic psychotherapy. Qualitative and quantitative evaluation of outcome was put into the context of therapeutic alliance development and its mediation by responsiveness between the psychotherapist and the client. An evidence-based case study design was used to integrate data into a clinically meaningful and complex presentation. Methods: The full course of 18 sessions was videotaped and transcribed. Helpful Aspects of Therapy form was administered to both participants after every session. After the sessions 3, 9, and 13, Interpersonal Process Recall interviews were conducted with both participants. At the end of the psychotherapy, both participants completed Client Change Interviews. As the outcome measures, Symptom Checklist - 90, Personal Health Questionnaire - 9, and Clinical Outcome in Routine Evaluation were used. Session Rating Scale and Working Alliance Inventory were used as alliance measures. Results: Both quantitative and qualitative outcome evaluation strongly supported the good outcome hypothesis. However, after 18 sessions, the client chose to drop out without consulting with the therapist. The analysis of qualitative data showed that the established setting of working alliance had different functions over different stages of psychotherapy. Changes in the client’s life required a different setting, however, a persistence of the psychotherapist may have contributed to the dropout. Discussion: The responsiveness of the psychotherapist to the client’s needs proved to be a crucial aspect in identifying the need to transform psychotherapy setting in response to the changing context. |
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