Bucci Wilma, Maskit Bernard
Derner Institute of Advanced Psychological Studies, Adelphi University, Garden City, NY 11530, USA.
J Am Psychoanal Assoc. 2007 Fall;55(4):1355-97. doi: 10.1177/000306510705500412.
This study represents a new generation of psychotherapy process research, using multiple perspectives on the data of the analytic situation, including impressions of the treating analyst, ratings of complete sessions by clinical judges, and objective linguistic measures. Computerized measures of language style developed in the framework of multiple code theory were applied to verbatim session recordings from a psychoanalytic case; the measures are illustrated in microanalyses of the process in two sessions. The results show agreement between the linguistic measures and clinical ratings based on a psychoanalytic perspective. The linguistic measures look beneath the surface of the therapeutic interaction by relying largely on lexical items of which clinicians are not likely to be explicitly aware, and enable a new perspective on the therapeutic discourse as seen in the graphic images of the microprocess. While the results of this study were limited to a single case, the automatized measures can be readily applied to large samples and in repeated single case designs. Two goals of process research, using measures such as those developed in this study, are discussed: to develop measures of mediating variables that can be used to identify specific treatment effects in comparative outcome studies; and, beyond this pragmatic aim, to assess development of capacities for self-exploration and self-regulation as psychoanalytic treatment goals.
本研究代表了新一代心理治疗过程研究,它从多个角度审视分析情境的数据,包括治疗分析师的印象、临床评判员对完整疗程的评分以及客观的语言测量。在多重编码理论框架下开发的语言风格计算机化测量方法被应用于一个精神分析案例的逐字记录疗程;这些测量方法在对两个疗程的过程进行微观分析时得到了说明。结果表明,基于精神分析视角,语言测量与临床评分之间具有一致性。语言测量主要依靠临床医生不太可能明确意识到的词汇项目,深入探究治疗互动的表面之下,并能从微观过程的图形图像中呈现出对治疗话语的新视角。虽然本研究的结果仅限于单个案例,但这些自动化测量方法可以很容易地应用于大样本以及重复的单案例设计中。文中讨论了使用本研究中开发的此类测量方法进行过程研究的两个目标:开发中介变量测量方法,用于在比较疗效研究中识别特定的治疗效果;以及超越这个务实目标,评估作为精神分析治疗目标的自我探索和自我调节能力的发展。