Institute for Psychotherapy, Department of Psychiatry-CHUV, University of Lausanne, Cèdres-Site de Cery, CH-1008 Prilly-Lausanne, Switzerland.
Clin Psychol Psychother. 2009 Sep-Oct;16(5):408-17. doi: 10.1002/cpp.616.
Several patient-related variables have already been investigated as predictors of change in psychodynamic psychotherapy. Defensive functioning is one of them. However, few studies have investigated adaptational processes, encompassing defence mechanisms and coping, from an integrative or comparative viewpoint. This study includes 32 patients, mainly diagnosed with adjustment disorder and undergoing time-limited psychodynamic psychotherapy lasting up to 40 sessions, and will focus on early change in defence and coping. Observer-rater methodology was applied to the transcripts of two sessions of the first part of the psychotherapeutic process. It is assumed that the contextual-relational variable of therapeutic alliance intervenes as moderator on change in adaptational processes. Results corroborated the hypothesis, but only for coping, whereas for defences, overall functioning remained stable over the first 20 sessions of psychotherapy. These results are discussed within the framework of disentangling processes underlying adaptation, i.e., related to issues on trait and state aspects, as well as the role of the therapeutic alliance.
已有多项与患者相关的变量被研究作为动力性心理治疗中变化的预测因子。防御机制便是其中之一。然而，鲜有研究从综合或比较的角度调查适应性过程，包括防御机制和应对策略。本研究纳入 32 名患者，主要诊断为适应障碍，接受长达 40 次疗程的限时动力性心理治疗，并将重点关注防御和应对策略的早期变化。观察者评定法应用于心理治疗过程第一部分的前两次会谈的记录。研究假设治疗联盟的情境关系变量作为调节变量干预适应性过程的变化。结果证实了这一假设，但仅适用于应对策略，而对于防御机制，整体功能在心理治疗的前 20 次会谈中保持稳定。这些结果在对适应性过程背后的机制进行细分的框架内进行了讨论，即与特质和状态方面的问题以及治疗联盟的作用相关。
