Department of Psychiatry-CHUV, Institute of Psychotherapy, University of Lausanne, Lausanne, Switzerland.
J Clin Psychol. 2013 Jul;69(7):727-36. doi: 10.1002/jclp.21931. Epub 2012 Oct 10.
Cognitive change over the course of psychodynamic psychotherapy has been postulated by several models, but has rarely been studied. Based on the adaptive skills model (Badgio, Halperin, & Barber, 1999), it is reasonable to expect that very brief dynamic psychotherapy may be associated with change in coping patterns and cognitive errors (also known as cognitive distortions) y.
N = 50 outpatients presenting with various psychiatric disorders and undergoing 4 sessions of Brief Psychodynamic Intervention (BPI; Despland, Drapeau, & de Roten, 2005; Despland, Michel, & de Roten, 2010) were included in this naturalistic study (mean age: 31 years; 56% female; all Caucasian). Cognitive errors and coping strategies were assessed using the Cognitive Errors Rating Scale (Drapeau et al., 2008) and Coping Patterns Rating Scale (Perry et al., 2005). These observer rated methods were applied to the verbatim transcriptions of all 4 therapy sessions completed by each patient.
Results indicate change in both cognitive errors and coping patterns over the course of BPI, including an increase in the Overall Coping Functioning and a decrease in unhelpful coping processes, such as isolation, which reflects a shift in participant appraisal towards stress appraised as a challenge at the end of treatment. These changes predicted symptom change at the end of treatment. While cognitive errors also changed over the course of BPI, no predictive effect was found with regard to symptom change.
These results are interpreted within the framework of common change principles in psychotherapy. Implications and future research are discussed.
几种模型都假设精神动力学心理治疗过程中的认知变化，但很少对此进行研究。根据适应技能模型（Badgio、Halperin 和 Barber，1999），可以合理地预期非常简短的动力心理治疗可能与应对模式和认知错误（也称为认知扭曲）的变化有关。
本自然研究纳入了 50 名因各种精神障碍就诊并接受 4 次简短心理动力学干预（BPI；Despland、Drapeau 和 de Roten，2005；Despland、Michel 和 de Roten，2010）的门诊患者（平均年龄：31 岁；56%为女性；均为白种人）。使用认知错误评定量表（Drapeau 等人，2008）和应对模式评定量表（Perry 等人，2005）评估认知错误和应对策略。这些观察者评定方法适用于每位患者完成的所有 4 次治疗会话的逐字记录。
结果表明，BPI 过程中认知错误和应对模式都发生了变化，包括整体应对功能的增加和无益应对过程（如孤立）的减少，这反映了参与者对压力的评估从治疗结束时的挑战转变为挑战。这些变化预测了治疗结束时的症状变化。虽然 BPI 过程中认知错误也发生了变化，但与症状变化无关。
这些结果是在心理治疗中常见变化原则的框架内解释的。讨论了其含义和未来的研究。
