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关系模式作为重度抑郁症症状改善创新时刻的中介。

Relational schemas as mediators of innovative moments in symptom improvement in major depression.

机构信息

a Psychotherapy and Psychopathology Research Unit, School of Psychology, CIPsi - Psychology Research Center , University of Minho , Braga , Portugal.

b Department of Mathematics , University of Minho , Braga , Portugal.

出版信息

Psychother Res. 2019 Jan;29(1):58-69. doi: 10.1080/10503307.2017.1359427. Epub 2017 Aug 5.

Abstract

OBJECTIVES

Innovative moments (IMs) are exceptions to the maladaptive framework of meaning that typically motivates clients to seek psychotherapy, and previous studies have shown that IMs are associated with psychotherapy outcomes. While IMs are exceptions that occur at the level of the therapeutic conversation, relational schemas are more stable patterns, and their increased flexibility may facilitate change during psychotherapy. With this in mind, we tested the hypothesis that IMs contribute to outcomes by improving the flexibility of relational schemas.

METHOD

The Core Conflictual Relationship Theme (CCRT) was used to assess relational schemas. IMs were evaluated using the Innovative Moments Coding System. The sample included 22 clients diagnosed with major depressive disorder. The flexibility of the three components of the CCRT (Wishes, responses of the self (RS), and responses of others (RO)) were tested as mediators between IMs and outcomes.

RESULTS

The flexibility of the RS was a mediator between IMs and outcomes, but Wishes and RO were not.

CONCLUSION

These findings align with previous research showing that RS is the component most open to change, whereas the other components seem less sensitive to change during brief therapy. Clinical or methodological significance of this article: This study shows the mediation role of relational schemas in the association between in-session events (innovative moments (IMs)) and the symptoms improvement. It contributes to the literature that emphasizes the importance of relational schemas in psychotherapy by using a mediation model, which has rarely been tested.

摘要

目的

创新时刻(IMs)是通常促使客户寻求心理治疗的适应不良框架的例外情况,先前的研究表明,IMs 与心理治疗结果相关。虽然 IMs 是在治疗对话层面发生的例外情况,但关系图式是更稳定的模式,它们的灵活性增加可能有助于心理治疗期间的变化。考虑到这一点,我们假设 IMs 通过提高关系图式的灵活性来促进治疗结果。

方法

使用核心冲突关系主题(CCRT)评估关系图式。使用创新时刻编码系统评估 IMs。该样本包括 22 名被诊断为重度抑郁症的患者。作为 IMs 和结果之间的中介,测试了 CCRT 的三个组成部分(愿望、自我反应(RS)和他人反应(RO))的灵活性。

结果

RS 的灵活性是 IMs 和结果之间的中介,但愿望和 RO 不是。

结论

这些发现与先前的研究一致,表明 RS 是最容易改变的组成部分,而其他组成部分在短暂治疗期间似乎对变化不太敏感。

本文的临床或方法学意义

本研究表明,在治疗过程中发生的事件(创新时刻(IMs))与症状改善之间存在关系图式的中介作用。它通过使用很少被测试过的中介模型,强调了关系图式在心理治疗中的重要性,为文献做出了贡献。

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