Gumz Antje, Neubauer Karolin, Horstkotte Julia Katharina, Geyer Michael, Löwe Bernd, Murray Alexandra M, Kästner Denise
Berlin University of Psychology (PHB), Berlin, Germany.
Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Hamburg-Eppendorf and Schön Klinik Hamburg Eilbek, Hamburg, Germany.
PLoS One. 2017 Aug 24;12(8):e0182949. doi: 10.1371/journal.pone.0182949. eCollection 2017.
Knowing which specific verbal techniques "good" therapists use in their daily work is important for training and evaluation purposes. In order to systematize what is being practiced in the field, our aim was to empirically identify verbal techniques applied in psychodynamic sessions and to differentiate them according to their basic semantic features using a bottom-up, qualitative approach.
Mixed-Method-Design: In a comprehensive qualitative study, types of techniques were identified at the level of utterances based on transcribed psychodynamic therapy sessions using Qualitative Content Analysis (4211 utterances). The definitions of the identified categories were successively refined and modified until saturation was achieved. In a subsequent quantitative study, inter-rater reliability was assessed both at the level of utterances (n = 8717) and at the session level (n = 38). The convergent validity of the categories was investigated by analyzing associations with the Interpretive and Supportive Technique Scale (ISTS).
The inductive approach resulted in a classification system with 37 categories (Psychodynamic Interventions List, PIL). According to their semantic content, the categories can be allocated to three dimensions: form (24 categories), thematic content (9) and temporal focus (4). Most categories showed good or excellent inter-rater reliability and expected associations with the ISTS were predominantly confirmed. The rare use of the residual category "Other" suggests that the identified categories might comprehensively describe the breadth of applied techniques.
The atheoretical orientation and the clear focus on overt linguistic features should enable the PIL to be used without intensive training or prior theoretical knowledge. The PIL can be used to investigate the links between verbal techniques derived from practice and micro-outcomes (at the session level) as well as the overall therapeutic outcomes. This approach might enable us to determine to what extent the outcome of therapy is due to unintended or non-theoretically relevant techniques.
了解“优秀”治疗师在日常工作中使用的具体言语技巧，对于培训和评估目的而言非常重要。为了将该领域的实践进行系统化，我们的目标是通过自下而上的定性方法，实证识别心理动力学治疗中应用的言语技巧，并根据其基本语义特征对其进行区分。
混合方法设计：在一项全面的定性研究中，基于转录的心理动力学治疗会话，使用定性内容分析法（4211条话语）在话语层面识别技巧类型。对已识别类别的定义进行了连续细化和修改，直至达到饱和。在随后的定量研究中，在话语层面（n = 8717）和会话层面（n = 38）评估了评分者间信度。通过分析与解释性和支持性技巧量表（ISTS）的关联，研究了这些类别的收敛效度。
归纳法产生了一个包含37个类别的分类系统（心理动力学干预列表，PIL）。根据其语义内容，这些类别可分为三个维度：形式（24个类别）、主题内容（9个）和时间焦点（4个）。大多数类别显示出良好或优秀的评分者间信度，并且与ISTS的预期关联大多得到证实。剩余类别“其他”的罕见使用表明，所识别的类别可能全面描述了应用技巧的广度。
无理论取向以及对明显语言特征的明确关注应使PIL无需深入培训或先验理论知识即可使用。PIL可用于研究源自实践的言语技巧与微观结果（在会话层面）以及总体治疗结果之间的联系。这种方法可能使我们能够确定治疗结果在多大程度上归因于意外或非理论相关的技巧。
