Llewelyn S P, Elliott R, Shapiro D A, Hardy G, Firth-Cozens J
Department of Psychology, Branksome Clinic, Parkstone, Poole, Dorset, UK.
Br J Clin Psychol. 1988 May;27(2):105-14. doi: 10.1111/j.2044-8260.1988.tb00758.x.
This study compared the impact of helpful and hindering events, as perceived by 40 clients, in two forms of psychotherapy: an exploratory, relationship-oriented therapy, and a prescriptive, cognitive/behavioural therapy. All clients received eight sessions of each type of treatment in a crossover design. Events were obtained by self-report both during and at the end of each period, and content analysed for type of therapeutic impact by three trained raters. Results showed that during treatment the most commonly occurring helpful impacts across both types of treatments were 'problem solution', 'awareness' and 'reassurance', while the most commonly occurring hindering impact was 'unwanted thoughts'. Similar impacts were reported at the end of each period, with the addition of 'personal contact'. In addition, it was found that 'problem solution' and 'reassurance' impacts were more commonly reported in prescriptive treatment, whereas 'awareness' and 'personal contact' impacts were more prevalent in exploratory treatment. Only the prevalence of 'unwanted thoughts' was correlated (negatively) with outcome. Some possible reasons for the lack of correlation between reported impacts and outcome are suggested.
本研究比较了40位来访者所感知到的有益事件和阻碍事件在两种心理治疗形式中的影响：一种是探索性的、以关系为导向的治疗，另一种是规范性的、认知/行为治疗。所有来访者在交叉设计中接受每种治疗类型的八次治疗。在每个治疗阶段期间及结束时，通过自我报告获取事件信息，并由三位经过培训的评估者对治疗影响的类型进行内容分析。结果显示，在治疗期间，两种治疗类型中最常出现的有益影响是“问题解决”“领悟”和“安心”，而最常出现的阻碍影响是“ unwanted thoughts”。在每个阶段结束时也报告了类似的影响，此外还有“人际接触”。此外，研究发现，“问题解决”和“安心”影响在规范性治疗中报告得更为常见，而“领悟”和“人际接触”影响在探索性治疗中更为普遍。只有“ unwanted thoughts”的发生率与治疗结果呈（负）相关。文中提出了报告的影响与治疗结果缺乏相关性的一些可能原因。
