Fiorentino Flavia, Gualco Ivan, Carcione Antonino, Lingiardi Vittorio, Tanzilli Annalisa
Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
Center for Individual and Couple Therapy, Genoa, Italy.
Front Psychol. 2024 Sep 5;15:1390754. doi: 10.3389/fpsyg.2024.1390754. eCollection 2024.
The impact of depth of elaboration in individual psychotherapy sessions on overall treatment effectiveness was found in the empirical literature. In the best sessions, relevant content is processed with greater depth; in contrast, in the shallower sessions, the emerging content is more superficial. Evidence suggests that achieving a high level of depth is closely related to specific therapist characteristics and relational dimensions (including clinicians' emotional responses to patients). The present study aimed to (a) compare therapist responsiveness and countertransference patterns in psychotherapy sessions with different levels of depth of elaboration; and (b) examine if the positive countertransference pattern mediated the relationship between therapist responsiveness and depth of elaboration.
Eighty-four clinicians were asked to select one patient with personality disorders in their care and complete the , the , and the concerning one of their sessions.
The results showed that sessions with higher levels of depth of elaboration were characterized by greater therapist responsiveness and more positive countertransference. Conversely, poor therapist responsiveness and hostile/angry, disengaged, and helpless/inadequate countertransference responses were found in shallower sessions. Moreover, positive countertransference mediated the relationship between therapist responsiveness and depth of elaboration.
This study sought to shed light on the processes underlying the outcomes of psychotherapeutic sessions, highlighting the strong impact of relational factors. Advancing knowledge of these mechanisms seems crucial to identifying the active ingredients of the therapeutic process and understanding what (does not) promote successful outcomes.
实证文献中发现了个体心理治疗 sessions 中阐述深度对整体治疗效果的影响。在最佳 sessions 中，相关内容得到更深入的处理；相比之下，在较浅的 sessions 中，出现的内容更肤浅。有证据表明，达到高水平的深度与特定的治疗师特征和关系维度密切相关（包括临床医生对患者的情感反应）。本研究旨在（a）比较不同阐述深度水平的心理治疗 sessions 中治疗师的反应性和反移情模式；（b）检验积极的反移情模式是否介导了治疗师反应性与阐述深度之间的关系。
84 名临床医生被要求从他们所治疗的患有 personality disorders 的患者中选择一名，并完成关于他们其中一个 sessions 的[具体量表名称 1]、[具体量表名称 2]和[具体量表名称 3]。
结果表明，阐述深度水平较高的 sessions 的特点是治疗师反应性更强，反移情更积极。相反，在较浅的 sessions 中发现治疗师反应性较差，反移情反应为敌意/愤怒、脱离和无助/不足。此外，积极的反移情介导了治疗师反应性与阐述深度之间的关系。
本研究旨在阐明心理治疗 sessions 结果背后的过程，强调关系因素的强大影响。增进对这些机制的了解对于确定治疗过程的有效成分以及理解什么（不）促进成功结果似乎至关重要。
