Long-term psychodynamic psychotherapy in a face-to-face versus videoconferencing setting: A single case study.

OBJECTIVE: Due to the coronavirus pandemic and crisis, psychotherapists around the world were forced to switch to video- or tele-based treatments overnight. To date, only a few studies on the effectiveness of video-based psychodynamic psychotherapy via the Internet exist. Therefore, the goal of the present study was to examine symptom improvement, therapeutic relationship, nonverbal synchrony processes, and intersession processes within a systematic single case design and compare face-to-face to video-based approaches in long-term psychodynamic-oriented psychotherapy. METHODS: We examined 85 sessions of a client with major depression whose psychodynamic psychotherapy changed from a face-to-face setting to a video-based setting. Video recordings were analyzed using motion energy analysis, and nonverbal synchrony was computed using a surrogate synchrony approach. Time series analyses were performed to analyze changes in symptom severity, therapeutic relationship, and intersession processes. RESULTS: The results showed that symptom severity improved descriptively, but not significantly, across the entire course of psychotherapy. There were significant differences, however, in the therapeutic relationship, intersession experiences, and synchronous behavior between the face-to-face and video-based settings. CONCLUSION: The results indicate that the presented methodology is well situated to investigate the question whether psychodynamic psychotherapy in video-based setting works in the sameway as in a face-to-face setting.

Growth curves of common factors in psychotherapy: Multilevel growth modelling and outcome analysis.

OBJECTIVE: A large body of literature discusses change mechanisms underlying psychotherapy with an emphasis on common factors. The present study examined how different comprehensive common factors change over the course of therapy and whether this change was associated with clinical outcome at discharge. METHOD: Three hundred forty-eight adults (mean age = 32.1, SD = 10.6; 64% female) attended a standardized 14-week day-clinic psychotherapy program. They provided longitudinal data on common factors based on weekly assessments. Additionally, pre- and post-assessment questionnaires on clinical outcome were completed. Using multilevel modelling, we predicted common factors by time (week in therapy). Multiple linear regression models tested the association between changes in common factors and clinical outcome. RESULTS: The common factor 'Therapeutic Alliance' was best fitted by linear growth models, whereas models for the common factors 'Coping', 'Cognitive Integration' and 'Affective Processing' indicated logarithmic changes over time. 'Coping', that is change in patients' ability to cope with their individual problems, was most closely linked with outcome. CONCLUSIONS: The present study provides evidence for the changeability of common factors over the course of therapy as well as their specific contributions to psychotherapeutic progress.

Dynamic dyadic processes in psychotherapy: Introduction to a special section.

There is a growing consensus among psychotherapy theoreticians and researchers that psychotherapy processes are an interpersonal phenomenon that can be studied as a dynamic system. The aim of this special section is to highlight the importance of exploring the complex processes that emerge over time from interactions and feedback loops amongst sub-components (e.g., emotions, non-verbal behavior, physiology, voice, subjective experience) within and between clients and therapists. The articles featured in this special section discuss multiple methods and angles to study dynamic dyadic processes in psychotherapy that can better capture the complexity of the therapeutic process and the ways it can lead to favorable outcomes. Future research that focuses on dynamic dyadic processes in psychotherapy is outlined.

Nonverbal synchrony in psychotherapy: coordinated body movement reflects relationship quality and outcome.

OBJECTIVE: The authors quantified nonverbal synchrony--the coordination of patient's and therapist's movement--in a random sample of same-sex psychotherapy dyads. The authors contrasted nonverbal synchrony in these dyads with a control condition and assessed its association with session-level and overall psychotherapy outcome. METHOD: Using an automated objective video analysis algorithm (Motion Energy Analysis; MEA), the authors calculated nonverbal synchrony in (n = 104) videotaped psychotherapy sessions from 70 Caucasian patients (37 women, 33 men, mean age = 36.5 years, SD = 10.2) treated at an outpatient psychotherapy clinic. The sample was randomly drawn from an archive (N = 301) of routinely videotaped psychotherapies. Patients and their therapists assessed session impact with self-report post-session questionnaires. A battery of pre- and postsymptomatology questionnaires measured therapy effectiveness. RESULTS: The authors found that nonverbal synchrony is higher in genuine interactions contrasted with pseudointeractions (a control condition generated by a specifically designed shuffling procedure). Furthermore, nonverbal synchrony is associated with session-level process as well as therapy outcome: It is increased in sessions rated by patients as manifesting high relationship quality and in patients experiencing high self-efficacy. Higher nonverbal synchrony characterized psychotherapies with higher symptom reduction. CONCLUSIONS: The results suggest that nonverbal synchrony embodies the patients' self-reported quality of the relationship and further variables of therapy process. This hitherto overlooked facet of therapeutic relationships might prove useful as an indicator of therapy progress and outcome.

[Evaluation of the bern day treatment programme and its position in the psychiatric network]. / Die Berner Psychotherapie-Tagesklinik: Evaluation und Einordnung in die psychiatrische Versorgungskette.

The Bern Day Treatment Programme offers cognitive-behavioural treatment to patients suffering from depression, eating disorders, anxiety disorders, and personality disorders. Treatment duration ranges from 12 to 20 weeks. Its concept is described in comparison to other similar institutions. To evaluate the programme the Beck Depression Inventory (BDI), the Symptom Check List (SCL-90-R), and the Change in Life Areas (VLB) were administered to 89 patients at admission and discharge. Their analyses revealed high symptom levels at admission and a significant improvement during treatment. Patients with personality disorders show less improvement in the VLB than patients without personality disorders. The results of the SCL-90-R indicate that the symptom levels at admission and the symptom reductions during treatment are similar to those of patients treated in inpatient units or in diagnostically specialised day treatment programmes. The Bern Day Treatment Programme seems to be feasible for highly impacted patients with non-psychotic disorders and might be a useful model for areas with low population density.