Unique and common mechanisms of change across cognitive and dynamic psychotherapies.
The goal of this article was to examine theoretically important mechanisms of change in psychotherapy outcome across different types of treatment. Specifically, the role of gains in self-understanding, acquisition of compensatory skills, and improvements in views of the self were examined. A pooled study database collected at the University of Pennsylvania Center for Psychotherapy Research, which includes studies conducted from 1995 to 2002 evaluating the efficacy of cognitive and psychodynamic therapies for a variety of disorders, was used. Patient samples included major depressive disorder, generalized anxiety disorder, panic disorder, borderline personality disorder, and adolescent anxiety disorders. A common assessment battery of mechanism and outcome measures was given at treatment intake, termination, and 6-month follow-up for all 184 patients. Improvements in self-understanding, compensatory skills, and views of the self were all associated with symptom change across the diverse psychotherapies. Changes in self-understanding and compensatory skills across treatment were predictive of follow-up symptom course. Changes in self-understanding demonstrated specificity of change to dynamic psychotherapy.
Department of Psychiatry, University of Pennsylvania, USA. gibbonsm@mail.med.upenn.edu
Mary Beth Connolly
MB
Gibbons
Paul
P
Crits-Christoph
Jacques P
JP
Barber
Shannon
S
Wiltsey Stirman
Robert
R
Gallop
Lizabeth A
LA
Goldstein
Christina M
CM
Temes
Sarah
S
Ring-Kurtz
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D001364:Awareness; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D032882:Comprehension; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007389:Internal-External Control; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D016584:Panic Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D010553:Personality Development; D010865:Pilot Projects; D011575:Psychoanalytic Therapy / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D012649:Self Concept; D020377:Self Efficacy; D055815:Young Adult