title: Narrative meaning making is associated with sudden gains in psychotherapy clients' mental health under routine clinical conditions.
abstract: OBJECTIVE
  The present study had two aims: (a) to replicate previous findings regarding the characteristics of sudden gains (SGs) in psychotherapy under routine clinical conditions and (b) to examine whether clients' narrative meaning-making processes were associated with SGs in mental health.
  
  
  METHODS
  54 psychotherapy clients completed the Systemic Therapy Inventory of Change (Pinsof et al., 2009) and wrote private narratives prior to beginning treatment and between every session for 12 assessment points over the course of psychotherapy for a variety of presenting problems. Clients' narratives were coded using existing systems (Adler, 2012; A. M. Hayes, Feldman, & Goldfried, 2006) to assess their content in eight themes: processing, avoidance, coherence, positive self, negative self, agency, hope, and hopelessness.
  
  
  RESULTS
  The prevalence, magnitude, and timing of SGs in mental health observed in the present study were similar to those observed in prior research. Two narrative meaning-making processes-processing and coherence-were significantly associated with SGs in mental health.
  
  
  CONCLUSIONS
  The present study significantly extends prior research on SGs, replicating the characteristics of these gains in routine clinical conditions with a measure of general functioning and identifying two narrative meaning-making processes that are associated with SGs in mental health.
authors.affiliation: Department of Psychology, Franklin W. Olin College of Engineering.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Adler
authors.forename: Luke H
authors.initials: LH
authors.lastname: Harmeling
authors.forename: Ilana
authors.initials: I
authors.lastname: Walder-Biesanz
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000628:therapy*; D008875:Middle Aged; D033262:Narration; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods*; D036301:Qualitative Research; D011897:Random Allocation; D015203:Reproducibility of Results; D016037:Single-Blind Method; D011795:Surveys and Questionnaires / Q000592:standards*; D016896:Treatment Outcome