title: One minute of grief: emotional processing in short-term dynamic psychotherapy for adjustment disorder.
abstract: OBJECTIVE
  Depth of emotional processing has shown to be related to outcome across approaches to psychotherapy. Moreover, a specific emotional sequence has been postulated and tested in several studies on experiential psychotherapy (Pascual-Leone & Greenberg, 2007). This process-outcome study aims at reproducing the sequential model of emotional processing in psychodynamic psychotherapy for adjustment disorder and linking these variables with ultimate therapeutic outcome.
  
  
  METHODS
  In this study, 32 patients underwent short-term dynamic psychotherapy. On the basis of reliable clinical change statistics, a subgroup (n = 16) presented with good outcome and another subgroup (n = 16) had a poor outcome in the end of treatment. The strongest alliance session of each case was rated using the observer-rated system Classification of Affective Meaning States. Reliability coefficients for the measure were excellent (κ = .82).
  
  
  RESULTS
  Using 1 min as the fine-grained unit of analysis, results showed that the experience of fundamentally adaptive grief was more common in the in-session process of patients with good outcome, compared with those with poor outcomes (χ2 = 6.56, p = .01, d = 1.23). This variable alone predicted 19% of the change in depressive symptoms as measured by the Beck Depression Inventory at the end of treatment. Moreover, sequences of the original model were supported and related to outcome.
  
  
  CONCLUSIONS
  These results are discussed within the framework of the sequential model of emotional processing and its possible relevance for psychodynamic psychotherapy.
authors.affiliation: Institute of Psychotherapy and General Psychiatry, Department of Psychiatry, University Hospital Center.
authors.forename: Ueli
authors.initials: U
authors.lastname: Kramer
authors.affiliation: Department of Psychology, University of Windsor.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pascual-Leone
authors.affiliation: Institute of Psychotherapy, Department of Psychiatry, University Hospital Center.
authors.forename: Jean-Nicolas
authors.initials: JN
authors.lastname: Despland
authors.affiliation: Institute of Psychotherapy, Department of Psychiatry, University Hospital Center.
authors.forename: Yves
authors.initials: Y
authors.lastname: de Roten
mesh_terms: D000275:Adjustment Disorders / Q000523:psychology* / Q000628:therapy*; D000328:Adult; D005260:Female; D006117:Grief; D006801:Humans; D008297:Male; D011614:Psychotherapy, Brief / Q000379:methods*; D064889:Psychotherapy, Psychodynamic / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult