title: Self-narrative reconstruction after dilemma-focused therapy for depression: A comparison of good and poor outcome cases.
abstract: The aim of this study is to improve the understanding of self-changes after an intervention for depression focused on implicative dilemmas, a type of cognitive conflict related to identity. As recent research has highlighted the relevance of identity-related dilemmas in clients with depression, we sought to assess the way in which clients resolve such inner conflicts after a tailored dilemma-focused intervention and how this is reflected in the clients' self-narratives.
  
  
  
  We used three instruments to observe differences between good (n = 5) and poor (n = 5) outcome cases: (i) the Repertory Grid Technique to track the resolution of dilemmas, (ii) the Change Interview to compile clients' accounts of changes at posttreatment, and (iii) the Innovative Moments Coding System to examine the emergence of clients' novelties at the Change Interview.
  
  
  
  Groups did not differ in terms of the number and relevance of client-identified significantly helpful events. However, between-group differences were found for the resolution of dilemmas and for the proportion of high-level innovative moment (IM) types. Furthermore, a greater self-narrative reconstruction was associated with higher levels of symptom improvement.
  
  
  
  Good outcome cases seem to be associated with the resolution of conflicts and high-level IMs.
authors.affiliation: a Department of Personality, Assessment and Psychological Treatments , University of Barcelona , Barcelona , Spain.|b Institute for Brain, Cognition and Behavior, University of Barcelona , Barcelona , Spain.
authors.forename: Adrián
authors.initials: A
authors.lastname: Montesano
authors.affiliation: c School of Psychology , University of Minho , Braga , Portugal.
authors.forename: Miguel M
authors.initials: MM
authors.lastname: Gonçalves
authors.affiliation: a Department of Personality, Assessment and Psychological Treatments , University of Barcelona , Barcelona , Spain.|b Institute for Brain, Cognition and Behavior, University of Barcelona , Barcelona , Spain.
authors.forename: Guillem
authors.initials: G
authors.lastname: Feixas
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003220:Conflict, Psychological; D003866:Depressive Disorder / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods*; D063545:Personal Narratives as Topic; D012649:Self Concept
keywords: depression; implicative dilemmas; innovative moments; resistance and ambivalence; self and identity