SciELO - Scientific Electronic Library Online

 
vol.41 issue2Cross-sectional study of readmissions to the psychiatric ward of Hospital Estadual Mário Covas in Santo André, state of São Paulo, between 2008 and 2015Relationship between sexual hormones, quality of life and postmenopausal sexual function author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Indicators

Related links

Share


Trends in Psychiatry and Psychotherapy

Print version ISSN 2237-6089On-line version ISSN 2238-0019

Abstract

LASKOSKI, Pricilla Braga et al. Interaction structures in the psychodynamic psychotherapy of a patient with chronic diseases and somatic symptoms. Trends Psychiatry Psychother. [online]. 2019, vol.41, n.2, pp.128-135.  Epub July 10, 2019. ISSN 2237-6089.  https://doi.org/10.1590/2237-6089-2017-0146.

Objective

This study aimed to identify and analyze the interaction structures (ISs) (patterns of reciprocal interaction between the patient-therapist dyad) that characterize the process of a successful long-term psychodynamic psychotherapy (28 months) of a patient with chronic diseases (lupus and fibromyalgia) and somatic symptoms.

Methods

The 113 sessions were videotaped and analyzed alternately (n = 60) by independent judges using the Psychotherapy Process Q-Set. Inter-rater reliability ranged from 0.60 to 0.90, with a mean of r = 0.71 (Pearson’s correlation). Through a principal component exploratory factor analysis, four ISs were identified.

Result

The patterns of interaction between patient and therapist showed clinical validity (i.e., they were easily interpretable in the context of the case under study). The ISs were non-linear and more or less prominent across different treatment sessions and stages. Some ISs were similar to those in other studies, and others were probably unique to the present process. In addition, some ISs were independent, whereas others were interrelated over time.

Conclusion

Process studies, such as the present one, seek to address questions about the characteristics of the interaction between patient and therapist as well as to identify particular patterns of interaction that are most prominent with a specific patient at a specific condition or time. Therefore, these studies can provide some support in establishing knowledge for clinical practice, assisting in the training of therapists, as well as in the elaboration of general guidelines for the technical management of patients with specific characteristics.

Keywords : Psychodynamic psychotherapy; process research; interaction structures; psychotherapeutic process.

        · abstract in Portuguese     · text in English     · English ( pdf )