Heer, Sara Soraya (2022). «Nichts ist so beständig wie der Wandel» – Eine Arbeit zu patient*innen- und therapeut*innenbezogener Veränderung in der Psychologischen Therapie. (Thesis). Universität Bern, Bern
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Abstract
Whether psychotherapy is effective or not, is a question that no longer arises today. In their examination of 17 meta-analyses, Luborsky and colleagues (2002) found that the comparison of different active treatments resulted in only small, not significant effect sizes. The conclusion drawn from this data was that differences in effectiveness between different psychotherapy orientations are minimal. In the following, the attention to psychotherapy integration arose. Since then, the interest in an integrative treatment has reached an extent that it has been considered a “movement” or zeitgeist, but still numerous questions regarding efficacy, effectiveness, and therapist training remain unanswered. Whereas there is more research available for “pure” approaches, most practitioners use these only in an adapted, integrative fashion. This leads to a dissatisfactory state where much of the available evidence does not correspond to the predominant practice. With the intention of contributing to bridge this research gap, the project “The Impact of Integrating Emotion Focused Components into Psychological Therapy”, also named Improve-Project, was formed. Psychological Therapy is an integrative therapy approach corresponding to General Psychotherapy, which postulates an ongoing process including all interventions and concepts relevant for the field, be they from psychotherapy orientations or basic science. As the name states the project aims to integrate elements from Emotion-focused Therapy into Psychological Therapy. To control for unspecific treatment effects, a second treatment arm, that integrated elements from the theory of self-regulation, was built. The goal was then to examine effects of assimilative integration under routine conditions and study the underlying mechanisms and processes of change. This dissertation presents four articles as part of the Improve Project. The study protocol provides the theoretical and conceptual framework for all further studies conducted as part of the Improve-Project. Study I is a qualitative study within which interviews were conducted with therapists about their experience with the task of assimilative integration. Study II is a process-outcome study that examines deep change, operationalized using the psychodynamic concept of restructuring, in the two treatment arms and its association with symptom change. Study III is a second process-outcome study, which investigates non-linear patterns of change, so-called Sudden Gains and Losses, within the two treatment arms and their relevance to treatment outcome. In addition, the goal of the study was to explore possible causes for the sudden changes. After an introduction to common theories and concepts of psychotherapy integration and change, the goals of both the Improve-Project and this dissertation will be presented in more detail. Subsequently, the articles are summarized and discussed in detail. Based on the findings, further possible research questions and implications for practice and psychotherapy training are proposed. Finally, a statement is made on the strengths and limitations of the dissertation.
| Item Type: | Thesis |
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| Dissertation Type: | Cumulative |
| Date of Defense: | 10 March 2022 |
| Subjects: | 100 Philosophy > 150 Psychology 600 Technology > 610 Medicine & health |
| Institute / Center: | 07 Faculty of Human Sciences > Institute of Psychology |
| Depositing User: | Hammer Igor |
| Date Deposited: | 03 Jul 2025 06:39 |
| Last Modified: | 03 Jul 2025 22:25 |
| URI: | https://boristheses.unibe.ch/id/eprint/6355 |
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