Order and Pattern Formation in Psychotherapy
Tóm tắt
In an empirical analysis of the dynamics of psychotherapy processes, concepts and tools from self-organization theory are applied. Our focus is on pattern formation in the ‘therapy system’, i.e. the system constituted by the interaction dynamics of therapist and patient. The hypothesis of pattern formation explored is based on data sets of 28 psychotherapy courses (10 behavioral, 3 client-centered, 9 heuristic, 6 schema-oriented; 40 to 90 weekly sessions). Patients' and therapists' therapy session records are analyzed (33 variables addressing various aspects of the therapeutic relationship, of progress within and outside the therapy setting). Multivariate methods are implemented to test the key hypothesis of self-organization theory, namely the reduction of degrees of freedom of a system. Consistent with this hypothesis, a significant reduction of degrees of freedom is found when the initial and final sessions of the therapies are compared. Correspondingly, ‘Landsberg order’ increased significantly in the course of therapies. Given these findings, the explorative question of how this self-organizing property relates to therapy outcome is investigated. We find a significant positive association with various outcome measures, such as: therapist's and client's evaluations of success (direct change measures), feelings of guilt, anxiety, social potence, depression (pre-post effect sizes), and others. These results suggest that order is related to therapy outcome. In our interpretation, order is a dynamical attribute of the therapeutic alliance to be considered as a promising therapy process variable.
Tài liệu tham khảo
Abarbanel, H.D.I., Brown, R., Sidorowich, J.J., & Tsimring, L.S. (1993). The analysis of observed chaotic data in physical systems. Review of Modern Physics, 65, 1331–1392.
Abraham, R.H., & Shaw, C.D. (1992). Dynamics—the geometry of behavior. Redwood City: Addison-Wesley.
Banerjee, S., Sibbald, P.R., & Maze, J. (1990). Quantifying the dynamics of order and organization in biological systems. Journal of Theoretical Biology, 143, 91–111.
Beckmann, D., Brähler, E., & Richter, H.-E. (1990). Der Giessen-Test (GT): ein Test für Individual-und Gruppendiagnostik. Bern: Huber.
Bélair, J., Glass, L., an der Heiden, U., & Milton, J. (Eds.) (1995). Dynamical disease. American Institute of Physics Press: Woodbury, NY.
Brunner, E.J., Tschacher, W., Quast, C., & Ruff, A. (1997). Veränderungsprozesse in Paarbeziehungen. Eine empirische Studie aus der Sicht der Selbstorganisationstheorie. In: Schiepek, G., & Tschacher, W. (Eds.), Selbstorganisation in Psychologie und Psychiatrie (pp. 221–234). Braunschweig: Vieweg.
Cattell, R.B. (1965). The scientific analysis of personality. Baltimore: Penguin Books.
Czogalik, D., & Hettinger, R. (1988). Mehrebenenanalyse der psychotherapeutischen Interaktion: Eine Verlaufsstudie am Einzelfall. Zeitschrift für Klinische Psychologie, 17, 31–45.
Derogatis, L.R. (1977). SCL-90-R. Administration, scoring, & procedures manual-I for the R(evised) version. Baltimore: Johns Hopkins University School of Medicine.
Franke, G. (1994). SCL-90-R. Die Symptom-Checkliste von Derogatis-Deutsche Version-. Weinheim: Beltz.
Gottschalk, A., Bauer, M.S., & Whybrow, P.C. (1995). Evidence of chaotic mood variation in bipolar disorder. Archives of General Psychiatry, 52, 947–959.
Grawe, K. (1988). Heuristische Psychotherapie: Eine schematheoretisch fundierte Konzeption des Psychotherapieprozesses. Integrative Therapie, 4, 309–324.
Grawe, K. (1991). University of Bern: Differential psychotherapy research. In: Beutler, L.E., & Crago, M. (Eds.), Psychotherapy research: An international review of programmatic sudies, (pp. 202–211). Washington: American Psychological Association.
Grawe, K., Caspar, F., & Ambühl, H. (1990). Differentielle Psychotherapieforschung: Vier Therapieformen im Vergleich. Zeitschrift für Klinische Psychologie, 19 (complete volume).
Grawe, K., & Braun, U. (1994). Qualitätskontrolle in der Psychotherapiepraxis. Zeitschrift für Klinische Psychologie, 23, 242–267.
Grawe, K., Donati, R., & Bernauer, F. (1997). Psychotherapy in transition—from speculation to science. Seattle: Hogrefe & Huber Publishers.
Greenberg, L.S. (1991). Research on the process of change. Psychotherapy Research, 1, 3–16.
Greenberg, L.S., & Pinsof, W.M. (Eds.) (1986). The psychotherapeutic process: a research handbook. New York: Guilford.
Haken, H. (1983). Synergetics—an introduction. Berlin: Springer.
Haken, H. (1988). Information and self-organization (a macroscopic approach to complex systems). Berlin: Springer.
Haken, H., & Koepchen, H.P. (Eds.) (1991). Rhythms in Physiological Systems. Berlin: Springer.
Kaplan, D., & Glass, L. (1995). Understanding nonlinear dynamics. New York: Springer.
Kendon, A. (1970). Movement coordination in social interaction: some examples considered. Acta Psychologica, 32, 1–25.
Kiresuk, T., & Lund, S.H. (1979). Goal attainment scaling: research, evaluation, and utilization. In: Schulberg, H.C., & Baker, F. (Eds.), Program evaluation in the health fields (2), New York: Human Sciences Press.
Krampen, G. (1981). IPC—Fragebogen zu Kontrollüberzeugungen. Göttingen: Hogrefe.
Kupper, Z. (1998). Dynamical models for chronic mental disorders (Dynamische Modelle für chronische psychische Störungen). Unpublished doctoral dissertation, University of Freiburg, Switzerland.
Kupper, Z., Tschacher, W., & Hoffmann, H. (1997). Correlates of order and ordering in the time course of schizophrenia. Poster presented to the Joint Conference on Complex Systems in Psychology/6. Herbstakademie, Gstaad, Switzerland.
Landsberg, P.T. (1984). Can entropy and “order” increase together? Physics Letters, 102A, 171–173.
Levenson, H. (1972). Distinctions within the concept of internal-external control. Proceedings of the 80th Annual Convention of the APA, 7, 261–262.
Levine, R.L., & Fitzgerald, H.E. (1992). Analysis of dynamic psychological systems, Vol. 1: Basic approaches to general systems. New York: Plenum Press.
Molenaar, C.P.M. (1994). Dynamic latent variable models in developmental psychology. In: Von Eye, A., & Clogg, C.C. (Eds.), Analysis of latent variables in developmental research, (pp. 155–180). Newbury Park, CA: Sage.
Orlinsky, D.E., & Howard, K.I. (1986). The psychological interior of psychotherapy: Explorations with the therapy session reports. In: Greenberg, L.S., & Pinsof, W.M. (Eds.), The psychotherapeutic process: a research handbook, (pp. 477–502). New York: Guilford.
Orlinsky, D.E., Grawe, K., Parks, K.B. (1994). Process and outcome in psychotherapy—noch einmal. Bergin, A.E., Garfield, S. L. Handbook of psychotherapy and behavior change. New York: Wiley 270–376.
Rapp, P.E., Jiménez-Montano, M.A., Langs, R.J., Thomson, L., & Mees, A.I. (1991). Toward a quantitative characterization of patient-therapist communication. Mathematical Biosciences, 105, 207–227.
Scheier, C., & Tschacher, W. (1994). Gestaltmerkmale in psychologischen Zeitreihen. Gestalt-Theory, 16, 151–171.
Scheier, C., & Tschacher, W. (1996). Appropriate algorithms for nonlinear time series analysis in psychology. In: Sulis, W., & Combs, A. (Eds.). Nonlinear dynamics in the life sciences, (pp 27–43). Singapore: World Scientific.
Shannon, C.E., & Weaver, W. (1949). The Mathematical Theory of Communication. Urbana: University of Illinois Press.
Shiner, J.S., Davison, M., & Landsberg, P.T. (in preparation). On measures for order and its relation to complexity. In: Tschacher, W., & Dauwalder, J.-P. (Eds.), Dynamics, Synergetics, Autonomous Agents—Nonlinear Systems Approaches to Cognitive Psychology and Cognitive Science. Singapore: World Scientific.
Singer, W., & Gray, C.M. (1995). Visual feature integration and the temporal correlation hypothesis. Annual Review of Neuroscience, 18, 555–586.
Totterdell, P., Briner, R.B., Parkinson, B., & Reynolds, S. (1996). Fingerprinting time series: dynamic patterns in self-report and performance measures uncovered by graphical nonlinear method. British Journal of Psychology, 87, 43–60.
Tschacher, W. (1997). Prozessgestalten—Die Anwendung der Selbstorganisationstheorie und der Theorie dynamischer Systeme auf Probleme der Psychologie. Göttingen: Hogrefe.
Tschacher, W., Schiepek, G., & Brunner, E.J. (1992) (Eds.). Self-organization and clinical psychology. (Empirical approaches to synergetics in psychology). Berlin: Springer.
Tschacher, W., & Scheier, C. (1995). Analyse komplexer psychologischer Systeme. II. Verlaufsmodelle und Komplexität einer Paartherapie. System Familie 8: 160–171.
Tschacher, W., & Grawe, K. (1996). Selbstorganisation in Therapieprozessen—Die Hypothese und empirische Prüfung der “Reduktion von Freiheitsgraden” bei der Entstehung von Therapiesystemen. Zeitschrift für Klinische Psychologie, 25, 55–60.
Tschacher, W., Scheier, C., & Hashimoto, Y. (1997). Dynamical analysis of schizophrenia courses. Biological Psychiatry, 41, 428–437.
Tuckman, B. (1965). Developmental sequence in small groups. Psychological Bulletin, 63, 384–399.
Ullrich, R., & Ullrich, R. (1977). Der Unsicherheitsfragebogen (Testmanual U). München: Pfeiffer.
Ullrich, R., & Ullrich, R. (1978). Das Emotionalitätsinventar (Testmappe EMI-B). München: Pfeiffer.
Zielke, M., & Kopf-Mehnert, C. (1978). VEV—Veränderungsfragebogen des Erlebens und Verhaltens. Weinheim: Beltz.