Raising the Bar in the Empirical Investigation of Psychotherapy

Clarkin, John

doi:10.1176/appi.ajp.2014.14060792

Cited by 11 publications

(12 citation statements)

References 2 publications

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“…On the basis of the clinical issues outlined, it is essential not only to go beyond the mere demonstration of outcome in psychotherapy, but also to improve our understanding of the underlying processes at work in treatment (Clarkin, 2014;Kramer, 2019) by conducting psychotherapy studies similar to those that have addressed borderline personality disorder (De Meulemeester, Vansteelandt, Luyten, & Lowyck, 2018;Fonagy & Bateman, 2006;Gratz, Bardeen, Levy, Dixon-Gordon, & Tull, 2015;Levy et al, 2006). At the present time, the mechanisms of changes in NPD are insufficiently understood.…”

Section: Mechanisms Of Change: Theoretical Considerations and Empiricmentioning

confidence: 99%

Processes of Change in Psychotherapy for Narcissistic Personality Disorder

Maillard

Berthoud

Kolly

et al. 2020

Journal of Personality Disorders

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The present study aims at determining the role for outcome of potential processes of change in psychotherapy for narcissistic personality disorder (NPD). They were examined on three levels: the content, the process, and the relationship. A total of 161 patients suffering with NPD were recruited in a naturalistic setting as part of the present study. They underwent a longterm clarification-oriented psychotherapy. Sessions 15, 20, and 25 were video-or audio-recorded and analyzed with an observer-rated instrument that measures the quality of the interaction processes from the patient's and therapist's perspectives. Different self-report measures were used to assess therapy outcomes. In-session improvement was observed in both patient and therapist processes across sessions. Patient improvement in the three levels of processes was systematically related with outcome. Only partial relationships were found between therapist improvement and outcome. The present study represents the first systematic insight into core changes in patients with NPD undergoing psychotherapy.

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Section: Mechanisms Of Change: Theoretical Considerations and Empiricmentioning

confidence: 99%

Processes of Change in Psychotherapy for Narcissistic Personality Disorder

Maillard

Berthoud

Kolly

et al. 2020

Journal of Personality Disorders

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“…Some confusion about not knowing which treatment works best for which patient is maintained, indicating that the question asked may be too complex to answer. Most importantly, the understanding of how and why these treatments for PDs work still remains unaddressed (Clarkin, 2014;Kazdin, 2009). Knowing how and why treatments work not only helps to understand and deliver therapy in a more informed way, but may also orient interventions towards the actual core processes at play in each therapy.…”

Section: On the Importance Of Knowing Why Treatments Workmentioning

confidence: 99%

“…as outlined by Clarkin (2014), psychotherapy research for personality disorders "raise the bar" and focus on mechanisms on change.…”

Section: On the Importance Of Knowing Why Treatments Workmentioning

confidence: 99%

Mechanisms of Change in Treatments of Personality Disorders: Introduction to the Special Section

Kramer

2018

Journal of Personality Disorders

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The present introduction to the Special Section on Mechanisms of Change in Treatments of Personality Disorders explains the value of research focusing on processes of change in psychotherapy by referring to a variety of methodologies. Whereas outcome for these treatments has been repeatedly demonstrated, it remains an open question what the core psychobiological features of change are. Taking a radically empirical perspective, this introduction focuses on patient and therapeutic relationship variables, such as emotional and socio-cognitive processing. The six empirical articles of the Special Section are introduced, as are the three discussions of the Special Section.

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“…Psychological treatments are considered first line for problems related to personality disorders [3][4][5][6]. Although there are several theoretical accounts on how these effects are produced, there is a paucity of systematic empirical research focusing on mechanisms of change in treatments of personality disorders (PDs) [7][8][9][10][11][12][13], aiming at empirically explaining how treatments work and, ultimately, increasing the treatment's effectiveness. Such an empirical understanding would be particularly useful at the beginning of treatment: a better knowledge of the determinants of initial symptom alleviation in psychological treatment would allow us to deliver even more potent treatments for these patients from the very first session on, and to prevent some of the long-term consequences of the disorder.…”

Section: Background and Rationale {6a}mentioning

confidence: 99%

Mechanisms of change in brief treatments for borderline personality disorder: a protocol of a randomized controlled trial

Kramer

Grandjean

Beuchat

et al. 2020

Trials

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Background: Borderline personality disorder (BPD) is one of the most frequent, most debilitating and lethal mental conditions and is associated with a serious burden of disease. Treatment for patients with BPD involves structured psychotherapy, and may involve brief psychiatric treatment as first-line intervention. No controlled study has assessed the effectiveness of such brief intervention. Whereas most psychotherapy studies in patients with BPD focus on the effectiveness of the intervention, we still lack an understanding of how and why these effects are produced from a patient process perspective. It is therefore of utmost importance to study the treatmentunderlying mechanisms of change. The present study plans to apply novel measurement methods for assessing change in two central psychobiological processes in BPD: emotion and socio-cognitive processing. The study uses theory-driven and ecologically valid experimental tasks, which take the patient's individual experience as the anchor, by integrating methodology from psychotherapy process and neurofunctional imagery research.Methods: The aim of this two-arm, randomized controlled study is to test the effects (i.e., symptom reduction) and the underlying mechanisms of change associated with a brief psychiatric treatment (10 sessions over 4 months), compared with treatment as usual. Participants (N = 80 patients with BPD) undergo assessments at four points (intake, 2 months, discharge, and 12-month follow up). In addition to symptom measures, individuals undergo a 2step assessment for the potential mechanisms of change (i.e., emotion and socio-cognitive processing): (1) behavioral and (2) (for a sub-sample) neurofunctional. We hypothesize that change in the mechanisms explains the treatment effects. Discussion: This study uses an easy-to-implement treatment of BPD, and a sophisticated assessment procedure to demonstrate the critical role of psychobiological change in emotion and socio-cognitive processing in brief treatments. It will help increase the effectiveness of brief treatment for BPD and help diminish the societal burden of disease related to BPD, in these early stages of treatment.(Continued on next page)

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Raising the Bar in the Empirical Investigation of Psychotherapy

Cited by 11 publications

References 2 publications

Processes of Change in Psychotherapy for Narcissistic Personality Disorder

Processes of Change in Psychotherapy for Narcissistic Personality Disorder

Mechanisms of Change in Treatments of Personality Disorders: Introduction to the Special Section

Mechanisms of change in brief treatments for borderline personality disorder: a protocol of a randomized controlled trial

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