Episodes of meeting as relevant episodes for the study of change in psychotherapy

Abstract

The study of the change process in psychotherapy has advanced considerably during the last 30 years, focusing its efforts on the study of relevant intra-session episodes in order to contribute to a better understanding of psychotherapy and how change occurs. Although there are different conceptualizations of relevant episodes, up to the present, the different episodes developed and the conception of change that emerges from each one, have focused mainly on the patient, neglecting the dyadic and relational aspects of the therapeutic process, which emphasize that new experiences of relationship with the therapist would be the essence of change. In this line an approach to relevant episodes, which includes change in psychotherapy as a relational and interactive phenomenon between patient and therapist, is that of Daniel Stern and the Boston Group (1998, 2004) which propose moments of meeting in psychotherapy as central moments for reorganizing the patient’s implicit relational knowing. However, despite its theoretical solidity, this approach lacks empirical systematization, which hinders its study. The aim of this dissertation was to design a procedure for identifying and outlining episodes of meeting between therapist and patient during the psychotherapeutic process and to establish the main characteristics (verbal, non-verbal and relational) of the interaction between patient and therapist during its occurrence. This descriptive-relational exploratory study was based on a qualitative methodological approach, that combined grounded theory with a phenomenological approach called the micro analytic interview. Eight therapeutic dyads, thirteen therapists, nine patients and five experts were interviewed to approach this phenomenon from different perspectives and grasp its central features. This thesis is considered relevant as it is a contribution for the investigation of the psychotherapeutic process and for clinical practice.