The Impact of Mental Imagery Instructions on Patients' and Therapists' Positive Affect and Strength-Based Behaviours Within Psychotherapy Sessions: A Randomized Controlled Process Study

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL Clinical psychology & psychotherapy Pub Date : 2024-08-01 DOI:10.1002/cpp.3036

Jan Schürmann-Vengels, Christoph Flückiger, Emilia Reyer, Patrizia Odyniec, Ulrike Willutzki

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Abstract

Objective

Increased attention has recently been paid to the well-being and flourishing of patients in psychotherapy. This study investigated the occurrence of positive affect (PA) and strength-based behaviours within psychotherapy sessions contrasting positive versus neutral imagery instructions.

Methods

This is a secondary analysis of a randomized controlled trial. Seventy-eight sessions of cognitive behavioural therapy involving 26 patients (69.23% female; M_age = 40.31) treated by 13 therapists were selected. PA and strength-based behaviours of patients and therapists were coded on a minute-by-minute basis with the Resource-Oriented Microprocess Analysis. Each session started with a brief mental imagery instruction. Data were analysed using multilevel modelling.

Results

Mild levels of PA were very common, whereas stronger expressions were occasional, especially at the beginning and end of sessions. Strength-based behaviours were employed in one-fifth of the videos analysed. Therapists in the positive imagery instruction showed more strength-based behaviours in the beginning phase of sessions, p < 0.05. The two imagery instructions significantly differed in the session trajectories of PA, p < 0.05. A quadratic trend with higher initial values and a sharper decline in PA were found in the positive instruction, whereas the neutral instruction showed a flatter trend.

Conclusion

Patients and therapists experience PA and discuss strengths in psychotherapy sessions despite patients' distress. The positive imagery instructions potentially induced a positive focus at baseline for therapists but had a negligible effect on the subsequent session progression.

Trial Registration

ClinicalTrials.gov identifier: NCT03767101 (registered December 6, 2018).

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心理治疗过程中心理想象指令对患者和治疗师的积极情绪和力量行为的影响：随机对照过程研究

目的：最近，人们越来越关注心理治疗中患者的幸福和健康。本研究调查了心理治疗过程中积极情绪（PA）和基于力量的行为的发生情况，并对积极和中性意象指导进行了对比：这是一项随机对照试验的二次分析。研究选取了认知行为疗法的 78 个疗程，共有 26 名患者（69.23% 为女性；Mage = 40.31）接受了 13 名治疗师的治疗。以资源为导向的微过程分析法（Resource-Oriented Microprocess Analysis）对患者和治疗师的 PA 行为和基于力量的行为进行了逐分钟编码。每次治疗都以简短的心理想象指导开始。数据采用多层次模型进行分析：轻微的心理压力表现非常普遍，而强烈的心理压力表现则时有发生，尤其是在课程开始和结束时。在分析的视频中，有五分之一的视频采用了强度行为。在积极想象教学中，治疗师在疗程开始阶段表现出更多基于力量的行为：患者和治疗师在心理治疗过程中会体验到 PA，并讨论患者的优势，尽管患者感到痛苦。积极想象指导有可能在基线阶段诱发治疗师的积极关注，但对后续疗程进展的影响微乎其微：试验注册：ClinicalTrials.gov identifier：NCT03767101（2018年12月6日注册）。

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来源期刊

Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-

CiteScore

6.30

自引率

5.60%

发文量

106

期刊介绍： Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.