The need for psychotherapy outcome research is growing in Japan as the societal demands for psychotherapy have increased in recent years. Although researchers in Japan recognize the importance of integrating clinical practice and empirical research in evaluating psychotherapy outcome, most Japanese studies to date have relied heavily on qualitative case studies (Haebara, 1997; Kanazawa, 2004; Tanno, 2001). With the help of six translators and 116 native Japanese pilot respondents, this study adapted the Outcome Questionnaire (OQ; Lambert et al., 1996), one of the most common quantitative measures of clinical outcome, for use in Japan. The translation of the original OQ into Japanese followed Beaton et al. (2000) to include forward translation, synthesis, back translation, and expert committee meetings. The study produced 4 pre-final versions, 2 pretests, and a pilot. With permission from the original questionnaire developers, a few items were modified to achieve cultural equivalence. The rigorous translation and adaptation processes, evaluated through the Translation Validity Index (Tang & Dixon, 2002) and Content Validity Index (Polit et al., 2007), sought semantic, content, and conceptual equivalence between the English and Japanese versions of the OQ. Study limitations and suggestions for further development of the Japanese OQ are discussed.

Previous research has revealed heterogeneity in outcome trajectories among individuals seeking psychotherapy. However, questions remain as to the number, nature, and predictors of these trajectories. Therefore, the present study had three aims: 1) to identify heterogeneous latent groups among treatment trajectories of 212 clients with major depressive disorder (MDD) seeking psychotherapy at a community mental health training clinic; 2) to identify significant associations between clinical and demographic variables and group membership; and 3) to identify correlations between trajectory shape and positive treatment outcome. Prior to treatment, participants provided demographic information and completed symptom severity ratings. Once in treatment, participants completed a self-report of distress via the Outcome Questionnaire (OQ-45) at every session. Growth mixture modeling was utilized to identify distinct patient subgroups based on outcome trajectories among the sample. Three distinct latent classes of treatment trajectory were identified, providing evidence of heterogeneity in treatment trajectories among individuals with MDD. Baseline distress, pre-treatment work problems, and sleep difficulties were found to be predictive of an individual's membership in a specific trajectory group. Finally, specific shapes of change, namely early response and sudden gains, were associated with positive treatment outcome. Findings from this study can be used to identify patients at risk for treatment failure, allowing clinicians to intervene earlier to enhance mid-treatment feedback and prognosis.

<p>The objective of this work was to investigate reflective-functioning (RF) as a measure of process in two independent studies that included three types of brief psychotherapy. RF is defined as the ability to recognize the existence and nature of mental processes taking place in the self and in others (e.g., intentions, beliefs, desires, and wishes). Theorists have suggested the ability for RF is crucial for predicting social causality and low RF has been found related to mental disorders. It has recently been suggested in the literature that improved ability for RF might be an important component of successful psychotherapy outcome, especially with respect to achieving structuralchange. RF was in this work investigated during the process through discourse analysis of the patients’ narratives of self-other interactions in the treatment sessions. The Psychotherapy Process Q-set (PQS) was implemented in order to isolate specific components of the process (process correlates) that identified high and low RF and to investigate the links between the process correlates and outcome. The first study investigated 29 cases of cognitive-behavioral therapy(CBT) and 35 cases of interpersonal psychotherapy (IPT) with an average treatment length of 16.2 sessions in a sample from the National Institute of Mental Health (NIMH) randomized clinical trial Treatment of Depression Collaborative Research Program (TDCRP). The sample in the first study consisted of 128 sessions in total, were one session from the early part (on average the 4th session) and one session in the later part of the treatment (on average the 12th session) were rated for RF. The second study investigated a sample of 30 cases of brief psychodynamic psychotherapy (BPDT) with an average treatment length of 15.8 sessions in a naturalistic designand obtained from the Mount Zion Psychotherapy Research Group. In total, the second study included 90 sessions of BPDT, and RF was assessed during the 1st, the 5th, and the 14th session of each treatment. The results from these two studies suggested that the patients’ ability for RF, as measured through the discourse from therapy sessions, is stable (in CBT and BPDT) or decreased(IPT) during the treatments. Furthermore, the process correlates defining high RF had a relation with good outcome, and process correlates defining low RF had a relation with poor outcome.The process correlates identified during the PQS-analysis suggested that both high and low RF was linked with personality characteristics in the patients. For example, high RF was linked to patients’ ability for introspection, expression of negative emotions, and commitment to treatment.Low RF was linked to patients’ expression of passivity, defensiveness, and suspiciousness. This work supported theorists’ suggestions that brief treatments are supportive in their nature and therefore do not promote structural changes (e.g., changes in RF). It is suggested that the abilityfor RF as assessed pre-treatment might be a useful predictor for success in brief psychotherapy and could therefore be used as a patient inclusion criteria for such treatments.</p>

The objective of this work was to investigate reflective-functioning (RF) as a measure of process in two independent studies that included three types of brief psychotherapy. RF is defined as the ability to recognize the existence and nature of mental processes taking place in the self and in others (e.g., intentions, beliefs, desires, and wishes). Theorists have suggested the ability for RF is crucial for predicting social causality and low RF has been found related to mental disorders. It has recently been suggested in the literature that improved ability for RF might be an important component of successful psychotherapy outcome, especially with respect to achieving structuralchange. RF was in this work investigated during the process through discourse analysis of the patients’ narratives of self-other interactions in the treatment sessions. The Psychotherapy Process Q-set (PQS) was implemented in order to isolate specific components of the process (process correlates) that identified high and low RF and to investigate the links between the process correlates and outcome. The first study investigated 29 cases of cognitive-behavioral therapy(CBT) and 35 cases of interpersonal psychotherapy (IPT) with an average treatment length of 16.2 sessions in a sample from the National Institute of Mental Health (NIMH) randomized clinical trial Treatment of Depression Collaborative Research Program (TDCRP). The sample in the first study consisted of 128 sessions in total, were one session from the early part (on average the 4th session) and one session in the later part of the treatment (on average the 12th session) were rated for RF. The second study investigated a sample of 30 cases of brief psychodynamic psychotherapy (BPDT) with an average treatment length of 15.8 sessions in a naturalistic designand obtained from the Mount Zion Psychotherapy Research Group. In total, the second study included 90 sessions of BPDT, and RF was assessed during the 1st, the 5th, and the 14th session of each treatment. The results from these two studies suggested that the patients’ ability for RF, as measured through the discourse from therapy sessions, is stable (in CBT and BPDT) or decreased(IPT) during the treatments. Furthermore, the process correlates defining high RF had a relation with good outcome, and process correlates defining low RF had a relation with poor outcome.The process correlates identified during the PQS-analysis suggested that both high and low RF was linked with personality characteristics in the patients. For example, high RF was linked to patients’ ability for introspection, expression of negative emotions, and commitment to treatment.Low RF was linked to patients’ expression of passivity, defensiveness, and suspiciousness. This work supported theorists’ suggestions that brief treatments are supportive in their nature and therefore do not promote structural changes (e.g., changes in RF). It is suggested that the abilityfor RF as assessed pre-treatment might be a useful predictor for success in brief psychotherapy and could therefore be used as a patient inclusion criteria for such treatments.

The purpose of this study was to explore and describe the use of Gestalt therapy as an alternative assessment technique with two primary school girls who have been sexually abused. The empirical study of limited extent, was qualitative in nature and conducted from the interpretivist paradigm. I used two indepth clinical case studies situated within the context of psychotherapy outcome research as research design. I developed and implemented alternative assessment based on Gestalt therapy and employed observation, interviews, informal discussions, analysis of documentation, a reflective diary, field notes and visual data (photographs and original media) as data collection and documentation methods. I purposefully selected two primary school girls who have been sexually abused as participants in the study. The findings of the study were, firstly, that Gestalt therapy could be used as an effective alternative assessment technique with the target participants as it seemingly provided a safe setting to express emotions, fears and needs related to the trauma of sexual abuse. In this regard, a finding was that the primary participants had to deal with challenging emotions including anxiety, fear, aggression, anger, hatred, rage, sadness and depression. A related finding was that they experienced a need for love, unconditional acceptance, support and protection. Similarly, the study found that they also displayed negative behaviour such as inadequate social behaviour, restlessness and withdrawal from challenging social situations. Most importantly, utilising this mode of assessment rendered insight into the defence mechanisms they employed such as denial, avoidance, suppression and escapism. Secondly, alternative assessments based on Gestalt therapy seemed to have a positive effect on both participants, as indicated by change during and after the process of assessment in terms of emotions, behaviour and the use of defence mechanisms. / Dissertation (MEd (Educational Psychology))--University of Pretoria, 2008. / Curriculum Studies / unrestricted

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