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PSYCHOTHERAPY RESEARCH METHODS

Modeling psychotherapy process by time-series panel analysis (TSPA)

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Pages 469-481 | Received 28 May 2008, Published online: 22 Sep 2009
 

Abstract

The authors introduce the methodology of aggregated time-series analysis (time-series panel analysis [TSPA]), by which prototypical process patterns are estimated using longitudinal psychotherapy process data. Empirical trajectories of 202 outpatients (15–107 sessions) were available. Presession questionnaires provided measures of patient's well-being and patient's therapy motivation. TSPA was contrasted with growth curve modeling. Fixed effects were estimated in both methods. Unbalanced longitudinal data considering multiple levels can be analyzed. Using Granger causality derived from time-lagged associations, the TSPA pattern revealed feedback relationships between well-being and therapy motivation. Growth curve analysis highlighted logarithmic increases of well-being trajectories. In particular, TSPA can illuminate change mechanisms in psychotherapy field data by its nonexperimental approximation to an analysis of causal dynamic structures.

ABSTRACT

Wir führen in eine Methode der aggregierten Zeitreihenanalyse ein (Zeitreihen-Panelanalyse, engl. Time-Series Panel Analysis, TSPA), mit deren Hilfe prototypische Muster aus longitudinalen Therapieprozessdaten modelliert werden können. Diese Methode wird anhand eines Datensatzes dargestellt, der die Trajektorien von 202 Patienten in ambulanter Psychotherapie (zwischen 15 und 107 Sitzungen pro Patient) enthält. Mittels Vorstundenbögen wurden vor jeder Sitzung die Variablen 'subjektives Wohlbefinden' und 'Therapiemotivation' von den Patienten eingeschätzt. Wir verglichen an diesen Daten TSPA mit der Analyse von Wachstumskurven. Bei beiden Methoden wurden feste Effekte geschätzt, und die longitudinalen Daten wurden unbalanciert sowie unter Berücksichtigung mehrerer Ebenen analysiert. In die TSPA geht die Information zeitverschobener Zusammenhänge ein (sog. Granger-Kausalität), womit wir zeigen konnten, dass zwischen Wohlbefinden und Therapiemotivation Rückkopplungsbeziehungen bestehen. Die Wachstumskurvenanalyse belegte logarithmische Zunahmen der Trajektorien von Wohlbefinden. Besonders TSPA erscheint geeignet, Veränderungsprozesse im Therapieprozess zu beleuchten, da auch nichtexperimentelle Daten als kausale dynamische Strukturen analysiert werden können.

RÉSUMÉ

Les auteurs introduisent la méthodologie des analyses en séries temporelles agrégées (‘time-series panel analysis’ [TSPA]), par lesquelles les profils prototypiques du processus sont estimés à partir de données longitudinales du processus thérapeutique. Les trajectoires empiriques de 202 patients ambulatoires (15-107 séances) étaient disponibles. Les questionnaires pré-séances fournissaient des mesures de bien-être du patient et de sa motivation à la thérapie. TSPA a été contrasté avec une modélisation du développement de courbes. Les effets fixes étaient estimées selon les deux méthodes. Les données longitudinales déséquilibrées considérant des niveaux multiples peuvent être analysées. Utilisant la causalité de Granger dérivée des associations décalées dans le temps, le profil TSPA révèle des relations de feedback entre bien-être et motivation à la thérapie. En particulier, TSPA peut révéler les mécanismes de changement dans les données de psychothérapie par son approximation non-expérimentale d'une analyse causale des structures dynamiques.

Os autores apresentam a metodologia de time series panel analysis (TSPA), através da qual são estimados padrões de processo protótipos, utilizando dados longitudinais do processo psicoterapêutico. Foram disponibilizadas as trajectórias empíricas de 202 pacientes de ambulatório (15 a 17 sessões). Os questionários pré-sessão forneceram uma medida do bem-estar do paciente e da motivação do paciente para a terapia. O TSPA foi comparado com a modelação por curva de crescimento. Os efeitos fixos foram estimados em ambos os métodos. Podem ser analisados dados considerando múltiplos níveis. Utilizando a causalidade de Granger derivada de associações time lagged, o padrão TSPA revelou relações de feedback entre bem-estar e a motivação para a terapia. A análise da curva de crescimento sublinhou aumentos logaritmicos de trajectórias de bem-estar. Em particular, o TSPA pode elucidar sobre os mecanismos da mudança no campo da psicoterapia através da sua aproximação não experimental a uma análise das estruturas dinâmicas causais.

ABSTRACT

Gli autori introducono la metodologia delle analisi aggregate di serie temporali (time-series panel analysis (TSPA), in base alla quale i modelli di processo sono stimati sulla base di dati longitudinali rilevati in psicoterapia. Sono disponibili gli esiti di 202 pazienti ambulatoriali (15-107 sessioni) . Prima della sessione sperimentale sono stati somministrati i questionari per misure nel paziente il benessere e la motivazione alla terapia. Il TSPA è risultato essere in contrasto con la growth curve modeling. Gli effetti fissi sono stati stimati con entrambe i metodi e i dati longitudinali sbilanciati possono essere analizzati da più livelli. Utilizzo la Causalità Fattoriale derivate dalle associazioni tempo-ritardate, il modello TSPA ha potuto rilevare delle relazioni tra benessere e terapia motivazionale. L'analisi della curva di crescita logaritmica ha evidenziato un aumento del benessere attraverso le traiettorie. In particolare, il TSPA può evidenziare dei meccanismi di cambiamento in psicoterapia da parte di approssimazioni non sperimentali ed un'analisi della dinamica delle strutture di causalità

Acknowledgements

The authors thank three anonymous reviewers for suggestions that have considerably improved this article. We are also indebted to the colleagues of the Ambulatory Psychotherapy Research Center of the University of Bern, headed by Professor Franz Caspar. The data were kindly made available to our department by an agreement of cooperation with the late Professor Klaus Grawe.

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