Outcomes of psychotherapy from the perspective of the users

Abstract

Psychotherapy is widely held to be an effective means to decrease depression. It seems, however, that not everyone benefits from every kind of therapy, and the relevant outcomes vary from person to person. In this article, the pre-therapy views and post-therapy experiences of 14 users of either long-term psychodynamic psychotherapy or short-term solution-focused therapy are analyzed. The interviewees’ personal views about their depression and therapy are approached with the concept of inner narrative. Three “basic stories” or orientations were found: life historical, situational and moral. These offered people different contexts from which to evaluate the outcomes of their therapy. The findings suggest that a person's expectations, hopes and values are worth taking into account to ensure positive therapy outcomes.

RÉSUMÉ

La psychothérapie est reconnue comme un moyen effectif pour diminuer la dépression. Il ne semble pas, cependant, que tout le monde bénéficie de toutes les formes de thérapies, et que les résultats varient d'une personne à l'autre. Dans cet article, ont été analysé l'opinion pré-thérapie et les expériences post-thérapie de 14 usagers ayant fait soit une psychothérapie psychodynamique au long cours, soit une thérapie brève focalisée sur les solutions. Les opinions personnelles des usagers sur leur dépression et la thérapie ont été abordées à l'aide du concept de narration intérieure. Trois « histoires de base » ou orientations ont été mise en lumière : historique de vie, situation de vie et morale de vie. Ces histoires offrent aux gens des contextes différents permettant d’évaluer les résultats de leur thérapie. Les résultats suggèrent que les attentes personnelles, les espoirs et les valeurs doivent être pris en compte pour assurer des résultats thérapeutiques positifs.

Abstract

A psicoterapia é geralmente considerada um meio eficiente para diminuir a depressão. Contudo, parece que nem todos beneficiam dos diferentes tipos de terapia. Além disso, os resultados variam de pessoa para pessoa. Neste artigo, os pontos de vista da pré-terapia e experiencias pós-terapia de 14 pacientes de psicoterapia psicodinâmica de longa duração e de terapia centrada nas soluções, de curta duração, são analisados. As opiniões pessoais dos entrevistados sobre a sua depressão e terapia foram exploradas com o conceito de narrativa interna. Encontraram-se três “histórias básicas” ou orientações: a vida histórica, a situacional e a vida moral. Estas orientações permitiram aos indivíduos diferentes contextos para avaliar resultados da sua terapia. Os resultados sugerem que as expectativas, esperança e valores pessoais devem ser tomados em consideração para assegurar resultados terapêuticos positivos.

Abstract

La psicoterapia è ampiamente ritenuta un mezzo efficace per alleviare la depressione. Comunque, sembra che non tutti beneficino di tutti i tipi di psicoterapia, e che i risultati rilevanti cambino da persona a persona . In questo articolo vengono analizzate le idee degli utenti rispetto la terapia sia prima che dopo il trattamento sia rispetto a psicoterapie psicodinamiche di lunga durata sia rispetto a psicoterapie brevi. Le idee personali degli intervistati rispetto la loro depressione ed il loro iter terapeutico sono state studiate attraverso una prospettiva narrativa. Sono stati individuate tre “storie di base” o orientamenti: storico, situazionale e morale. I risultati suggeriscono che è necessario prendere in considerazione le aspettative personali, le speranze ed i valori per assicurarsi un risultato positivo.

Abstract

Keywords:

• depression
• qualitative research methods
• outcome research
• long term psychotherapy
• brief psychotherapy
• narrative approach

Palavras-chave:

• depressão
• método de investigação qualitativo
• outcomes de investigação
• psicoterapia de longa duração
• psicoterapia breve
• abordagem narrativa

Keywords:

• depressione
• metodi di ricerca qualitative
• ricerca sul risultato
• psicoterapia a lungo termine
• psicoterapia breve
• approccio narrativo

Acknowledgements

This article is based on the doctoral dissertation of the first author (Valkonen, 2007). We gratefully acknowledge the financial support for the study from the Social Insurance Institution, Finland. The article was written as a part of the research project “Coping with depression in social context,” funded by the Academy of Finland. We thank the participants of the Helsinki Psychotherapy Study, the Study Group and especially the head of the study, Professor Paul Knekt. Warm thanks to Professor John McLeod for his valuable advice.

Notes

1. In this section, we use the term “patient” consistently with the HPS terminology even though the term “user of psychotherapy” was used elsewhere in this article.

2. Quotations are translated from spoken Finnish by the authors. An effort has been made to capture the rhythm and tone of the original expressions, even though dialect words and unique word order was not always possible to restore. If the quotation is shortened in between, it is marked with three dots in brackets. Added and replaced words are written in square brackets with italics to improve the readability and anonymity of the text. After a quotation the gender and the code number of interviewee is mentioned. All quotations in this section are from pre-therapy interviews.

3. The code number of the participant (1–14), the assessed basic story at pre-therapy phase (LH for life-historical, S for situational and M for moral), the allocated form of therapy (LPP or SFT).