Exploring In-Session Process with Qualitative and Quantitative Methods in Psychotherapy with an Adolescent

ABSTRACT

There is emerging evidence for the effect of psychotherapy in adolescents with depression. Research indicates that therapists often use techniques from different theoretical models when working with adults. Research on the therapy process in adolescents is scarce. We explore the therapist’s interventions in a time-limited psychodynamic adolescent therapy with Susanna suffering from major depression. Susanna quite suddenly became worse at mid-treatment, with self-harming and suicidal ideations. Rating scales for analyzing in-session relational processes included the Structural Analysis of Social Behavior (SASB), the Adolescent Psychotherapy Q-set (APQ), and the Transference Work Scale (TWS). Self-reports on symptoms, interpersonal problems, and working alliance were obtained before, during, and at the end of and one year after treatment. Different tools seemed to expose different aspects of the process and the patient’s development. Only patient-rated questionnaires revealed the mid-treatment crises. Combining different and pan-theoretical rating scales on here-and-now interventions (TWS and SASB) and whole sessions (APQ), as well as clinician-rated measures and a variety of self-reports, indicated that different psychotherapeutic techniques were integrated in the therapy and seemed beneficial to patient’s outcome. The therapist adhered to the treatment manual. This way of exploring the therapy process may be used for different treatment modalities.

Acknowledgments

A special thanks to everyone involved in the FEST-IT study, including patients, therapists and raters.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics approval and consent to participate

The Regional Ethics Committee for health in Norway approved the study protocol and the information given to the patients (REK: 2011/1424 FEST-IT). Written informed consent was obtained from each participant.

Consent for publication

Written informed consent was obtained and the patient’s name changed to maintain anonymity.

Availability of data and materials

Data from the FEST-IT were used. Trial registration: ClinicalTrials.gov Identifier: NCT01531101.

Competing interests

The authors declare they have no competing interests.

Authors’ contributions

All authors read and approved the final manuscript. Specifically, KC supported the SASB analysis and HSJD the APQ analysis.

Supplementary data

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

This study was supported by grants from The University of Oslo, Vestfold Hospital Trust, the MRK Foundation, Josef and Halldis Andresen’s Foundation and Solveig and Johan P. Sommer’s Foundation.