Mechanisms of action in psychotherapy

Although active involvement of patient and therapist predicts psychotherapy outcome, little is known about the mechanisms of action involved in the process. The authors investigated the relationships between variables that describe the participants' actions intrinsic to their active involvement and treatment outcome. A successful and an unsuccessful case were selected for 15 therapists, and an early and a late session for each case were coded using a newly developed instrument. Patients of a successful treatment compared with patients of an unsuccessful treatment made significant changes along variables that indicate the degree and quality of their involvement in treatment. This link between the participants' actions and treatment outcome may have practical utility in future investigations of the active components of different treatment modalities.