Qualitative multi-centered study: Trustworthiness of the three-level model (3-LM) Part 1

The 3-Level Model (3-LM) is proposed as a guide or heuristic for observing and describing patient change. Used since 2011 in the context of the International Psychoanalytic Association (IPA), its trustworthiness as a model still needs to be studied. OBJECTIVES AND METHODS: This study aimed to assess the trustworthiness of the 3-LM by comparing the output of three groups of IPA-certified analysts (Europe, North America and South America). The comparison was made using process and outcome measures as analytical tools. This objective was divided into specific objectives presented in two articles. Each group belonged to a different geographical region of the IPA. They all worked on the same clinical case and their output was analysed using the same structured qualitative methodology. To analyse levels 1 and 3 of the model, the Consensual Qualitative Research (CQR) method was used. For level 2, the Operationalised Psychodynamic Diagnosis (OPD-2) was used. RESULTS AND DISCUSSION: There was a predominance of convergence between each of the groups for each of the levels analysed, with some points of divergence. The implications of these results for the trustworthiness of the model, clinical practice, training and research in psychoanalysis are discussed.