Lessons from ten years of psychotherapy process research.

Area of Science:

• Psychology
• Psychotherapy Research
• Clinical Psychology

Background:

• A decade of psychotherapy process research (2009-2019) across eight journals reveals a fragmented knowledge base.
• Limited robust and replicated findings exist regarding key psychotherapy variables and their impact on outcomes.

Approach:

• A Mixed Studies Review synthesized quantitative and qualitative primary studies.
• Qualitative Meta Analysis and a bottom-up procedure generated specific content categories for interpretive synthesis.

Key Points:

• Macroprocess variables include ongoing change, therapeutic relationship (alliance), and intervention.
• Microprocess variables include change events, ruptures, and therapist intervention.
• Therapeutic alliance consistently predicts outcomes; rupture repair and therapist communication influence patient communication.

Conclusions:

• Knowledge on psychotherapy is fragmented; alliance research shows clear outcome impact.
• Linking change mechanisms to ongoing change and developing transtheoretical models are crucial for future research.
• Psychotherapy process research is a valuable tool for understanding change mechanisms.