Individual Target Problems, Self-Observation and Change in Short-Term Psychodynamic Psychotherapy

Abstract

AbstractThe objective of this study was to analyze and illustrate the relationships between different expectations for psychotherapy, quality of self-observation and change in short-term psychodynamic psychotherapy. To conduct this, two patients from the Helsinki Psychotherapy Study were selected for qualitative analysis. The selection was based on the patients’ responses on the Target Complaints (TC) questionnaire, i.e., reasons for seeking psychotherapy, completed as part of the pre-treatment patient assessment. TC responses were classified as psychiatric symptoms or personality and functioning problems. The data for further analysis was selected for both patients from pre-treatment interviews and two follow-up interviews and analyzed in detail by dialogical sequence analysis (DSA), considering the quality of self-observation as a factor contributing to change. As a result, qualitative changes in relation to problematic experiences and development of self-observation appeared in the patient with mainly personality and functioning problems. In contrast, there were little respective changes in the experience of the patient whose target problems were limited to psychiatric symptoms. The results suggest that a patient’s exclusive identification of psychiatric symptoms as target problems may indicate poor suitability for short-term psychodynamic psychotherapy which emphasizes the developmental nature of psychotherapeutic change and the importance of self-observation as a factor of change.