Changing CHAP (Change after Psychotherapy) scales – emergence of a reflexive evaluation methodology for small Gestalt therapy practices

Abstract

"Abstract: This paper presents the process of developing a reflexive evaluation methodology for small private Gestalt psychotherapy practices, based on Rolf Sandell’s CHAP (Change after Psychotherapy) model. Therapy outcomes for four clients were assessed with use of the CHAP model extended to introspection and interview analysis to ensure a connection to Gestalt psychotherapy theoretical foundations of I-Thou relationship, dialogue and phenomenology. The learning process was supported by a third-party reviewer (supervisor). The sample included two clients who finished therapy years prior to assessment, one client who finished therapy months prior to assessment, and one client who had quit therapy unexpectedly years prior to assessment. Given the relatively satisfactory reliability of the tool irrespective of significant study limitations, it can be highly recommended to all Gestalt therapists. To assess outcomes of Gestalt therapy (GT) techniques and approach in general, a higher level of attention should be paid to sampling and raters’ training, regular application of the Gestalt Therapy Fidelity Scale1 and modification of the ‘Basic conflict’ aspect to fit the GT theoretical framework. Ratings and interview analysis of the client who quit therapy after eleven sessions indicate that application of GT techniques may have a strong, long-lasting impact, even in ‘brief interventions’, which calls for further research. Keywords: psychotherapy, outcome, evaluation, reflexive methodology, CHAP, rating."