Changes in a Therapeutic Intervention and the Patient's Responses to this Intervention Over the Course of Therapy: A Longitudinal Case Study.

Abstract

To examine change in psychotherapeutic conversations, Conversation Analysis (CA) can be a powerful tool. The present study goes beyond previous studies for conducting a longitudinal analysis of psychotherapy by focusing on both conversational partners equally-the therapist and her interventions and the patient and her responses. Video recordings of sessions involving an entire outpatient psychodynamic psychotherapy in the German language serve as database. The analysis demonstrates evidence of change in the actions of both participants. The therapist, for example, changes her choice of words over the course of the therapy, indicating in later sessions that she relies on previous interventions and assumes that the patient has gained knowledge. In the first half of the therapy, the patient offers usually dispreferred responses. Toward the end of the therapy, she offers less dispreferred responses but still does not cooperate completely. This study shows how changes in both the therapist's interventions and the patient's responses can be recognized over the course of psychotherapy sessions, even if these changes are rather small.