[Psychotherapeutic processes--regarding the difficulty in explaining psychotherapeutic changes].

Abstract

Until now, there is no sufficient answer to the question how psychotherapy works. It is argued that progress will come from three areas. First, the understanding what the term "therapeutic process" means has to be improved. It will be useful to start from the three central phenomena of psychotherapy: (a) client changes within the therapeutic situation and his/her life context, (b) therapeutic procedures including personal characteristics of therapists, (c) the context of the institution of psychotherapy. Second, there is a need to define more carefully elements of the therapeutic process, e.g. there is an inflational (mis-) use of the term "therapeutic relationship". Referring to a model by LINSENHOFF, BASTINE & KOMMER (1982), two components of psychotherapy process (problem conceptualization and therapeutic relationship) were critically examined. Third, two different ways to analyse psychotherapeutic change were evaluated: In Type A-studies, therapeutic processes were characterized by stable features as interactional factors (e.g. age, gender, education of the participants; therapeutic maxims). In contrast, Type B-studies rely on a transactional view of the therapeutic process as a sequence of heterogeneous segments (therapeutic episodes; therapeutic strategies).