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Helpful and hindering events in psychotherapy: a practice research network study.

Type of publication Peer-reviewed
Publikationsform Original article (peer-reviewed)
Author Castonguay Louis G, Boswell James F, Zack Sanno E, Baker Sally, Boutselis Mary A, Chiswick Nancy R, Damer Diana D, Hemmelstein Neal A, Jackson Jeffrey S, Morford Marolyn, Ragusea Stephen A, Roper J Gowen, Spayd Catherine, Weiszer Tara, Borkovec Thomas D, Grosse Holtforth Martin,
Project Explicit and implicit change of depression in exposure-based cognitive therapy
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Original article (peer-reviewed)

Journal Psychotherapy (Chicago, Ill.)
Volume (Issue) 47(3)
Page(s) 327 - 44
Title of proceedings Psychotherapy (Chicago, Ill.)
DOI 10.1037/a0021164


This paper presents the findings of a psychotherapy process study conducted within the Pennsylvania Psychological Association Practice Research Network (PPA-PRN). The investigation was the product of a long-term collaborative effort, both in terms of the study design and implementation, between experienced clinicians of various theoretical orientations and full-time psychotherapy researchers. Based on a relatively large sample of clients seen in independent practice settings, close to 1,500 therapeutic events (described by clients and therapists as being particularly helpful or hindering) were collected. These events were coded by three independent observers using a therapy content analysis system. Among the findings, both clients and therapists perceived the fostering of self-awareness as being particularly helpful. The results also point to the importance of paying careful attention to the therapeutic alliance and other significant interpersonal relationships. The merits and difficulties of conducting scientifically rigorous and clinically relevant studies in naturalistic contexts are also discussed.