Change in defense mechanisms and coping over the course of short-term dynamic psychotherapy for adjustment disorder

• Published in: Journal of clinical psychology Vol. 66; no. 12; pp. 1232 - 1241
• Main Authors: Kramer, Ueli, Despland, Jean-Nicolas, Michel, Luc, Drapeau, Martin, de Roten, Yves
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-12-2010; Wiley; Wiley Periodicals Inc
• Subjects: Adaptation, Psychological; Adjustment; Adjustment Disorders - therapy; Adult; Biological and medical sciences; Clinical psychology; coping; Defense Mechanisms; Emotional disorders; Female; hierarchical linear modeling; Humans; Individual psychotherapy; Male; Medical sciences; psychodynamic psychotherapy; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotherapies. Psychological and clinical counseling; Psychotherapy; Psychotherapy, Brief - methods; Treatment Outcome; Treatments; Young Adult; Short term; Human; Therapeutic process; Analytical psychotherapy; Treatment efficiency; hierarchical linear modeling; Treatment; Follow up study; defense mechanisms; Evolution; Defense mechanism; Adaptation disorder; Coping; Predictive factor; psychodynamic psychotherapy
• ISSN: 0021-9762; 1097-4679
• DOI: 10.1002/jclp.20719

Short‐term dynamic psychotherapy (STDP) has rarely been investigated with regard to its underlying mechanisms of change, even if psychoanalytic theory informs us about several potential putative mechanisms of change in patients. Change in overall defensive functioning is one. In this study, we explored the role of overall defensive functioning, by comparing it on the process level with the neighbouring concept of overall coping functioning. A total of N=32 patients, mainly presenting adjustment disorder, were included in the study. The patients underwent STDP up to 40 sessions; three sessions per psychotherapy were transcribed and analyzed by using two observer‐rating scales: Defense Mechanism Rating Scales (Perry, 1990) and Coping Action Patterns (Perry, Drapeau, Dunkley, & Blake, 2005). Hierarchical linear modeling was applied to model the change over the course of therapy and relate it to outcome. Results suggest that STDP has an effect on the target variable of overall defensive functioning, which was absent for overall coping functioning. Links with outcome confirm the importance of the effect. These results are discussed from methodological and clinical viewpoints. © 2010 Wiley Periodicals, Inc. J Clin Psychol 66:1–10, 2010.