Narrative measures in psychotherapy research: introducing the special section.

[Excerpt] The aim of this special section is to present a review of recent advances in the assessment of changes in client narratives. An emerging trend in the psychotherapy research field suggests that narrative-based meaning reconstruction is an important foundation for the articulation of a new, more adaptive view of self (Angus & Kagan, 2013) in psychotherapy. Additionally, a range of research-informed treatment models, including psychodynamic (Luborsky, 1998), humanistic (Angus, Watson, Elliott, Schneider, & Timulak, 2015) and systemic therapy approaches (Dallos & Vetere, 2009), emphasize that client changeinpsychotherapyisfacilitatedthroughpersonal story disclosure, emotional engagement and reflection for new meaning construction and self-narrative reorganization. In fact, recent research from Angus et al. (inpress)andGonçalvesetal.(thisissue),usingdifferent methods and clinical samples, have independently established that successful psychotherapy involves client self-narrative transformation processes evidenced in late phase therapy sessions. (...

A Review of empirical studies investigating narrative, emotion and meaning-making modes and client process markers in psychotherapy

Despite the importance of narrative, emotional and meaning-making processes in psychotherapy, there has been no review of studies using the main instruments developed to address these processes. The objective is to review the studies about client narrative and narrative-emotional processes in psychotherapy that used the Narrative Process Coding System or the Narrative-Emotion Process Coding System (1.0 and 2.0). To identify the studies, we searched The Book Collection, PsycINFO, PsycARTICLES, PsycBOOKS, PEP Archive, Psychology and Behavioral Sciences Collection, Academic Search Complete and the Web of Knowledge databases. We found 27 empirical studies using one of the three coding systems. The studies applied the Narrative Process Coding System and the Narrative-Emotion Process Coding System to different therapeutic modalities and patients with various clinical disorders. In some studies, early, middle and late phases of therapy were compared, while other studies conducted intensive case analyses of Narrative Process Coding System and Narrative-Emotion Process Coding System patterns comparing recovered vs unchanged clients. The review supports the importance to look for the contribution of narrative, emotion, meaning-making patterns or narrative-emotion markers, to treatment outcomes and encourages the application of these instruments in process-outcome research in psychotherapy.info:eu-repo/semantics/publishedVersio

Narrative Prozesse im Beratungs- und Psychotherapiediskurs: das Narrative Processes Coding System (NPCS)

"Das Kodiersystem für Narrative Prozesse ist eine Methode der Psychotherapieforschung, die es erlaubt, Strategien und Prozesse zu identifizieren, mittels derer Klient und Therapeut die Ereignisse des Alltagslebens in eine bedeutungsvolle Darstellung umwandeln, die die Erfahrungen des Klienten und seiner Mitmenschen sowohl organisiert als auch repräsentiert. Diese Darstellung entsteht sowohl innerhalb einer Therapiesitzung in Form von Mikronarrativen als auch im Verlauf einer gesamten Therapie in Form des – nachfolgend im Mittelpunkt des Interesses stehenden - makronarrativen Rahmens, der die singulären Ereignisse, die in der therapeutischen Beziehung beschrieben werden, auf einander bezieht und vernetzt. Die Arbeit entwickelt zunächst eine Narrative Prozesstheorie der Psychotherapie (Narrative Processes Theory of Therapy) und beschreibt dann das narrative Kodiersystem (Narrative Processes Coding System), das entwickelt wurde, um empirische Schlüsselkomponenten des Modells identifizieren und evaluieren zu können. Befunde aus der Analyse erfolgreicher Psychotherapien werden mit dem Kodiersystem für Narrative Prozesse beschrieben und Implikationen für zukünftige Forschungsarbeiten und für die Praxis diskutiert." (Autorenreferat)"The Narrative Processes Coding System is a research tool that enables researchers to identify strategies and processes by which a client and therapist transform the events of everyday life into a meaningful story that both organises and represents the clients' experience of self and others in the world. Recognizing the significance of the work of some psychotherapy and counselling process investigators to elect to use clients' within session descriptions of relationship events or micronarratives as their unit of narrative analysis, we are centrally interested in the development of the macronarrative framework in which the singular events described in a therapy relationship – micronarratives – come to be articulated, experienced and linked together in such a way that the client's sense of his or her life story - in essence, the sense of self – may be transformed at the conclusion of the therapeutic relationship. The following paper first details the Narrative Processes Theory of Therapy and subsequently outlines the narrative coding system that has been developed to identify and evaluate empirically key components of the model. Findings emerging from the analysis of successful psychotherapy dyads using the Narrative Processes Coding System are described and the implications for future research and practise are discussed." (author's abstract

Narrative change in emotion-focused psychotherapy: a study on the evolution of reflection and protest innovative moments

Innovative moments (IMs) are exceptions to a client’s problematic self-narrative in the therapeutic dialogue. The innovative moments coding system is a tool which tracks five different types of IMs*action, reflection, protest, reconceptualization and performing change. An in-depth qualitative analysis of six therapeutic cases of emotion-focused therapy (EFT) investigated the role of two of the most common IMs*reflection and protest*in both good and poor outcome cases. Through this analysis two subtypes (I and II) of reflection and protest IMs were identified, revealing different evolution patterns. Subtype II of both reflection and protest IMs is significantly higher in the good outcome group, while subtype I of both IMs types does not present statistically significant differences between groups. The evolution from subtype I to subtype II across the therapeutic process seems to reflect a relevant developmental progression in the change process

Ambivalence in emotion-focused therapy for depression: the maintenance of problematically dominant self-narratives

Objective: Ambivalence can be understood as a cyclical movement between an emerging narrative novelty—an Innovative Moment (IM)—and a return to a problematically dominant self-narrative. The return implies that the IM, with its potential for change is devalued right after its emergence. Our goal is to test the hypothesis that the probability of the client expressing such form of ambivalence decreases across treatment in good-outcome cases but not in poor-outcome cases. Method: Return-to-the-Problem Markers (RPMs) signaling moments of devaluation of IMs were coded in passages containing IMs in six clients with major depression treated with emotion-focused therapy: three good-outcome cases and three poor-outcome cases. Results: The percentage of IMs with RPMs decreased across therapy in good-outcome cases, whereas it remained unchanged and high in the poor-outcome cases. Conclusions: These results were consistent with the theoretical suggestion that therapeutic failure may be associated with this form of ambivalence.Obiettivo: L'ambivalenza può essere considerata come un movimento ciclico tra un nuovo elemento narrativo emergente - Innovative Moment (IM) - e il ritorno ad una auto-narrazione problematica dominante. Il ritorno implica che il IM perde il proprio potenziale di favorire un cambiamento nel momento in cui emerge. Il nostro obiettivo è quello di verificare l'ipotesi che la probabilità che il paziente possa esprimere tale forma di ambivalenza diminuisce nel corso di un trattamento che ha un buon esito, ma non nei casi con esito negativo. Metodo: in sei pazienti affetti da depressione maggiore trattati con terapia focalizzata sulle emozioni, sono stati codificati i passaggi contenenti IM utilizzando il Return-to-the-Problem Markers (RPMs) che segnala i passaggi in cui IM vengono svalutati: tre casi con buon esito e tre con esito negativo. Risultati: La percentuale di IM con gli RPM diminuiva nel corso delle terapie dei casi con buon esito, mentre è rimasto invariato ed elevato nei casi con scarso esito. Conclusioni: Questi risultati sono coerenti con il presupposto teorico che il fallimento terapeutico possa essere associato a questa forma di ambivalenza.Objetivo: A ambivalência pode ser entendida como um movimento cíclico entre uma novidade narrativa emergente – um Momento de Inovação (MI) – e um retorno à narrativa problemática dominante. O retorno implica que o MI, com o seu potencial para a mudança, seja desvalorizado logo após a sua emergência. O nosso objetivo é testar a hipótese de que a probabilidade do cliente expressar tal forma de ambivalência diminui ao longo do tratamento em casos de sucesso mas não em casos de insucesso terapêutico. Método: Marcadores de Retorno ao Problema (MRP) que assinalam momentos de desvalorização dos MIs foram codificados em passagens contendo MIs em seis casos de clientes com depressão major tratados com terapia focada nas emoções: três casos de sucesso e três casos de insucesso. Conclusões: Estes resultados foram consistentes com as sugestões teóricas de que o insucesso terapêutico poderá estar associado a esta forma de ambivalência.Ziel: Ambivalenz kann als zyklische Bewegung zwischen einer emergenten narrativen Neuheit – einem Innovative Moment (IM) – und einer Rückkehr zu einer problematischen dominanten Selbst-Erzählung verstanden werden. Diese Rückkehr impliziert, dass der IM mit seinem Potential für Veränderung direkt nach seinem Auftauchen abgewertet wird. Unser Ziel ist die Hypothese zu testen, dass die Wahrscheinlichkeit, dass der Klient eine solche Form der Ambivalenz zeigt, bei Fällen mit gutem Therapieergebnis über die Behandlung abnimmt, aber nicht in Fällen mit schlechtem Ergebnis. Methode: Rückkehr-zu-dem-Problem Marker (RPMs), die Momente signalisieren, in denen IMs abgewertet werden, wurden in Passagen, die IMs beinhalten, von sechs Klienten mit Major Depression, die mit emotionsfokussierter Therapie behandelt wurden, kodiert: 3 Fälle mit gutem und 3 Fälle mit schlechtem Therapieergebnis. Ergebnisse: Der Prozentsatz von IMs mit RPMs verringerte sich bei Fällen mit gutem Ergebnis über die Therapie hinweg, wohingegen er in den Fällen mit schlechtem Ergebnis unverändert und hoch blieb. Schlussfolgerung: Die Ergebnisse waren mit dem theoretischen Vorschlag konsistent, dass therapeutischer Misserfolg mit dieser Form der Ambivalenz assoziiert ist.目標：矛盾可以視為是種擺盪在新產生的新穎敘說—創意時刻(IM)—和回復到一種有問題的支配性自我敘說之間的循環動作。回復意味著潛藏改變契機的IM，其價值在出現後即被摒棄。我們的目標是檢視以下假設的可能性：「在具良好成效的案例中，案主在治療歷程中表達這種形式的矛盾會降低；而在不良成效的案例中則否」。方法：在六位具有嚴重憂鬱症患者的IM段落中，找到顯示IM價值降低時刻的故態復萌標記（RPMs）並加以編碼。這六位患者均接受情緒焦點治療，其中三位為具良好成效案例，另外三位為不良成效案例。結果：在具良好成效案例中，IM當中具有RPM的比率降低；而在不良成效的案例中，RPM的比率維持不變或更高。結論：此結果與理論假設一致，即假設治療的失敗可能與這種形式的矛盾有關

Real-world waste dispersion modelling for benthic integrated multi-trophic aquaculture

In real-world situations, marine fish farms accommodate multiple fish species and cohorts within the farm, leading to diverse farm layouts influenced by cage dimensions, configurations, and intricate arrangements. These cage management practices are essential to meet production demands, however, farm-level complexities can impact model predictions of waste deposition and benthic impact near fish cages. This is of particular importance when the cages are used for integrated multi-trophic aquaculture (IMTA) with benthic feeders, where this waste not only affects environmental conditions but also provides a potential food source. The Cage Aquaculture Particulate Output and Transport (CAPOT) model incorporated multiple species, cohorts, and cage arrangements to estimate waste distribution from a commercial fish farm in the Mediterranean between October 2018 and July 2019. This spreadsheet model estimated dispersion for individual fish cages using a grid resolution of 5 m x 5 m. The study categorized discrete production periods for each fish cage every month, aligning with intermittent changes in biomass and food inputs due to different cage management practices throughout production. This approach facilitated the use of detailed input data and enhanced model representativeness by considering variations in cage biomass, food types, settling velocities, and configurations. Model outputs, represented in contour plots, indicated higher deposition directly below fish cages that varied monthly throughout fish production cycles. Deposition footprints reflected changes in cage biomass, food inputs, and farm-level practices reflecting this real-world scenario where aquaculture does not follow a production continuum. Moreover, cohort dynamics and cage movements associated with the cage management practices of the fish farm influenced the quantity and fate of wastes distributed around fish cages, revealing variability in deposition footprints. Clearly, these findings have important implications for the design of benthic IMTA systems, with species such as sea cucumber and polychaetes. Variability in waste deposition creates challenges in identifying where the benthic organisms should be placed to allow optimal uptake of waste to meet their food requirements and increase survivability. Evidently, models have an important role to play and this study emphasizes the need for representative input data to describe actual food inputs, cage biomass changes, and management practices for more representative farm-scale modelling and essentially to improve particulate waste management. To effectively mitigate benthic impacts through IMTA, models must quantify and resolve particulate waste distribution and impact around fish farms to maintain a balanced system with net removal of wastes. Resolving farm-level complexities provides vital information about the variability of food availability and quality for extractive organisms that helps improve recycling of organic wastes in integrated systems, demanding a more representative modelling approach

Real-world waste dispersion modelling for benthic integrated multi-trophic aquaculture

In real-world situations, marine fish farms accommodate multiple fish species and cohorts within the farm, leading to diverse farm layouts influenced by cage dimensions, configurations, and intricate arrangements. These cage management practices are essential to meet production demands, however, farm-level complexities can impact model predictions of waste deposition and benthic impact near fish cages. This is of particular importance when the cages are used for integrated multi-trophic aquaculture (IMTA) with benthic feeders, where this waste not only affects environmental conditions but also provides a potential food source. The Cage Aquaculture Particulate Output and Transport (CAPOT) model incorporated multiple species, cohorts, and cage arrangements to estimate waste distribution from a commercial fish farm in the Mediterranean between October 2018 and July 2019. This spreadsheet model estimated dispersion for individual fish cages using a grid resolution of 5 m x 5 m. The study categorized discrete production periods for each fish cage every month, aligning with intermittent changes in biomass and food inputs due to different cage management practices throughout production. This approach facilitated the use of detailed input data and enhanced model representativeness by considering variations in cage biomass, food types, settling velocities, and configurations. Model outputs, represented in contour plots, indicated higher deposition directly below fish cages that varied monthly throughout fish production cycles. Deposition footprints reflected changes in cage biomass, food inputs, and farm-level practices reflecting this real-world scenario where aquaculture does not follow a production continuum. Moreover, cohort dynamics and cage movements associated with the cage management practices of the fish farm influenced the quantity and fate of wastes distributed around fish cages, revealing variability in deposition footprints. Clearly, these findings have important implications for the design of benthic IMTA systems, with species such as sea cucumber and polychaetes. Variability in waste deposition creates challenges in identifying where the benthic organisms should be placed to allow optimal uptake of waste to meet their food requirements and increase survivability. Evidently, models have an important role to play and this study emphasizes the need for representative input data to describe actual food inputs, cage biomass changes, and management practices for more representative farm-scale modelling and essentially to improve particulate waste management. To effectively mitigate benthic impacts through IMTA, models must quantify and resolve particulate waste distribution and impact around fish farms to maintain a balanced system with net removal of wastes. Resolving farm-level complexities provides vital information about the variability of food availability and quality for extractive organisms that helps improve recycling of organic wastes in integrated systems, demanding a more representative modelling approach

Socially anxious mothers’ narratives to their children, and their relation to child representations and adjustment

Anxious mothers’ parenting, particularly transfer of threat information, has been considered important in their children’s risk for social anxiety disorder (SAnxD), and maternal narratives concerning potential social threat could elucidate this contribution. Maternal narratives to their pre-school 4-5 year-old children, via a picture book about starting school, were assessed in socially anxious (N=73), and non-anxious (N=63) mothers. Child representations of school were assessed via Doll Play (DP). After one school term, mothers (CBCL) and teachers (TRF) reported on child internalizing problems, and child SAnxD was assessed via maternal interview. Relations between these variables, infant behavioral inhibition, and attachment, were examined. Socially anxious mothers showed more negative (higher threat attribution), and less supportive (lower encouragement) narratives, than controls, and their children’s DP representations, SAnxD and CBCL scores were more adverse. High narrative threat predicted child SAnxD; lower encouragement predicted negative child CBCL scores and, particularly for behaviorally inhibited children, TRF scores and DP representations. In securely attached children, CBCL scores and risk for SAnxD were affected by maternal anxiety and threat attributions, respectively. Low encouragement mediated the effects of maternal anxiety on child DP representations, and CBCL scores. Maternal narratives are affected by social anxiety, and contribute to adverse child outcome

The Role of Optimism and Psychosocial Factors in Athletes Recovery from ACL Injury: A Longitudinal Study

Despite a growing interest into the role of psychosocial factors during the recovery period following sports injuries, there remains a paucity of longitudinal studies examining the indirect relationships between psychosocial factors, psychological responses, and recovery outcomes. The purpose of this study was to construct and test a conceptual model which examined the indirect relationships between psychosocial factors, rehabilitation adherence, and perceived knee function up to 12 months post anterior cruciate ligament (ACL) surgery. A prospective, longitudinal, and repeated measures design was employed, wherein 81 injured athletes (Mage 26.89, SD = 7.52) completed measures of psychosocial factors, rehabilitation adherence, and perceived knee function on seven occasions (pre-surgery to 1 year post-surgery). Bayesian structural equation modeling evaluated the hypothesized indirect relationships proposed within the conceptual model. The main findings from this study was empirical support for a time-ordered, conceptual model which demonstrated that pre-surgery optimism had a significant overall indirect effect on perceived knee function at 12 months post-surgery (sum of indirect; αβ = .08, post. SD = .05, CI [.01, .04]), as well as a specific indirect effect through secondary appraisal at 1 month post-surgery, efficacy at 2 months post-surgery, and rehabilitation adherence at 6 months post-surgery (αβ = .03, post. SD = .03, CI [.00, .10]). Collectively, this study provides support for a number of previously hypothesized, but not empirically examined, indirect relationships between psychosocial factors and recovery outcomes. In doing so, we provide a conceptual model which has the potential to help guide individualised treatment recommendations, as well as identify individuals at risk of compromised recovery outcomes following ACL surgery

The Structural Validity of the IKDC and its Relationship with Quality of Life Following ACL Reconstruction

Objective: The purpose of this study was to (1) examine the structural validity of the International Knee Documentation Committee Subjective Knee Form (IKDC) in light of previously reported dimensionality issues, and (2) examine the relationships between the IKDC and patients’ knee-related quality of life 2-9 years after anterior cruciate ligament (ACL) reconstruction. Methods: A prospective research design was employed, wherein 319 patients (mean age = 29.07, SD = 9.03) completed the IKDC before surgery, 191 patients (mean age = 29.71, SD = 9.36) completed the IKDC at 6 months post-surgery, and 132 patients (mean age = 34.34, SD = 7.89) completed the IKDC and the Anterior Cruciate Ligament Quality of Life Survey (ACL-QOL) at 2-9 years post-surgery. Results: Bayesian structural equation modeling analysis confirmed the two-factor structure (symptom & knee articulation and activity level) represented the most accurate conceptualisation of perceived knee function across the three time points. Moreover, findings revealed that of the two IKDC subscales preoperatively, ‘activity level’ was most strongly associated with long-term quality of life at 2-9 years following surgery, whereas 2-9 years postoperatively, ‘symptoms and knee articulation’ was most strongly associated with long-term quality of life. Conclusions: The IKDC provides clinicians with a convenient total score to assess patients’ perceived knee function, but its unidimensional factor structure is a poor representation of its items and fails to detect discrepancies in patients’ post-operative quality of life, such as the relative importance of perceived knee activity level before reconstructive surgery