The process of change in psychotherapy with a pregnant patient following perinatal losses: An analysis of a case study. Issue 5 (15th February 2019)

• Record Type: Journal Article
• Authors: Cohen, Keren; Leibovich, Liat; Markin, Rayna; Zilcha‐Mano, Sigal
• Other Names: Behn Alex guestEditor.
• Is Part Of: Journal of clinical psychology. Volume 75:Issue 5(2019)
• Page Start: 874
• Page End: 885
• Publication Date: 2019-02-15
• Subjects: alliance -- interpersonal patterns -- major depressive disorder -- perinatal loss -- psychotherapy -- supportive‐expressive therapy; Psychology -- Periodicals; 616.89
• DOI: 10.1002/jclp.22763
• Languages: English
• ISSNs: 0021-9762

Abstract

Abstract: Aim: Despite research suggesting increased anxiety and depressive symptoms after a perinatal loss and during future pregnancies, little knowledge exists to guide clinicians treating pregnant women after perinatal loss. This case study explores processes that facilitated therapeutic change for a pregnant patient with major depressive disorder (MDD) and posttraumatic stress disorder after perinatal losses. Method: The study integrated quantitative and narrative analyses in a single case derived from the pilot phase of a randomized controlled trial on supportive‐expressive therapy for MDD. Results: The quantitative and narrative analyses suggest that an improvement in maladaptive interpersonal patterns toward the therapist, in the form of attachment avoidance, made it possible to form a strong alliance, which in turn led to a successful outcome. Conclusions: The findings highlight the importance of improving maladaptive interpersonal patterns as a prerequisite to enable patients after pregnancy losses to develop and maintain a corrective therapeutic experience.