Focus is key: Panic-focused interpretations are associated with symptomatic improvement in panic-focused psychodynamic psychotherapy. (8th November 2019)

• Record Type: Journal Article
• Authors: Keefe, John R.; Solomonov, Nili; Derubeis, Robert J.; Phillips, Alexander C.; Busch, Fredric N.; Barber, Jacques P.; Chambless, Dianne L.; Milrod, Barbara L.
• Is Part Of: Psychotherapy research. Volume 29:Number 8(2019)
• Page Start: 1033
• Page End: 1044
• Publication Date: 2019-11-08
• Subjects: psychodynamic psychotherapy -- panic disorder -- psychotherapy process -- adherence; psicoterapia psicodinâmica -- transtorno do pânico -- processo de psicoterapia -- aderência; 精神動力心理治療 -- 恐慌症 -- 心理治療歷程 -- 依從; Psychotherapy -- Periodicals; Psychotherapy -- Research -- Periodicals; Psychotherapy -- Periodicals; Psychothérapie -- Périodiques; Psychothérapie -- Recherche -- Périodiques; 616.891405
• DOI: 10.1080/10503307.2018.1464682
• Languages: English
• ISSNs: 1050-3307

Abstract

ABSTRACT: Objective: This study examines whether, in panic-focused psychodynamic psychotherapy (PFPP), interpretations of conflicts that underlie anxiety (panic-focused or PF-interpretations) are specifically associated with subsequent panic disorder (PD) symptom improvement, over and above the provision of non-symptom-focused interpretations. Method: Technique use in Sessions 2 and 10 of a 24-session PFPP protocol was assessed for the 65 patients with complete outcome data randomized to PFPP in a two-site trial of psychotherapies for PD. Sessions were rated in 15-min segments for therapists' use of PF-interpretations, non-PF-interpretations, and PF-clarifications. Robust regressions were conducted to examine the relationship between these interventions and symptom change subsequent to the sampled session. Interpersonal problems were examined as a moderator of the relationship of PF-interpretations to symptom change. Results: At Session 10, but not at Session 2, patients who received a higher degree of PF-interpretations experienced greater subsequent improvement in panic symptoms. Non-PF-interpretations were not predictive. Patients with more interpersonal distress benefitted particularly from the use of PF-interpretations at Session 10. Conclusions: By the middle phase of PFPP, panic-focused interpretations may drive subsequent improvements in panic symptoms, especially among patients with higher interpersonal distress. Interpretations of conflict absent a panic focus may not be especially helpful.