Quality assurance

Dr. Peseschkian developed positive psychotherapy, which has many points of contact with systemic therapy. Both approaches start from a “positive”, optimistic view of people, build on the resources and abilities of clients, find other meanings for “problems” through reinterpretation, and actively involve the client’s environment. Positive psychotherapy is also a rich source of inspiration for the use of humour and intuitive means such as stories and metaphors.

In his study “Computer-aided quality assurance in positive psychotherapy”, Dr. Peseschkian describes its scope and some results. He received the Richard Merten Prize in 1997 for this work.

The project

Since 1974, the Wiesbaden Training Group for Psychotherapy and Family Therapy (WIPF), led by Dr. Peseschkian, has worked on an effectiveness study for quality assurance. A preliminary study with 1,400 patients produced a test, the Wiesbaden Inventory for Positive Psychotherapy and Family Therapy (WIPPF), which became part of the ongoing efficacy study. This study has been carried out intensively since July 1995.

Positive psychotherapy is a form of short-term psychotherapy with a transcultural and interdisciplinary perspective, assigned to the procedures based on depth psychology. It rests on three principles:

• The positive image of man from a transcultural point of view
• Working on conflict content and conflict dynamics through reinterpretation and meta-communication
• Systematic five-stage integral psychotherapy

The method

Looking at structural quality, process or treatment quality, and quality of results, the first findings on the quality of results are presented here: the changes in symptoms, experience and behaviour between the start of therapy and several points after it ended.

The sample (N = 415) consists of people with various psychosomatic diagnoses (for example depressive disorders, anxiety and panic disorders, somatoform disorders, adjustment disorders and abuse of psychotropic substances) and with purely somatic diagnoses. It was collected nationwide with 38 psychotherapists. Patients were examined before psychotherapy, after treatment and later (follow-up), and compared with a control group without psychotherapeutic treatment.

Results

Measure	Comparison	Result
Symptom questionnaires	Pre/post change, PPT vs. control	Highly significant; mean effect size e = 0.476
VEV (experience and behaviour)	Post and follow-up, PPT vs. control	Highly significant; effect size e = 1.24
VEV and SCL-90	Post vs. follow-up, PPT patients	No significant decline (F = 1.179; F = 2.473; p = .05)

Using several diagnostic questionnaires, the study showed highly significant improvements in symptoms between pre- and post-measurement for PPT patients. The control group showed no significant difference. Cross-sectional comparisons (ANOVAs) between the post-measurements and the follow-up values showed no significant difference on either scale, which indicates that the effects are stable over time.

Summary

Compared with the control group, patients treated with positive psychotherapy showed a significant reduction in symptoms and greater changes in experience and behaviour after therapy. The effects are stable for up to five years after the end of therapy. The mean duration of therapy for the 344 patients treated with positive psychotherapy was 30 sessions.