Quality Assurance
Positive psychotherapy: a short-term psychotherapeutic procedure involving computer-aided quality assurance
First proof of effectiveness (Hessisches Ärzteblatt (8/1997))
Proof of effectiveness of positive psychotherapy as part of quality assurance Dr. Nossrat Peseschkian
Dr. Peseschkian developed positive psychotherapy and has many points of contact with systemic therapy. Both approaches are based on a “positive”, i.e. expose optimistic views of people, start with the resources and abilities of the clients, work out other meanings of “problems” with reinterpretations, and actively involve the client’s environment. With regard to the use of humor and intuitive means such as stories and metaphors, we find positive and extensive sources of inspiration in positive psychotherapy. The successful proof of efficacy of a therapy that relies on similar mechanisms of action is therefore also interesting for system engineers. Dr. Peseschkian, who is a member of the scientific advisory board of our institute, describes the scope and some results of his study “Computer-aided quality assurance in positive psychotherapy”. He was awarded the Richard Merten Prize in 1997 for his work.
The project
Since 1974, the Wiesbaden Training Group for Psychotherapy and Family Therapy (WIPF) under the direction of Dr. Peseschkian presented an effectiveness study in terms of quality assurance. In the form of a preliminary study in which 1,400 patients were examined, a test was created, the Wiesbaden Inventory for Positive Psychotherapy and Family Therapy (WIPPF), which was integrated into the ongoing efficacy study for quality assurance in positive psychotherapy (PPT). This study has been carried out intensively since July 1995.
Positive psychotherapy is a form of short-term psychotherapy from the transcultural and interdisciplinary point of view, which is assigned to the procedures based on depth psychology. The PPT is based on three principles:
– The positive image of man from a transcultural point of view
– Processing of conflict content and conflict dynamics through reinterpretation / metacommunication
– Systematic five-step integral psychotherapy
The Method
From the point of view of structural quality, process or treatment quality and quality of results, the first findings on the quality of results of PPT are presented here.
The observed changes in symptoms, experience and behavior that occurred between the start of therapy and at different times after the end of therapy were analyzed. Here is a sample of the sample and measuring battery briefly described, followed by a summary of the most important results on the two specific areas:
1. Sample description
The sample of this study (N = 415) consists of people with different psychosomatic (e.g. depressive disorders, anxiety and panic disorders, somatoform disorders, adjustment disorders and abuse of psychotropic substances) and with various purely somatic diagnoses. It was collected nationwide with the participation of 38 psychotherapists. The patients were examined before psychotherapy (pre-measurement), after treatment (post-measurement) and later (catamnesis). These results were compared to a control group without psychotherapeutic treatment.
Results
To test the effectiveness of positive psychotherapy with regard to symptoms and changes in experience and behavior, various comparisons were made between the prospectively recorded patients treated with the PPT and the control group, and effect sizes were calculated.
Using various test diagnostic questionnaires, it was possible to demonstrate highly significant improvements in symptoms between pre- and post-measurement for PPT patients.
However, no significant difference could be found in the control group. The comparison of pre / post differences between the PPT patients and the control group also showed highly significant differences in favor of the PPT patients, which achieved an average effect size of e = 0.476.
The VEV is a highly sensitive measuring instrument that is usually used to record therapy-induced changes in experience and behavior. This questionnaire was used in the context of the post measurement and the catamnestic surveys. A comparison between the VEV values of the PPT patients and that of the control group again revealed highly significant differences, which even achieved an effect size of e = 1.24. The PPT patients showed markedly improved results.
In order to estimate whether the improvements achieved immediately after the end of therapy can still be demonstrated long after the end of therapy, cross-sectional comparisons (Anovas) calculated between the results of the post measurements and the catamnestically recorded values of the PPT patients. Neither the VEV (F = 1.179) nor the SCL-90 (F = 2.473) showed significant differences (p = .05) between the post and catamnestic measurements.
Summary
Compared to the control group, the patients treated with positive psychotherapy showed a significant reduction in their symptoms and a higher degree of changes in experience and behavior after completion of their therapy. The cross-sectional comparison also indicates a temporal stability of the proven effects. This finding is valid for a period of five years after the end of therapy. The mean therapy duration of the 344 patients with whom positive psychotherapy was carried out was 30 sessions.
Literature from the author