EXPLAIN

PSYCHOTHERAPEUTIC
CHANGE MECHANISMS.

Sukanya K
THERAPY IS ABOUT
______________?
THERAPY IS ABOUT
MAKING CHANGE
Yet some do not change (33%).
The therapist acts as an agent who catalyzes change.
 SEQUENCES OF A
SUCCESSFUL
TREATMENT PROCESS
 1.

Elaboration of the symptoms

and complaints by the patient.
 2.
The patients discuss feelings
associated with their symptoms.
 3.

Relation of feelings to
dissatisfactions with the
environment.
 4.

Recognition of their repetitive

patterns of behavior and
acknowledgement of these as being
responsible for their tension.
 5.

Awareness of dissatisfaction
with behaviour patterns leads
to attempts at changing them,
but also realizes their
compulsive persistence
 6.
Cognizance of the
functional nature of
behaviour patterns
 7.
Exploration of preponderant
patterns and the determination
of their origin in early
relationships
 8.

Disclosure of the archaic

nature of the disturbing
life trends and
mechanisms of defense
 9.
Challenging of early attitudes
 10.
Serious consideration of rights to a
more productive life
 11.

Intense dissatisfaction with current

patterns, insecurities, and devaluated
self-esteem
 12.
Experimentation with new
modes of behaviour
 13.

Liberation from old values and types of

action
 14.
Evolution of greater security,
assertiveness, and a sense of mastery
 15.

Development of a different conception of oneself,

of more constructive interpersonal relationships,
and of greater capacities for the expression of
personal needs
Bitan, Shaldev & Abayed: Therapists’
views of mechanisms of change in
psychotherapy: a Mixed-method
approach

◦ N (107)
◦ 8 general factors:
◦ Therapeutic bond
◦ Therapist characteristics
◦ Professionalism
◦ Theory-driven mechanism
◦ Client motivation
◦ Client characteristics
◦ Cognitions
◦ Unable/general factors
Wasserman & Wasserman: Mechanisms
of therapeutic change

◦ Several models- Transtheoretical model of change

◦ 5 stages, 10 processes
◦ The 10 processes
5 cognitive and affective 5 behavioural processes
experiential processes

1. Consciousness-raising 1. Self-liberation

2. Emotional arousal 2. Counterconditioning

3. Self-reevaluation 3. Stimulus control

4. Environmental reevaluation 4. Reinforcement management

5. Social liberation 5. Helping relationships

◦ Intentions and readiness factor

Wasserman & Wasserman: Mechanisms Not to b
e

of therapeutic change To be

◦ Continuum models
◦ Network model- evaluate the reward value of each predictor
variable
◦ Taking action-
◦ Network properties of overcoming the status quo
◦ Changing the perceived valuation of the default option
◦ Accumulation-to-bound models
◦ Response vigour- neuromodulation and computational theories
◦ Choosing not to choose
◦ Effort and choosing
◦ Therapy and choice
Wasserman & Wasserman: Mechanisms
of therapeutic change
Thank you!
References:
◦Bitan, D.T.; Shalev, S.; & Abayed, S. (2022). Therapists’ Views of
Mechanisms of Change in Psychotherapy: A Mixed-Method
Approach. https://doi.org/10.3389/fpsyg.2022.565800
◦Wasserman, T.; & Wasserman, L.D. (2019). Mechanisms of
Therapeutic Change. Therapy and the Neural Network Model. (179-
190). https://doi.org/10.1007/978-3-030-26921-0_12
◦Wolberg, L.R. (2013). The Technique of Psychotherapy (4th ed.).
International Psychotherapy Institute E-Books.