Development of Brazilian prototypes for short-term psychotherapies

Abstract Introduction: The Psychotherapy Process Q-Set (PQS) prototype method is used to measure the extent to which ideal processes of different psychotherapies are present in real cases, allowing researchers to examine how adherence to these models relates to or predicts change. Results from studies of short-term psychotherapies suggest that the original psychodynamic prototype is more suitable for studying psychoanalysis and long-term psychodynamic psychotherapy than its time-limited counterparts. Furthermore, culture probably influences how therapies are typically conducted in a given country. Therefore, it seems appropriate to develop Brazilian prototypes on which to base studies of short-term psychodynamic and cognitive-behavioral processes in this country. Objective: To develop prototypes for studying processes of short-term psychotherapies and to examine the degree of adherence of two real psychotherapy cases to these models. Methods: Expert clinicians used the PQS to rate a hypothetical ideal session of either short-term psychodynamic psychotherapy (STPP) or cognitive-behavioral therapy (CBT). Ratings were submitted to Q-type factor analysis to confirm the two groups. Regressive factor scores were rank ordered to describe the prototypes. These ideal models were correlated with ratings of actual therapy processes in two complete psychotherapy cases, one STPP and the other CBT. Results: Agreement levels between expert ratings were high and the two ideal models were confirmed. As expected, the PQS ratings for actual STPP and CBT cases had significant correlations with their respective ideal models, but the STPP case also adhered to the CBT prototype. Conclusion: Overall, the findings reveal the adequacy of the prototypes for time-limited therapies, providing initial support of their validity.

摘要引言：心理治疗过程Q分类法（Psychotherapy Process Q-Set, PQS）原型方法，用于衡量不同心理治疗的理想流程在真实临床案例中的呈现程度，助力研究者探讨遵循此类治疗模型与治疗效果变化之间的关联，或对疗效变化起到预测作用。现有短期心理治疗相关研究结果显示，相较于其限时衍生版本，原始心理动力学原型更适用于精神分析及长期心理动力学心理治疗的相关研究。此外，文化因素或会影响特定国家内心理治疗的常规实施模式。因此，为巴西开展短期心理动力学与认知行为治疗流程的相关研究先构建适配该国的原型模型，具备合理性。

研究目标：开发适配的短期心理治疗流程原型，并检验两例真实心理治疗案例对这些模型的契合程度。

研究方法：由临床专家采用心理治疗过程Q分类法（PQS），分别对短期心理动力学心理治疗（short-term psychodynamic psychotherapy, STPP）与认知行为治疗（cognitive-behavioral therapy, CBT）的假想理想会谈进行评分。将评分结果提交至Q型因子分析，以验证两类治疗模型的分组合理性；通过回归因子得分的秩次排序，对所构建的原型模型进行描述。将上述理想模型与两例完整心理治疗案例（1例为短期心理动力学心理治疗，另1例为认知行为治疗）的实际治疗流程评分开展相关性分析。

研究结果：专家评分间的一致性程度较高，且两类理想模型均得到验证。正如预期，两例真实案例的PQS评分与其各自对应的理想模型均存在显著相关性，但该短期心理动力学心理治疗案例同时也契合认知行为治疗原型。

研究结论：整体而言，本研究结果证实该原型模型适用于限时心理治疗的相关研究，为其效度提供了初步实证支持。