A longitudinal analysis of reflective functioning and its association with psychotherapy outcome in patients with depressive and anxiety disorders

Babl, Anna; Berger, Thomas; Decurtins, Hannah; Gross, Inke; Frey, Tom; Caspar, Franz; Taubner, Svenja (2022). A longitudinal analysis of reflective functioning and its association with psychotherapy outcome in patients with depressive and anxiety disorders. Journal of counseling psychology, 69(3), pp. 337-347. American Psychological Association 10.1037/cou0000587

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The ability to mentalize has been discussed as potential change mechanism in psychotherapy. Reflective functioning (RF) offers an empirical framework for the assessment of mentalization in therapy sessions. In the present study, we assessed RF longitudinally and examined its association with symptomatic distress, symptom severity of depression and anxiety, and interpersonal problems over the course of treatment. Thirty-seven patients diagnosed with depression or anxiety disorders received 25 ± 3 sessions of integrative cognitive-behavioral therapy (CBT) in an outpatient setting. The observer-rated in-session Reflective Functioning Scale (RFS) was applied to transcripts of therapy Sessions 1, 8, 16, and 24. The effects of RF were investigated both within and between patients using hierarchical linear modeling. RF significantly increased over the course of treatment, and this improvement in RF was significantly associated with depressive symptoms. This means that after a session where patients positively deviated from their own average RF during treatment, they reported lower depression severity. In post hoc analyses, we found a significant interaction effect of the within- and between-patient RF effects on interpersonal problems. Patients with overall higher levels of RF and with positive deviations from their own average RF over the course of treatment tended to have less interpersonal problems during psychotherapy. The present study contributes to the preliminary evidence that changes in RF may serve as a common factor in psychotherapy in contrast to being a specific factor in psychodynamic therapies. More longitudinal studies are necessary to gain a better understanding of RF as a change mechanism in psychotherapy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Item Type:	Journal Article (Original Article)
Division/Institute:	07 Faculty of Human Sciences > Institute of Psychology > Clinical Psychology and Psychotherapy 07 Faculty of Human Sciences > Institute of Psychology > Cognitive Psychology, Perception and Methodology
UniBE Contributor:	Babl, Anna Margarete, Berger, Thomas (B), Caspar, Franz
Subjects:	600 Technology > 610 Medicine & health 100 Philosophy > 150 Psychology
ISSN:	0022-0167
Publisher:	American Psychological Association
Language:	English
Submitter:	Melanie Best
Date Deposited:	13 Jan 2022 12:03
Last Modified:	29 Mar 2023 23:38
Publisher DOI:	10.1037/cou0000587
PubMed ID:	34618487
URI:	https://boris.unibe.ch/id/eprint/162383