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Comparing the process in psychodynamic and cognitive-behavioral therapies.
Abstract
Archival records were used to compare the therapy process in 30 brief psychodynamic and 32 cognitive-behavioral therapies. Verbatim transcripts of 186 treatment sessions were rated with the Psychotherapy Process Q-set, designed to provide a standard language for the description of process. Results demonstrated that although some features were common to both treatments, there were important differences. Cognitive-behavioral therapy promoted control of negative affect through the use of intellect and rationality combined with vigorous encouragement, support, and reassurance from therapists. In psychodynamic psychotherapies, there was an emphasis on the evocation of affect, on bringing troublesome feelings into awareness, and on integrating current difficulties with previous life experience, using the therapist-patient relationship as a change agent. The clinical theoretical precepts underlying psychodynamic treatments received considerable support. In cognitive-behavioral therapies, there was evidence for the importance of developmental, as opposed to rationalist, intervention strategies for treatment outcome.
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“Research indicates that combining psychoanalytic techniques with cognitive therapy enhances treatment outcomes, whereas cognitive techniques alone demonstrate limited association with long-term improvements (123).”
From Psychoanalytically informed MDMA-assisted therapy for pathological narcissism: a novel theoretical approach (2025) · cites this paper as [123]
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Westen, D., Novotny, C. M., & Thompson-Brenner, H. (2004) · Psychological Bulletin · doi:10.1037/0033-2909.130.4.631 · Cited by 1,212
“…all (e.g., Castonguay , Goldfried, Wiser, Raue, & Hayes, 1996; Feeley, DeRubeis , & Gelfand, 1999; Henry, Strupp, Butler, Schacht, & Binder, 1993; Jones & Pulos, 1993)—and correlational analyses have sometimes identified important but unexpected links between process and outcome, such as the…”
BackgroundMethodLane, R. D., Ryan, L., Nadel, L., & Greenberg, L. S. (2014) · Behavioral and Brain Sciences · doi:10.1017/s0140525x14000041 · Cited by 611
“Jones and Pulos (1993) found that the strategies of evocation of affect, and the bringing of troublesome feelings into awareness, were correlated positively with outcome in both cognitive-behavioral and dynamic therapies.”
BackgroundBlagys, M. D., & Hilsenroth, M. J. (2000) · Clinical Psychology Science and Practice · doi:10.1093/clipsy.7.2.167 · Cited by 355
“For example, cognitive-behavioral therapists often make explicit suggestions for in-session or outside-of-session activities, while psychodynamic-interpersonal therapists are hesitant to make specific suggestions because of their potential implications ( Jones & Pulos, 1993).”
BackgroundMethodResultInfluentialThe Scientific Status of Unconscious Processes: Is Freud Really Dead?
Westen, D. (1999) · Journal of the American Psychoanalytic Association · doi:10.1177/000306519904700404 · Cited by 320
Gabbard, G. O., & Westen, D. (2003) · The International Journal of Psychoanalysis · doi:10.1516/n4t0-4d5g-nnpl-h7nl · Cited by 284
“With new technologies for measuring what actually happens in treatment hours (Jones and Pulos, 1993; Ablon and Jones, 1998) and for assessing personality structure (Westen and Shedler, 1999a, 1999b), we are now in the position to discover and measure what clinicians are doing, what changes and what…”
Method
Metadata
- Authors
- Jones, E. E., & Pulos, S. M.
- Affiliations
- University of California, Berkeley (US)
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 1993
- Volume
- 61
- Issue
- 2
- Pages
- 306-316
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- OpenAlex
- W2011642517
- Cited by
- 301
- References
- 0
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 5 · 2023: 9 · 2022: 4 · 2021: 9 · 2020: 14 · 2019: 8 · 2018: 15 · 2017: 6 · 2016: 5 · 2015: 15 · 2014: 14 · 2013: 15 · 2012: 12
- FWCI
- 3.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01mh038348-06)
- National Institute of Mental Health (R01 MH 38348)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
- Keywords
- psychodynamic psychotherapy, cognitive behavioral therapy, therapeutic process, Psychotherapy Process Q-Set, brief psychotherapy, emotional awareness, therapeutic relationship
- MeSH terms
- Adaptation, Psychological, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Outcome and Process Assessment, Health Care, Psychoanalytic Therapy, Psychotherapy, Brief, Q-Sort, Cognitive Behavioral Therapy
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