Ongoing change and therapeutic outcome were studied in five psychotherapeutic processes: three brief psychodynamic therapies, one social constructionist family therapy, and one group therapy of a comprehensive nature for drug abuse patients. Using qualitative methodology, in-session and extrasession change moments were identified and classified in a hierarchy of generic change indicators. Additionally, all patients were administered Lambert's Outcome Questionnaire. Results show that (a) extrasession change moments are more frequent toward the end of therapy, (b) therapy types differ in the frequency of some change indicators but not others, and (c) change indicators observed at the beginning of therapy are of lower level than those occurring at the end.

Objective: The aim of this review is to systematize and interpret results produced over one decade of Psychotherapy Process Research (2009–2019) in eight journals. Method: It is a Mixed Studies Review of quantitative as well as qualitative primary studies. The analysis of the results of these studies included a descriptive quantitative part and a qualitative part that followed the logic of Qualitative Meta Analysis, categorizing the main results of both types of studies in a bottom-up procedure that generates specific content categories that are synthesized in further steps of a higher level of abstraction, leading to an “interpretive synthesis” presented in a narrative way. Results: The review shows that psychotherapy process research uses a variety of qualitative and quantitative methods, often creating new procedures. Furthermore, the review indicates that the most commonly assessed macroprocess variables are ongoing change, therapeutic relationship (predominantly therapeutic alliance), and therapeutic intervention; while the most extensively studied microprocess variables are change events, difficult episodes (mainly ruptures), and therapeutic intervention. Macrolevel results reveal that the main contents of ongoing change are the building of new meanings and progressive psychological integration; underscore the association of the therapeutic alliance with ongoing change and outcome; and show the complexity of associating intervention with outcome, because different phases of therapy (and problems) need different assessments. Microlevel results indicate that change events impact on ongoing change and outcome; that for ruptures the key fact is their repair; and that therapist communication has an immediate influence on patient communication. Conclusion: Our knowledge regarding relevant aspects of psychotherapy is very fragmented; robust and replicated results are still scarce. Only a few variables have been found to consistently predict outcome across most therapies. Only in the field of alliance research it has been possible to perform meta-analyses that clearly demonstrate the impact of this factor on final outcomes. Despite these limitations, psychotherapy process research is a powerful tool for uncovering change mechanisms and is at present widely implemented. Our conclusion is that, in order to generate useful future knowledge, change mechanisms need to be linked to ongoing change; this, in turn, requires models of change, hopefully of a transtheoretical nature.

Drawing on the speech acts theory, a linguistic pattern was identified that could be expected to be associated to therapeutic change, characterized by being uttered in the first person singular and present indicative, and by being self-referential in its propositional content. The frequency of the pattern was examined among verbalizations defined as change moments in three therapies with different theoretical orientation. Results show that the majority of change moments have the specified pattern, and that this pattern is significantly more frequent in change moments than in random non-change-related verbalizations, and so, it does not pertain to therapeutic conversation in general. Implications are discussed concerning the possibility of using the linguistic pattern as an additional and complementary criterion in the identification of moments of change in the therapeutic process.

De acuerdo a la Encuesta Nacional de Salud³, realizada entre los años 2009 y 2010, la prevalencia de síntomas depresivos en la personas mayores de 15 años es de 17,2%, valor que aumenta a 25,7% si se considera sólo a las mujeres. Según los datos epidemiológicos arrojados por el estudio de Vicente y cols. en el año 2002, la prevalencia de vida de depresión alcanza a 9% en las mujeres y 6,4% en los hombres⁴. De acuerdo al estudio de carga de enfermedad y carga atribuible, la depresión unipolar es la segunda causa de años de vida perdidos ajustados por discapacidad en población general en Chile y la primera en mujeres entre 20 y 44 años⁵. Entre los años 2008 y 2009, los trastornos mentales y del comportamiento generaron el mayor gasto por concepto de licencias médicas en el país (20,7%), y dentro de estos trastornos, la depresión corresponde a 59,3%⁶.

Clients', therapists', and observers' identification of change was studied in 27 therapeutic processes, and agreement on the amount, temporal location, and content of change was related to outcome. Results show that clients reported more changes in successful therapies. Client–therapist temporal match of change moments was low irrespective of outcome. Results from all three perspectives were consistent in that manifestation of new behaviors and emotions was the most representative content of change among all therapies. Meanwhile, client–therapist agreement on the frequency of grouped change indicators reported was associated with positive outcome, whereas client–observer agreement was related to negative outcome. Therapists and observers agreed in both successful and nonsuccessful therapies. The relationship between agreement and therapeutic outcome is discussed in relation to each dimension of analysis.

In order to study the effects of mindfulness meditation interventions administered to adolescents within their educational institutions, a qualitative systematic review was conducted. Sixteen studies published in main databases were analysed. The results show that mindfulness, as a prevention strategy in educational contexts, resulted in significant changes in the followings variables: (a) psychological (e.g., reduction in depressive symptoms); (b) psychosocial (e.g., increased social skills); and (c) physiological (e.g., improvement of blood pressure). Although the results were conclusive, their interpretation and generalization should be carefully analysed as there were no medium- and long-term follow-up evaluations, in addition to the fact that there has been a minimal assessment of the psychological mechanisms involved in the change processes.