Notwithstanding the many methodological advances made in the field of psychotherapy research, at present a metatheoretical, school-independent framework to explain psychotherapy change processes taking into account their dynamic and complex nature is still lacking. Over the last years, several authors have suggested that a dynamic systems (DS) approach might provide such a framework. In the present paper, we review the main characteristics of a DS approach to psychotherapy. After an overview of the general principles of the DS approach, we describe the extent to which psychotherapy can be considered as a self-organizing open complex system, whose developmental change processes are described in terms of a dialectic dynamics between stability and change over time. Empirical evidence in support of this conceptualization is provided and discussed. Finally, we propose a research design strategy for the empirical investigation of psychotherapy from a DS approach, together with a research case example. We conclude that a DS approach may provide a metatheoretical, school-independent framework allowing us to constructively rethink and enhance the way we conceptualize and empirically investigate psychotherapy. (PsycINFO Database Record

Objective: The aim of the study is to validate the ability of ACASM (Automated Co-occurrence Analysis for Semantic Mapping) to provide a representation of the content of the therapeutic exchange that is useful for clinical analysis. Method: We compared the clinical case analyses of a good outcome psychodynamic therapy performed by a group of clinicians (n = 5) based on the verbatim transcripts (transcript-based analysis) with the clinical case analyses performed by another group of clinicians (n = 5) based on the ACASM representation of the same sessions (ACASM-based analysis). Comparison concerned two levels: the descriptive level and the interpretative level of the clinical case analysis. Results: Findings showed that, inconsistently with our hypothesis, ACASM-based descriptions of the case obtained worse evaluations than transcript-based descriptions of the case (on all 3 criteria adopted). On the contrary, consistently with our hypothesis, ACASM is undistinguishable from the verbatim transcripts as regards the case interpretation (on 2 out of 3 criteria adopted). Conclusions: ACASM provides a description of the case that, though different from the one provided by the transcripts, enables clinicians to elaborate clinical interpretations of the case which approximate those produced by clinicians working directly on verbatim transcripts.

The COVID-19 pandemic is increasing negative consequences on mental health around the globe. To date, research on what psychological factors could influence individuals’ distress is still scarce. The current study aims to test a multiple mediation model to examine the role of Intolerance of Uncertainty (IU) and emotional regulation (i.e., expressive suppression and cognitive reappraisal) as joint factors, which can increase understanding of psychological distress due to the COVID-19 outbreak. An online survey measuring fear of COVID-19, IU, emotional regulation, and psychological distress was administered to 3863 Italian adults (females 73.3%; M_age = 36.44; SD = 14.74) during lockdown. Results showed that IU partially mediated the effect of fear of COVID-19 on depression, anxiety and stress. Moreover, individuals with difficulties in managing the uncertainties due to their fear of COVID-19 may be at risk for heightened use of expressive suppression and depression. However, individuals with both higher IU and expressive suppression showed lower level of stress. High cognitive reappraisal has a mediational effect on the relationship between fear of COVID-19, IU, and lower psychological distress. Findings suggest that IU and emotional regulation should be targeted for informing the development of tailored treatments to reduce the negative consequences of the outbreak.

Editorial: Dynamic systems theory and embodiment in psychotherapy research. A new look at process and outcome