Changing the way we study change in psychotherapy.

Abstract

Despite a recent surge of interest in the mechanisms and processes of change during psychotherapy, investigations to date have yielded lamentably few interpretable results. The present article highlights previous barriers to the study of change in psychotherapy and offers a conceptual and methodological framework to increase the interpretability of future studies. A frequently overlooked distinction between change mechanisms, or intermediate changes in the client over the course of treatment, and change processes, or the active ingredients of the therapeutic process, is presented and developed into a multiphase model of programmatic change research. It is argued that investigators should first develop an understanding of change mechanisms and only subsequently conduct targeted process research to identify important change processes.