Analysis of the therapeutic process in a case of couple therapy for depression: how to deal with a problematic within-system alliance / Análisis del proceso terapéutico en un caso de terapia de pareja para la depresión: cómo lidiar con una alianza intra-sistema problemática

Abstract

Spanish

The purpose of this study was to analyse the therapeutic process of a case of couple therapy for depression. The evolution of symptoms, marital satisfaction and therapeutic alliance were evaluated during therapy. Results showed that symptoms followed a specific trajectory where the patient displayed a sudden deterioration towards the end of their therapy but, at follow-up, reached a clinically significant change in both individual and relational measures. The analysis of the process highlighted the association between the couple’s relational pattern and its problematic within-system alliance, as well as the relevance of this association for explaining the trajectory of change. The most useful case management interventions were: (a) fostering a relational formulation of symptoms; and (b) the use of therapy termination as an intervention. Results from this case study support the role of relational mechanisms for the process of change and provide technical alternatives that can be applied in cases at risk of failure.

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