Writing Manuals for Psychodynamic Group Treatments

Abstract

Treatment manuals may have different purposes. In clinical work it may be to demonstrate the main feabtures and principles of a treatment method to trainees. In psychotherapy research it may be an attempt to ensure that all patients are influenced in a similar way, thus trying to increase the internal validity of the study. Measures taken to ensure internal validity (randomization, inclusion of patients with similar diagnosis, check of treatment fidelity etc.) often reduce the possibility of generalizing the results from such studies to a regular clinical context (external validity).

This article describes how treatment manuals for short- and long-term analytic group psychotherapies (20 and 80 weekly sessions, respectively) were developed. We wanted to study the significance of the treatment length, and potential moderators and mediators of differential change in the treatment of regular patients with mixed disorders (anxiety, affective, and mild to moderate personality disorders) who had been referred to outpatient services. The article presents reflections, choices, and dilemmas encountered in developing these manuals. Brief examples from the manuals are presented, highlighting differences between the two formats.