Patients’ and therapists’ actions on the precipice of change: Session processes before sudden gains and sudden losses.

In the present study, sessions prior to sudden gains, sudden losses, and neutral control sessions were examined regarding the processes of change resource activation, problem actuation and therapeutic alliance. With respect to these change processes, we examined whether pregain, preloss, and neutral sessions are distinguishable by particular patterns. For the current project, videos of 30 pregain, 29 preloss, and 30 neutral control sessions from n = 89 patients receiving integrative cognitive–behavioral therapy were rated minute-by-minute using Resource-Oriented Microprocess Analysis. The sample was drawn from a total of N = 365 patients, who had completed treatment or who had attended at least 20 sessions of therapy between the years of 2007 and 2011. Discriminant function and survival analyses as well as a binary logistic regression analysis were performed to identify patterns and timing of change processes associated with session types (gains, losses, and neutral sessions). The three session types differed with regard to patterns of resource activation and problem actuation. No difference concerning therapeutic alliance was found. The findings may help future studies to generate new hypotheses regarding processes that are involved in the occurrence of sudden changes. (PsycInfo Database Record (c) 2020 APA, all rights reserved)