Objective: The complex phenomenon of psychotherapy outcome requires further conceptual and methodological developments that facilitate clinically meaningful research findings. In this study, we rely on an idiosyncratic and process-oriented understanding of treatment effects in order to investigate long-term outcome. A conceptual model of long-term outcome is presented that comprises both a taxonomy of change and explanatory factors. Method: A mixed methods naturalistic study was conducted in an inpatient psychotherapy setting. Long-term quantitative outcome data are complemented with a data-driven thematic analysis of interviews with 22 participants, five to six years after ending inpatient psychotherapy. Results: Long-term outcome findings show improved well-being for the majority of former patients and this until five to six years after treatment. From the patients’ perspectives, long-term changes can be situated on different interrelated existential levels: reconnection to others and (the meaning of) life, a revelation, an altered self, life changes, and altered expectations and ideas about recovery and treatment. The complex interplay of the person, the therapy centre, the outside world and the evolution over time helped explain the experienced changes and individual differences. Conclusion: The findings support the value of an idiosyncratic and process-oriented understanding of outcome and recovery as well as substantiate the importance of multiple methods and perspectives when studying the effects of psychotherapy.

中文翻译：

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从患者的角度理解长期结果：住院心理治疗的混合方法自然主义研究


目的：心理治疗结果的复杂现象需要进一步的概念和方法发展，以促进具有临床意义的研究结果。在这项研究中，我们依靠对治疗效果的特殊且面向过程的理解来研究长期结果。提出了长期结果的概念模型，其中包括变化分类和解释因素。方法：在住院心理治疗环境中进行混合方法自然主义研究。在结束住院心理治疗五到六年后，对 22 名参与者进行了数据驱动的专题分析，对长期定量结果数据进行了补充。结果：长期结果显示，大多数以前患者的健康状况有所改善，直到治疗后五到六年为止。从患者的角度来看，长期的变化可以发生在不同的相互关联的存在层面上：与他人和生命（的意义）的重新联系、启示、改变的自我、生活的变化以及对康复和治疗的期望和想法的改变。人、治疗中心、外部世界以及随时间的演变之间复杂的相互作用有助于解释所经历的变化和个体差异。结论：研究结果支持对结果和恢复进行特殊且以过程为导向的理解的价值，并证实了在研究心理治疗效果时多种方法和观点的重要性。