ABSTRACT

The present special issue includes single and multiple case studies which report on the phenomenon of ‘paradoxical’ outcomes in psychotherapy, operationalized as discordant outcome assessments within the same case. In an attempt to find ground for my published response, I endeavored to juxtaposition the cases from the different studies, and by doing that gain an overview of the contributions and arguments. As a result of that exercise, I suggest three different types of paradoxical outcome with different pathways and implications. Discussing the concept of ‘illusory mental health’ as a possible explanation for paradoxical outcome, I suggest that self-ratings within a nonclinical range, given by respondents assessed as psychologically distressed, could be perceived as ‘genuine’ markers of a tolerable level of coping and symptom relief, not only as an indication of a defensive attitude. I conclude that it might be more advantageous to relate ‘paradoxical’ outcomes to aspects of the therapeutic process, rather than to psychological dispositions of the clients.

摘要

本期特刊包括单个和多个案例研究，它们报告了心理治疗中“矛盾”结果的现象，在同一案例中作为不一致的结果评估进行操作。为了找到我发表的回应的依据，我努力将不同研究中的案例并列在一起，并通过这样做获得对贡献和论点的概述。作为该练习的结果，我提出了三种不同类型的矛盾结果，具有不同的途径和含义。讨论“虚幻心理健康”的概念作为对矛盾结果的可能解释，我建议非临床范围内的自我评价，由被评估为心理困扰的受访者给出，可以被视为可容忍应对水平的“真实”标志和症状缓解，不仅作为一种防御态度的表示。我的结论是，将“矛盾的”结果与治疗过程的各个方面联系起来可能更有利，而不是与来访者的心理倾向联系起来。