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It matters not only where you come from but also where you are going, and the interplay between the two: Reply to Huppert (2022).
American Psychologist ( IF 16.4 ) Pub Date : 2022-05-19 , DOI: 10.1037/amp0000996
Sigal Zilcha-Mano 1
Affiliation  

Two main sources of confusion dominate research on trait-like (between-patients) and state-like (within-patient) effects in psychotherapy. The first is that being higher than another person on a given construct (between-individuals differences) has the same statistical and clinical implications as showing increases from one time point to the next on that construct (within-individual changes). However, research shows that it is a mistake to mix together the two effects. The second is overlooking the interplay between trait-like (between-individuals) differences and state-like (within-individual) changes in the same construct, although such interactive effects between the two may reveal critical information for guiding clinical decision-making. Two types of such interplays are briefly discussed, as well as their distinct clinical implications. The first refers to a compensatory effect according to which those with the lowest trait-like levels on a mechanism of change are the ones benefiting most from state-like improvements in that mechanism, so that where you start from need not have a deterministic effect if you are going in a promising new direction; on the contrary, it may point to the most critical state-like change required to return to healthy homeostasis. The second refers to a complementary effect, according to which treatment should focus on identifying individuals’ trait-like strengths and capitalizing on them in treatment planning to drive state-like improvement. Differentiating between the two types of interplay is critical for basing treatment planning (determining the required state-like changes) on the individual’s case conceptualization (trait-like characteristics).

中文翻译:

重要的不仅是你来自哪里,而且你要去哪里,以及两者之间的相互作用:回复于佩尔 (2022)。

混淆的两个主要来源主导了心理治疗中特质样(患者之间)和状态样(患者内部)效应的研究。第一个是在给定结构上高于另一个人(个体间差异)与显示从一个时间点到下一个时间点在该结构上的增加(个体内部变化)具有相同的统计和临床意义。然而,研究表明,将这两种效应混为一谈是错误的。第二个是忽略同一结构中的特征样(个体之间)差异和状态样(个体内部)变化之间的相互作用,尽管两者之间的这种相互作用可能会揭示指导临床决策的关键信息。简要讨论了两种类型的这种相互作用,以及它们独特的临床意义。第一个是指一种补偿效应,根据这种效应,那些在变化机制上具有最低特征水平的人是从该机制的状态改进中受益最多的人,因此,如果您从哪里开始,则不需要具有确定性效应你正朝着一个充满希望的新方向前进;相反,它可能指向恢复健康稳态所需的最关键的状态变化。第二个是一种互补效应,根据这种效应,治疗应侧重于识别个体的特质优势,并在治疗计划中利用它们来推动状态改善。区分两种类型的相互作用对于将治疗计划(确定所需的类似状态的变化)建立在个人的病例概念化(类似特征的特征)上至关重要。因此,如果您正朝着一个有希望的新方向前进,那么您从哪里开始就不需要产生确定性的影响;相反,它可能指向恢复健康稳态所需的最关键的状态变化。第二个是一种互补效应,根据这种效应,治疗应侧重于识别个体的特质优势,并在治疗计划中利用它们来推动状态改善。区分两种类型的相互作用对于将治疗计划(确定所需的类似状态的变化)建立在个人的病例概念化(类似特征的特征)上至关重要。因此,如果您正朝着一个有希望的新方向前进,那么您从哪里开始就不需要产生确定性的影响;相反,它可能指向恢复健康稳态所需的最关键的状态变化。第二个是一种互补效应,根据这种效应,治疗应侧重于识别个体的特质优势,并在治疗计划中利用它们来推动状态改善。区分两种类型的相互作用对于将治疗计划(确定所需的类似状态的变化)建立在个人的病例概念化(类似特征的特征)上至关重要。第二个是一种互补效应,根据这种效应,治疗应侧重于识别个体的特质优势,并在治疗计划中利用它们来推动状态改善。区分两种类型的相互作用对于将治疗计划(确定所需的类似状态的变化)建立在个人的病例概念化(类似特征的特征)上至关重要。第二个是一种互补效应,根据这种效应,治疗应侧重于识别个体的特质优势,并在治疗计划中利用它们来推动状态改善。区分两种类型的相互作用对于将治疗计划(确定所需的类似状态的变化)建立在个人的病例概念化(类似特征的特征)上至关重要。
更新日期:2022-05-20
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