Integration of Cognitive and Emotional Processing Predicts Poor and Good Outcomes of Psychotherapy

With the aim of investigating analogies and differences between psychotherapeutic processes, ten good-outcome and ten poor-outcome cases were selected from a sample of patients treated at the University Hospital of Psychiatry, Salzburg, Austria, and the Department of Psycho-Traumatology of the Clinic St. Irmingard, Prien am Chiemsee, Germany. They were monitored daily using the Therapy Process Questionnaire (TPQ), and their evolution over time was analyzed by means of Principal Components Analysis and Linear Discriminant Analysis. The results highlight that poor-outcome patients show a separation between cognitive processes (Principal Component 1) and relational-emotional processes (Principal Component 2) (r=− 0.25; p=n.s.), while in the good-outcome patients these aspects are well integrated (r=0.70; p=0.02). These results corroborate the validity of the daily monitoring procedure and also indicate the need for greater attention to the relational and emotional aspects of the patients rather than merely to their cognitive functioning and well-being. Key Message In poor-outcome cases, burdensome emotions and interpersonal experiences on the one hand and cognitive/ well-being aspects of the mental processing on the other, stay unrelated. Successful therapeutic processing, as in goodoutcome cases, requires an integration of cognitive and affective components