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Research Axis 1: Psychotherapy process research

The first objective is to better understand the processes of change. Psychotherapy process refers to actions, experience, and relatedness of patient and therapist in therapy sessions (e.g., interpretations) that lead to intermediate changes in the patient (e.g., insight) and ultimately to treatment outcome. Each psychotherapeutic orientation has developed specific models of the therapy process, based on their distinct theoretical models and treatment approach. This type of research is crucial for refining existing treatment models and providing a better understanding of the nature of change in psychotherapy.

Subject positioning in the context of therapeutic interventions for victims of sexual abuse

Sam Flores (started in 2023; supervised by Jochem Willemsen) is launching a research project focused on the analysis of therapeutic discourses and psychotherapy as a place of subjective positioning that is open to influences from moral registers and repertoires of thought that are specific to the protagonists of therapeutic dialogue. He is particularly interested in how conceptualizations of sexual violence in the literature and in clinical practice influence the subjectivity of victims of sexual violence during the therapeutic process. This study is a transversal project which is interested both in therapeutic interventions for victims and in the reflexivity of psychotherapists at several levels: social, political, ethical and psychological.

What is the impact of therapist’s multicultural orientation on the working alliance?

Liselotte Cullman (started in 2022; supervised by Jochem Willemsen) will investigate the role of cultural differences in therapy and how therapists can deal with these differences to strengthen the therapeutic relationship. Central concept in this project is ‘multicultural orientation’ which consists of an ability to be other-oriented, curious and open to diverse perspectives, an ability to notice and address cultural themes in therapy when they arise, and an ability to engage in discussions of culture and identity. The research team will conduct a scoping review and a large-scale survey study among therapists to investigate the theoretical and empirical structure of multicultural orientation. Next, a naturalistic, prospective study will allow to test whether multicultural orientation in therapists is indeed associated with the development of a better working alliance when working with clients with different cultural backgrounds. In the final stage of this project, we will study in detail how multicultural orientation influences the working alliance through a mixed-methods case comparison.

Single case studies in psychotherapy

Single Case Archive (2013-…; Jochem Willemsen) is a international collaborative project with three aims: 1) making case studies more easily accessible for research, clinical and teaching purposes, 2) facilitating meta-studies and reviews of case studies, and 3) stimulating methodological developments in the field of case study research. Case studies are an essential complement to other types of research in the field of psychotherapy research and they help to bridge the gap between research and practice. One of the major achievements of this project is the creation of an online database of clinical, systematic, and experimental single case studies from all psychotherapeutic orientations (www.singlecasearchive.com). This resource was created in 2013 by researchers from Ghent University and the University of Essex.

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Key paper:

  • Meganck, R., Krivzov, J., Notaerts, L., Willemsen, J., Kaluzeviciute, G., Dewaele, A., & Desmet, M., (2022). The Single Case Archive: Review of a multi-theoretical online database of published peer-reviewed single case studies. Psychotherapy, 59(4), 641-646. http://doi.org/10.1037/pst0000431

Psychoanalytic psychotherapy for treatment-resistant depression

Jochem Willemsen, Felicitas Rost, David Taylor, Peter Fonagy, and Marie Hustinx (with funding from the International Psychoanalytic Association) investigate why psychoanalytic psychotherapy is effective for the treatment of treatment-resistant depression in many patients (as demonstrated by the Tavistock Adult Depression Study) but not all. The approach taken in this study is a mixed-method case comparison approach with matched cases from the Tavistock Adult Depression Study. Two cases were selected, one unsuccessful and one successful, from the same therapist and matched on a number of clinical and demographical variables to maximize comparability. The comparability of the cases allows us to focus on the differences at the level of the process. Our focus is on the role of interpretations (transference interpretations and others) and the dynamic transference-countertransference.

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Key paper:

  • Willemsen, J., Rost, F., Hustinx, M., Fonagy, P., & Taylor, D. (2024). Examination of a case of “treatment failure” in long-term psychoanalytic psychotherapy for treatment-resistant depression. The International Journal of Psychoanalysis, 105(4), 475–495. https://doi.org/10.1080/00207578.2024.2352827

Research axis 2: Psychotherapist training and professional development

The second objective is to empirically study the effects of psychotherapy training. Somewhat surprisingly, studies of expertise and therapist development have failed to find strong associations between clinical training or experience and therapist performance. Existing approaches to therapist training often lack empirical underpinning and crucial questions remain unanswered: how best to train core skills in therapist, how to assure continued good performance, what is the role of supervision and personal therapy in professional development? The Psychological Sciences Research Institute (IPSY) has a tradition of developing training approaches for specific therapist skills such as helping skills (Jaeken et al., 2017), therapeutic attitudes and personality development (Brison et al., 2015) and case conceptualization (Philippot et al., 2019). Prof Emmanuelle Zech has developed an online training resource for the development of helping skills. Moreover, a unique infrastructure for training of and research into relational skills (labo des compétences relationnelles) has become available recently at IPSY.

Psychoanalytic clinical reasoning

Niccolò Polipo (2020-2024; supervised by Jochem Willemsen) is conducting a project on the use of psychoanalytic clinical reasoning for the purposes of case conceptualization and reflective practice. Using qualitative research methods, the research team has developed an empirically grounded model of the conceptual and reflective skills that analysts use in everyday practice in order to move from A (the raw clinical material) to B (an improved understanding of the clinical case at hand). Using quantitative research methods, the team is going to test whether a teaching module based on the model can enhance psychoanalytic clinical reasoning skills in trainee or practicing therapists through didactic teaching methods and distance learning. The ultimate aim is to explore whether a deliberate practice in psychoanalytic clinical reasoning skills can improve the training and continuing professional development of future generations of mental health professionals.

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Key paper:

Personal and professional development of psychotherapists

Hubert de Condé (started in 2020; co-supervised by Emmanuelle Zech and Jochem Willemsen) will explore the integration of personal and professional experiences in therapists and how this integration leads to changes in profession practices. In particular, the project aims to investigate a model regarding the personal and professional development of the person-of-the-therapist. In this circular and reflective model, it is assumed that the personal and professional development is driven by significant events (like personal and professional experiences), which lead to the development of reflexivity. In turn, reflexivity gives rise to the development of a Way of Being (both professional / therapeutic and personal), which can have several outcomes (positive or negative). This model will be investigated through several cross-sectional and longitudinal qualitative studies with trainees and qualified psychotherapists from different theoretical orientations.

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Key paper:

  • de Condé, H., Zech, E., & Willemsen, J. (2024). The person behind the therapist: a recall study on significant events that contribute to therapists’ personal and professional development. Research in Psychotherapy: Psychopathology, Process and Outcome, 27(2). https://doi.org/10.4081/ripppo.2024.791

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