Development and Case Study Application of a Proxy-Generated Outcome Measure of Suffering for use with Clients with Illusory Mental Health

Main Article Content

Giulia Guglielmetti
Enrico Benelli

Abstract

The concept of illusory mental health is described as the rationale for needing an approach for working with individuals who are unaware of their suffering and are therefore unable to describe their problems through self-report instruments. The use of a nomothetic approach using self-report or clinician-generated standardised instruments is compared with an idiographic approach for working with such individuals. A case study is used to illustrate the development and first application of a Proxy-Generated Outcome Measure  (PGOM) that allows clinicians, observers and researchers to trace an individualised understanding of a client’s core sufferings and changes occurring during the process of psychotherapy. A comparison with a nomothetic outcome measure is also presented.

Article Details

How to Cite
Guglielmetti, G., & Benelli, E. (2020). Development and Case Study Application of a Proxy-Generated Outcome Measure of Suffering for use with Clients with Illusory Mental Health. International Journal of Transactional Analysis Research & Practice, 11(1), 32–57. https://doi.org/10.29044/v11i1p32
Section
Articles
Author Biographies

Giulia Guglielmetti

Clinical psychologist, masters degree in Dynamic Clinical Psychology at the University of Padua.

Enrico Benelli, University of Padua

PhD, Provisional Teaching and Supervising Transactional Analyst (Psychotherapy) (PTSTA-P), Vice-President of CPD (Centre for Dynamic Psychology) in Padua (Italy), Adjunct Professor of Dynamic Psychology, University of Padua

References

Allport, G. (1960). Personality and social encounter. Boston: Beacon Press.

American Psychiatric Association. (2013). The Diagnostic and Statistical Manual of Mental Disorders (5th Ed.). Washington, DC: Author. https://doi.org/10.1176/appi.books.9780890425596

Barisone, M. G., Lerda, S., Ansaldi, S., De Vincenzo E., & Angelini, G. (2004). Psychopathology and epilepsy: clinical experience in a centre for the diagnosis and care of epilepsy. Journal of Psychopathology, 10 (3). https://www.jpsychopathol.it/issues/2004/vol10-3/barisone.html accessed 22 February 2020

Beck, A. T., Steer, R. A., & Brown, G. K. (1996). BDI-II, Beck Depression Inventory: Manual (2nd ed.). Boston: Harcourt Brace. https://doi.org/10.1037/t00742-000

Benelli, E., De Carlo, A., Biffi, D., & McLeod, J. (2015). Hermeneutic Single Case Efficacy Design: A systematic review of published research and current standards. Testing, Psychometrics, Methodology in Applied Psychology, 22, 97-133. DOI:10.4473/TPM22.1.7

Bohart, A. C, Berry, M., & Wicks, C. (2011). Developing a Systematic Framework for Utilizing Discrete Types of Qualitative Data as Therapy Research Evidence. Pragmatic Case Studies in Psychotherapy, 7 (1), Article 9, 145-155. https://doi.org/10.14713/pcsp.v7i1.1076

Bohart, A.C., Tallman, K.L., Byock, G., & Mackrill, T. (2011). The "Research Jury" Method: The application of the jury trial model to evaluating the validity of descriptive and causal statements about psychotherapy process and outcome. Pragmatic Case Studies in Psychotherapy, 7 (1), Article 8, 101-144. https://doi.org/10.14713/pcsp.v7i1.1075

Bram, A.D., Gottschalk, K.A., & Leeds, W.M. (2018). Chronic fatigue syndrome and the somatic expression of emotional distress: Applying the concept of illusory mental health to address the controversy. Journal of Clinical Psychology. https://doi.org/10.1002/jclp.22692

Caputo, A. (2017). Social desirability bias in self-reported well-being measures: evidence from an online survey. Universitas Psychologica, 16(2), 1-13. https://doi.org/10.11144/Javeriana.upsy16-2.sdsw

Cousineau, T. M., & Shedler, J. (2006). Predicting physical health: implicit mental health measures versus self-report scales. The Journal of Nervous and Mental Disease, 194 (6), 427- 432. https://doi.org/10.1097/01.nmd.0000221373.74045.51

Dazzi, N., Lingiardi, V., & Gazzillo, F. (2009). La diagnosi in psicologia clinica. Personalità e psicopatologia. Milano: Raffaello Cortina.

Elliott, R., Shapiro, D. A., & Mack, C. (1999). Simplified Personal Questionnaire procedure manual. Toledo, OH: University of Toledo.

Elliott, R., Slatick, E., & Urman, M. (2001). Qualitative change process research on psychotherapy: Alternative strategies. Psychologische Beiträge, 43, 69-111.

Elliott, R., Wagner, J., Sales, C. M., Rodgers, B., Alves, P., & Café, M. (2016). Psychometrics of the Personal Questionnaire: A client-generated outcome measure. Psychological Assessment, 28 (3), 263-278. https://doi.org/10.1037/pas0000174

Evans, C., Connell, J., Barkham, M., Margison, F., Mellor-Clark, J., McGrath, G., e Audin, K. (2002). Towards a standardised brief outcome measure: Psychometric properties and utility of the CORE-OM. British Journal of Psychiatry, 180, 51-60. https://doi.org/10.1192/bjp.180.1.51

Ghisi, M., Flebus, G. B., Montano, A., Sanavio, E., & Sica, C. (2006). Beck Depression Inventory-Second Edition. Adattamento italiano: Manuale. Firenze: Organizzazioni Speciali (O-S).

Gordon, R. M. & Bornstein, R. F. (2015). Brief Manual for the Psychodiagnostic Chart-2 (PDC-2) A Practical Tool to Operationalize the PDM-2 and Integrate It with the ICD and DSM. https://www.researchgate.net/publication/288004361_Brief_Manual_for_the_Psychodiagnostic_Chart-2_PDC-2_A_Practical_Tool_to_Operationalize_the_PDM-2_and_Integrate_It_with_the_ICD_and_DSM accessed 22 February 2020

Gordon, R. M., & Bornstein, R. F. (2012). The Psychodiagnostic Chart: A practical tool to integrate and operationalize the PDM with the ICD or DSM. Retrieved from http://www.mmpiinfo.com/pdm-blog - no longer accessible 22 February 2020

Gordon, R. M. & Bornstein, R. F. (2015). The Psychodiagnostic Chart-2 v.8.1 (PDC-2), DOI: 10.13140/RG.2.1.3905.4169.

Gordon, R. M., & Bornstein, R. F. (2018). Construct Validity of the Psychodiagnostic Chart: A Transdiagnostic Measure of Personality Organization, Personality Syndromes, Mental Functioning, and Symptomatology. https://doi.org/10.1037/pap0000142

Grice, J. W. (2004). Bridging the Idiographic-Nomothetic divide in ratings of self and others on the Big Five. Journal of Personality, 72 (2), 203-241. https://doi.org/10.1111/j.0022-3506.2004.00261.x

Hamilton, M. A. (1960). Hamilton Depression Rating Scale (HDRS). J Neurol Neurosurg Psychiatry, 23: 56-62. https://doi.org/10.1136/jnnp.23.1.56

Huprich, S. K., McWilliams, N., Lingiardi, V., Bornstein, R. F., Gazzillo, F., & Gordon, R. M. (2015). The Psychodynamic Diagnostic Manual (PDM) and the PDM-2: Opportunities to significantly affect the profession. Psychoanalytic Inquiry, 35, 60-73.

https://doi.org/10.1080/07351690.2015.987594

Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12-19. https://doi.org/10.1037/0022-006X.59.1.12

Lingiardi, V., & McWilliams, N. (2017). Psychodynamic Diagnostic Manual: Second Edition (PDM-2). New York: Guilford Press.

Lingiardi, V., McWilliams, N., Bornstein, R. F., Gazzillo, F., & Gordon, R. M. (2015). The Psychodynamic Diagnostic Manual Version 2 (PDM-2): Assessing patients for improved clinical practice and research. Psychoanalytic Psychology, 32(1), 94-115. https://doi.org/10.1037/a0038546

Loomis, M. E. (1982). Contracting for change. Transactional Analysis Journal, 12 (1), 51-54. https://doi.org/10.1177/036215378201200107

McLeod, J. (2001). An administratively created reality: Some problems with the use of self-report questionnaire measures of adjustment in counselling/psychotherapy outcome research. Counselling and Psychotherapy Research, 1 (3), 215-226. https://doi.org/10.1080/14733140112331385100

McLeod, S. A. (2007). Nomothetic idiographic debate. Retrieved from https://www.simplypsychology.org/nomothetic-idiographic.html

Millon, T. (1991). Classification in psychopathology: Rationale, alternatives, and standards". In Journal of Abnormal Psychology, 100(3), 245-261. https://doi.org/10.1037/0021-843X.100.3.245

Pagnini, F., Gibbons, C. J., & Castelnuovo (2012). The importance of an idiographic approach for the severe chronic disorders - the case of the amyotrophic lateral sclerosis patient. Frontiers in Psychology, 3: 509. https://doi.org/10.3389/fpsyg.2012.00509

Palmieri, G. (2011). La valutazione degli interventi psicologici tramite il CORE-OM. Unpublished document from the conference at Casa di Cura Villa Igea, Trieste.

Paulhaus, D. L. (1986). Self-deception and impression management in test responses. In Angleitner A and Wiggins JS (eds) Personality Assessment via Questionnaires: Current Issues in Theory and Measurement. Berlin: Springer-Verlag. https://doi.org/10.1007/978-3-642-70751-3_8

Reich, R. R., Below, M. C., & Goldman, M. S. (2010) Explicit and Implicit Measures of Expectancy and Related Alcohol Cognitions: A Meta-Analytic Comparison. Psychology of Addictive Behaviors, 24 (1), 13-25. https://doi.org/10.1037/a0016556

Shedler, J., Mayman, M., & Manis, M. (1993). The illusion of mental health. American Psychologist, 48 (11), 1117-1131. https://doi.org/10.1037/0003-066X.48.11.1117

Shedler, J., Karliner, R. and Katz, E. (2003). Cloning the clinician: A method for assessing illusory mental health. Journal of Clinical Psychology, 59(6), 635-650. https://doi.org/10.1002/jclp.10148

Sinha, N., & Glass A. (2017). Dissociating medial temporal and striatal memory systems with a same/different matching task: Evidence for two neural systems in human recognition. Journal of General Psychology, 144, 110 - 129. https://doi.org/10.1080/00221309.2016.1276044

Spielberger, C. D., Gorsuch, R. L., Lushene, R., Vagg, P. R., e Jacobs, G. A. (1983). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.

Spitzer, R. L., Kroenke, K., & Williams, J. B. (1999). Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Journal of the American Medical Association. Nov 10; 282:18, 1737-44. https://doi.org/10.1001/jama.282.18.1737

Subic-Wrana, C., Bruder, S., Thomas, W., Lane, R., Köhle, K. (2005). Emotional Awareness Deficits in Inpatients of a Psychosomatic Ward: A Comparison of Two Different Measures of Alexithymia. Psychosomatic Medicine, 67 (3):483-489. https://doi.org/10.1097/01.psy.0000160461.19239.13

Ward, G., & McLeod, J. (2018, June). Case analysis of sources of outcome data in pluralistic counselling for a client suffering from childhood trauma. Paper delivered at Society for Psychotherapy Research Annual Conference, Amsterdam.

Westen, D., Gabbard, G., & Blagov, P. (2006). Back to the future: Personality structure as a context for psychopathology. In R. F. Krueger & J. L. Tackett (Eds.), Personality and psychopathology: Building bridges (pp. 335-384). New York: Guilford Press.

Westen, D., & Shedler, J. (2007). Personality diagnosis with the Shedler-Westen Assessment Procedure (SWAP): integrating clinical and statistical measurement and prediction. Journal of Abnormal Psychology, 116: 810-822. https://doi.org/10.1037/0021-843X.116.4.810

Widdowson, M. (2012c). TA treatment of depression: a hermeneutic single-case efficacy design study- case three: "Tom". International Journal of Transactional Analysis Research, 3 (2), 15-27. https://doi.org/10.29044/v3i2p15

Widdowson, M. (2014). Transactional analysis psychotherapy for a case of mixed anxiety & depression: A pragmatic adjudicated case study - 'Alastair''. International Journal of Transactional Analysis Research, 5 (2), 66-76. https://doi.org/10.29044/v5i2p66

Wineke, J., Eurelings-Bontekoe, E., Dijke, A.V., Moene, F., Gool, A.V. (2015). Do Patients with Somatoform Disorders Present with Illusory Mental Health? Journal of Psychology & Psychotherapy 5: 213. https://doi.org/10.4172/2161-0487.1000213

World Health Organisation (1992) ICD-10 Classification of Mental and Behavioural Disorders. Geneva: Author.

Most read articles by the same author(s)

1 2 > >>