Narrative and clinical change in Cognitive Behavior Therapy: a comparison of two recovered cases

Psychotherapy research suggests that therapeutic change is associated with the emergence and development
of innovative moments (IMs)—that is, exceptions to the problematic self-narrative that
brought the client to therapy. This study compares two recovered cases of major depression, according
to symptom measures, that presented contrasting profiles of evolution of IMs: one typical
of successful therapy (Barbara), and another typical of unsuccessful therapy (Claudia). The core
conflictual relationship theme (CCRT) was used to study narrative change independently of the innovative
moments coding system (IMCS). The results suggest a high congruence between the IMCS
and the CCRT profiles. Although Barbara presented changes in the IMCS and the CCRT in a similar
way, Claudia’s self-narratives (IMs and CCRT), despite symptom change, did not change. The results
are discussed, considering the importance of narrative changes in recovery from depression and the
maintenance of therapeutic gains.
This article was supported by the Portuguese Foundation for Science and Technology (FCT), by the Grant PTDC/PSI-PCL/121525/2010 (Ambivalence and unsuccessful psychotherapy, 2012-
2015) and by the PhD Grant SFRH/BD/77324/2011.
This study was conducted at Psychology Research Centre, University of Minho, and supported
by the Portuguese Foundation for Science and Technology and the Portuguese Minister of Education
and Science through national funds and when applicable co-financed by FEDER under
the PT2020 Partnership Agreement (UID/PSI/01662/2013).