The process of change in psychotherapy with a pregnant patient following perinatal losses: An analysis of a case study

Keren Cohen, Liat Leibovich, Rayna Markin, Sigal Zilcha-Mano

Research output: Contribution to journalArticlepeer-review

Abstract

Aim: Despite research suggesting increased anxiety and depressive symptoms after a perinatal loss and during future pregnancies, little knowledge exists to guide clinicians treating pregnant women after perinatal loss. This case study explores processes that facilitated therapeutic change for a pregnant patient with major depressive disorder (MDD) and posttraumatic stress disorder after perinatal losses. Method: The study integrated quantitative and narrative analyses in a single case derived from the pilot phase of a randomized controlled trial on supportive-expressive therapy for MDD. Results: The quantitative and narrative analyses suggest that an improvement in maladaptive interpersonal patterns toward the therapist, in the form of attachment avoidance, made it possible to form a strong alliance, which in turn led to a successful outcome. Conclusions: The findings highlight the importance of improving maladaptive interpersonal patterns as a prerequisite to enable patients after pregnancy losses to develop and maintain a corrective therapeutic experience.

Original languageEnglish
Pages (from-to)874-885
Number of pages12
JournalJournal of Clinical Psychology
Volume75
Issue number5
DOIs
StatePublished - May 2019

Bibliographical note

Funding Information:
The writing of this paper was supported by the Israel Science Foundation (ISF).

Publisher Copyright:
© 2019 Wiley Periodicals, Inc.

Keywords

  • alliance
  • interpersonal patterns
  • major depressive disorder
  • perinatal loss
  • psychotherapy
  • supportive-expressive therapy

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Psychology

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