Are "self-organizing" psychotherapy systems more succesful? A systems theory analysis

Background: According to system theories, psychotherapy is conceptualized as a process of self-organization. Within this process, the systems' components tend to synchronize increasingly. As Tschacher & Grawe (1996) have pointed out, this may reduce the number of dimensions underlying the system description. We asked whether these results and the interpretation of self-organization would be confirmed by another sample and whether self-organization may be correlated with success of therapy. Methods: Session protocols of 16 courses of therapy were analyzed. Factor analysis (Cattel's O technique) we revealed the dimensional structure of response patterns for each of the first and last of 20 sessions. Patients with and without a reduced number of factors were compared with regards to the reduction of the number and severity of psychopathological symptoms, attainment, therapeutic goals, and interpersonal problems. Results: The number of dimensions that were required to describe the therapeutic sessions was reduced. Patients from systems with low self-organization potential showed less conflict potential in their interacting behavior. Conclusions: The concept of self-organization does not seem to be useful in describing and explaining the relationship between process and outcome parameters in psychotherapy. The method of assessing self-organization that was chosen may have contributed to the weak relationship between therapy process and outcome.