| Nonlinear Dynamics, Psychology, and Life Sciences, Vol. 18, Iss. 2, Apr, 2014, pp. 155-176 @2014 Society for Chaos Theory in Psychology & Life Sciences Dynamic Patterns in Psychotherapy - Discontinuous Changes and Critical Instabilities during the Treatment of Obsessive Compulsive Disorder Abstract: In therapy processes of a variety of disorders, discontinuous trajectories of
symptom changes have been identified. In this study, we are reporting on such sudden gains
that occur in the treatment of clients with obsessive-compulsive disorder (OCD) following
cognitive-behavioral group therapy. Time series analysis of data taken from 18 OCD clients
revealed that a discontinuously shaped symptom reduction took place already before
exposure/response prevention (ERP) in a large number of clients. Coincidently with the
steepest gradient of symptom change an increased level of dynamic complexity in daily ratings of 47 items
of a specific change questionnaire was observed. Our results support hypotheses from the theory of
complex self-organizing systems, postulating nonstationarity and critical instabilities during order transitions.
Our study underlines the usefulness of real-time monitoring procedures with high-frequency ratings
(daily measurements) in therapeutic routine practice. Keywords: process-outcome research, sudden gains, obsessive-compulsive disorder, nonlinear dynamics, critical instability |