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The field of psychotherapy has developed through several decades, and a variety of psychotherapeutic methods exist. Research on outcome and process is necessary for making recommendations for future practice to improve the individual’s mental health. There is a need for more research measuring process and change in psychotherapy with young people. In this thesis data from two randomized clinical trials designed to measure effects of a specific technique, transference work, in dynamic psychotherapy is used; FEST (the First Experimental Study of Transference-interpretations) and FEST-IT (the First Experimental Study of Transference Work – In Teenagers). The main objective was to investigate use of different methods for measuring process and change in psychodynamic therapy with adults and adolescents. A combination of quantitative approach and in-depth qualitative analysis of a single adolescent patient case was used in paper I. The therapist flexibly adjusted different psychotherapeutic techniques in the therapeutic work. Measurements being specific and non-specific (pan-theoretical) to psychodynamic therapy revealed different aspects of the process leading to change. An instrument for assessment of specific change in dynamic psychotherapy (Psychodynamic Functioning Scales; PFS) was evaluated for use in adolescent psychotherapy (paper II). The interrater reliability was good. The “dynamic capacity” measured with PFS differs from general symptom-measures. However, possible differences in measuring e.g. insight in adolescents and adults are discussed. Paper III describes the development of a psychotherapy process rating scale focusing on patients’ relationships outside therapy (Relational Work Scale). Detailed measurement of process and change contribute to further answers to the main research questions: what leads to change and what works for whom?

Additional file 1. Scales developed to assess change in dynamic psychotherapy.

Relational Work Scale (RWS). (DOCX 16Â kb)