Current strands
1. Dynamics of the working case formulation
An empirical project based on session-by-session analysis of psychotherapy recordings, anonymised with the written consent of patients and therapists. The aim is to describe at which moments in a session a clinician's working formulation undergoes a visible shift, what specific data trigger the shift, and how subsequent intervention strategy changes. Of particular interest is the asymmetry of revision: under what conditions a clinician readily abandons an initial hypothesis, and under what conditions she holds it despite disconfirming data.
2. Anchoring on the initial formulation
A series of vignette studies with practising psychotherapists. Participants are presented with an unfolding case; in one group, the first batch of data deliberately points toward one diagnostic frame, in the other, toward an alternative. In subsequent stages the data become identical across groups. The measure is the extent to which the initial frame continues to influence the interpretation of later, identical data.
3. Comparing supervision models
A joint project with the Moscow node comparing three models of group clinical supervision — psychodynamic, cognitive-behavioural, and integrative — in terms of inter-rater agreement on diagnostic conclusions and treatment plans among supervisees. The primary hypothesis is that different models do not so much improve the "accuracy" of appraisals as they systematically displace them in characteristic directions.
4. Cognitive maps of sequential decisions
Methodological work on a format for representing chains of clinical decisions in written supervision. We are developing a compact notational language in which the working formulation, observations, alternative hypotheses, and intervention decisions are recorded uniformly. The intended use is in training junior clinicians and in retrospective audit of complex cases.
5. Affective tone and substantive interpretation
A controlled experiment in which the same transcript of a conversation with a patient is read aloud by two professional actors with different emotional tones. Clinicians hear one of the two versions and then formulate an initial appraisal and a plan for the next steps. We study how acoustic features, formally unrelated to content, systematically displace substantive interpretation.
Applied outputs
Several active strands aim, alongside research findings, at methodological by-products — materials for supervision and self-audit of practice:
- A map of typical biases in sequential diagnostic decisions (draft available within the network).
- A short guide to structured discussion of difficult cases (in preparation).
- A checklist for revising the working formulation in ongoing therapy (released, see Publications).
Limitations
Most of our data have been collected in relatively narrow contexts: Finnish-language and Russian-language outpatient psychotherapy, particular supervision models, predominantly individual work with adults. Transferring our observations to other populations (children and adolescents, group therapy, other cultural settings) requires caution and dedicated empirical grounding.