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Aim: Mixed-methods approaches promise a deep understanding of psychotherapeutic processes. This study uses qualitative and quantitative data from daily diary entries and daily self-assessments during inpatient treatment. The aim of the study is to get an insight into the similarities and differences between both types of data and how they represent self-organized pattern transitions in psychotherapy. While a complete correlation of results is not expected, we anticipate observing amplifying and subsidiary patterns from both perspectives., Materials and Methods: Daily, five MDD patients wrote diaries and completed self-assessments using the Therapy Process Questionnaire, a questionnaire for monitoring the change dynamics of psychotherapy. The data were collected using the Synergetic Navigation System, an online tool for real-time monitoring. Diary entries of the patients described their experiences in everyday life. The qualitative text analysis was conducted using Mixed Grounded Theory, which provided categories representing the patients' ongoing experiences of transformation and stagnation. The time series data was analyzed using the dynamic complexity algorithm and the pattern transition detection algorithm. Results from qualitative and quantitative analyses were combined and compared. Following the process of data triangulation, the leading perspective came from the theory of self-organization. In addition to presenting the overall results for all five patients, we delve into two specific case examples in greater detail., Results: Specific and highly diversified diary entries of 5 patients were classified into the categories of perceived pattern stability, noticing improvement, broadening the perspective, critical instability, and experiencing moments of Kairos. Patients reported problems not only related to their disorder (e.g., lack of energy and hopelessness) but also to phases and steps of change, which could be related to the theory of self-organization (e.g., problem attractors, critical fluctuations, pattern transitions, and Kairos). Qualitative and quantitative analysis provide important supplementary results without being redundant or identical., Conclusion: Data triangulation allows for a comprehensive and multi-perspective understanding of therapeutic change dynamics. The different topics expressed in the diary entries especially help to follow micro-psychological processes, which are far from being a simple reaction to interventions. The way patients experience themselves being in stability or instability and stagnation or transformation is surprisingly close to the general features of self-organizing processes in complex systems., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Nordholt, Garrison, Aichhorn, Ochs and Schiepek.)

Many eye-tracking studies investigate visual behavior with a focus on image features and the semantic content of a scene. A wealth of results on these aspects is available, and our understanding of the decision process where to look has reached a mature stage. However, the temporal aspect, whether to stay and further scrutinize a region (exploitation) or to move on and explore image regions that were yet not in the focus of attention (exploration) is less well understood. Here, we investigate the trade-off between these two processes across stimuli with varying properties and sizes. In a free viewing task, we examined gaze parameters in humans, involving the central tendency, entropy, saccadic amplitudes, number of fixations and duration of fixations. The results revealed that the central tendency and entropy scaled with stimulus size. The mean saccadic amplitudes showed a linear increase that originated from an interaction between the distribution of saccades and the spatial bias. Further, larger images led to spatially more extensive sampling as indicated by a higher number of fixations at the expense of reduced fixation durations. These results demonstrate a profound shift from exploitation to exploration as an adaptation of main gaze parameters with increasing image size.