HYPOTHESIS AND THEORY article
Front. Psychiatry
Sec. Computational Psychiatry
A Transdiagnostic Conflict Square Algorithm: A Four Node Computational Framework for Psychotherapy and Functional Diagnosis
Kliniken Erlabrunn gGmbH, Breitenbrunn, Germany
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Abstract
Clinical services need more than categorical labels to guide safe dosing, maintain alliance, and plan functional recovery. The Conflict-Square Algorithm (CSA) offers a compact bedside grammar for moment-to-moment decisions during psychotherapy. Clinicians track four observable signals-Defense, Anxiety/Affect Tolerance, Progression, and Superego/Shame-and gate intervention intensity by three safety thresholds (A-C). Each clinically meaningful moment is summarized as one auditable episode line in plain language: trigger, observable response, threshold, action, and expected functional impact (Mini-ICF-APP). To strengthen reproducibility, we provide (i) operational threshold definitions with observable markers and common misclassification errors, grounded in established anxiety-channel descriptions (striated-muscle, smooth-muscle, cognitive-perceptual/CPD), (ii) a short scope and contraindication checklist, (iii) several consecutive worked micro-episodes demonstrating node shifts, threshold transitions, and dose modulation over time, and (iv) a minimal machine-readable schema plus a threshold-gating state diagram. As a proof-of-concept feasibility demonstration, we report aggregate coding statistics from three published psychotherapy training videos distributed by the ISTDP Institute (transcribed for analysis with written permission; N=2,809 speaker turns) using a three-label therapist intervention mapping (invite progression / defense work / anxiety regulation) aligned with CSA nodes. CSA is presented as a teachable, testable decision framework-not as a validated diagnostic instrument-and we outline a pragmatic validation program (rater agreement, safety-rule adherence, usability, and functional outcomes) and future multimodal extensions (e.g., optional physiological monitoring for biofeedback and threshold detection).
Summary
Keywords
Clinical Decision Rules, Computational Psychiatry, Conflict-Square Algorithm, human-in-the-loop, ICD-11 Severity, Mini-ICF-APP, Psychotherapy process, Safety thresholds
Received
17 August 2025
Accepted
17 February 2026
Copyright
© 2026 Niederlohmann. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Eik Niederlohmann
Disclaimer
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