Resolving interpersonal conflicts: An analysis of stylistic consistency.

In three experiments, we examined people's consistency in their styles of resolving interpersonal conflicts. In Experiment 1, 40 Yale undergraduates described recent significant interpersonal conflicts with a same-sex peer, an opposite-sex peer, and a parent, and their methods of resolving these conflicts. They then rated the extent to which each of seven styles of conflict resolution characterized their actual and ideal styles of conflict resolution. In Experiment 2, 40 Yale summer school subjects again described and rated their own methods for resolving recent significant interpersonal conflicts with a parent, a teacher, a roommate, and a romantic partner. They also rated styles of conflict resolution for hypothetical conflicts involving these same significant others. In Experiment 3, 40 Yale undergraduates rated actual and ideal styles of conflict resolution as they pertained to both sides of two real conflicts: one regarding a contract dispute between Yale University and Local 34, the union for clerical and technical workers, and the other between the United States and the Soviet Union over arms negotiations. Strong consistencies in styles of conflict resolution were observed within individuals across various interpersonal conflicts, and at the same time widespread differences were observed across individuals in preferred styles of conflict resolution. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Internalization of interpersonal process in time-limited dynamic psychotherapy.

[Correction Notice: An erratum for this article was reported in Vol 31(3) of Psychotherapy: Theory, Research, Practice, Training (see record 2009-17141-002). This article contained, as Figure 1, an SASB model. The authorship and copyrights for the model were not acknowledged. The following acknowledgement should have been included: "Adapted from Benjamin (1984). Principles of Prediction using Structural Analysis of Social Behavior (SASB). In R. A. Zucker, J. Aronoff, and A. J. Rabin (Eds.), Personality and the Prediction of Behavior (pp. 121- 174). New York: Academic." An apology is offered to the author, Dr. Lorna Smith Benjamin. The particular version used in the article was developed in collaboration with Clinton W. McLemore.] Investigated the internalization of positive aspects of therapist–patient (TP) interactions among 70 patients and their 16 therapists who participated in a 5-yr study (H. H. Strupp et al, unpublished) of time-limited dynamic psychotherapy. Patients sought help for anxiety, depression, or other problems with a clear interpersonal component and qualified for an Axis I or Axis II diagnosis on the Diagnostic and Statistical Manual of Mental Disorders-III (DSM-III). Instruments included the Structural Analysis of Social Behavior and outcome measures of depression, anxiety, and psychological functioning. Patients' intrapsychic functioning became more similar to interpersonal activity in the TP relationship over the course of psychotherapy. Intrapsychic movement toward interpersonal activity in the TP relationship was associated with positive outcome on measures of depression, anxiety, and on independent clinician ratings of patient psychological functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Homework in interpersonal psychotherapy (IPT): Rationale and practice.

Interpersonal therapy (IPT) is a time-limited therapy that was initially created for the treatment of major depressive disorder but has shown efficacy in other psychiatric disorders and a variety of populations. The present article is divided in two parts. The first part summarizes the structure, phases, and techniques of IPT and presents the four problem areas that are used as possible foci for the therapy. The second part presents the rational for use of homework and illustrates the use of homework in a variety of situations, with different types of patients suffering from acute and chronic forms of mood and anxiety disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clients' pretherapy interpersonal attitudes and psychotherapy outcome.

Investigated whether 55 outpatient counseling clients' (aged 16–57 yrs) pretherapy scores on affiliation–hostility and dominance–submission dimensions of the Interpersonal Check List (ICL) would be related to outcome of therapy. Ss, who received an average of 24 sessions, completed the ICL both pre- and posttherapy. Ss whose therapy was successful, as rated by both therapist and client, were significantly more affiliative (less hostile) than were less-than-successful therapy clients both pre- and posttherapy. 21 of 29 Ss whose predominant pretherapy interpersonal stance was characterized as affiliative had successful outcomes, whereas only 10 of 26 Ss whose predominant pretherapy interpersonal stance was characterized as hostile had successful outcomes. No significant differences were observed between outcome groups on the dominance–submission dimension either pre- or posttherapy. However, as expected, a significant number of successful therapy Ss showed a pre- vs posttherapy shift in their interpersonal stances from submission to dominance. Results highlight the reported difficulty of short-term dynamic psychotherapy with hostile clients and suggest the importance of assessing clients' pretherapy interpersonal attitudes as 1 influence on therapeutic process and outcome. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dimensions of interpersonal facilitation in psychotherapy and child development.

A survey of studies on the consequences of relational dimensions (active expressiveness vs. passive restrictedness and acceptance vs. rejection) for counseling-psychotherapy processes and outcomes suggests that optimal effects occur under conditions of active engagement in the context of positive regard. The 2-dimensional model suggests resolutions of some inconsistent findings and defines some areas needing more direct study. Comparison with findings on parent-and teacher-offered conditions upon child development lends support to the generality of the model for interpersonal facilitation and suggests research explorations of new treatment-training modes. (3 p. ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dynamic factors in patient assessment and prediction of change in short-term dynamic psychotherapy.

Assessed 25 outpatients via the Rorschach assessment prior to short-term, dynamic therapy to see whether patient characteristics would predict outcome in intrapsychic organization, as measured with L. S. Benjamin's (see record 1975-02991-001) Structural Analysis of Social Behavior (SASB). SASB and other outcome measures were administered after termination of psychodynamic therapy. Findings show good predictive value of the Rorschach developmental dimensions Differentiation and Articulation in predicting an Introject change outcome index. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive change processes in psychotherapy.

Several types of cognitive-behavioral therapy are now practiced that use different sets of theoretical concepts and propose different kinds of change mechanisms. None, however, is directly grounded in experimental research in cognitive and social psychology, and few address basic issues such as the relevance of conscious versus nonconscious cognitive processes and the validity of the self-report data on which therapy depends. Put forward in this article is a model that describes the conscious and nonconscious processing of emotional stimuli and distinguishes between knowledge that is verbally accessible and knowledge that can only be recovered by exposure to situational cues. Also proposed are three mechanisms of cognitive change that involve altering verbally accessible knowledge, the accessibility of nonconscious situational memories, and self-regulatory strategies. These mechanisms are related to the current practices of behavioral and cognitive-behavioral therapies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dependency changes in psychotherapy as related to interpersonal relationships.

Studied 60 tape-recorded psychotherapy sessions representing the 1st, middle, and next to last interviews with 20 clients. Raters classified S's dependency statements with respect to the category of interpersonal relationships involved. While dependency statements involving the formal structure of the relationship decreased throughout therapy, dependency involving family relationships initially decreased then stabilized. Dependency statements involving the relationship between S and therapist 1st increased and then also stabilized. Dependency in social relationships remained constant through the middle phase, then decreased through the termination of therapy, suggesting a relatively specific resolution of dependency needs and conflicts. Additional data suggest that early termination and unsuccessful therapy experience is related to the early development of intense dependency by Ss. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist competence and patient outcome in interpersonal psychotherapy of depression.

This article examines whether the therapist's level of competence in conducting interpersonal psychotherapy of depression (IPT) is associated with patient improvement. Data from 35 depressed outpatients treated for up to 16 sessions as part of the IPT training program for the National Institute of Mental Health Treatment of Depression Collaborative Research Program were used. Multiple regression analyses were performed to predict outcome from 4th-session ratings of therapist skill while controlling for important pretreatment patient characteristics including level of depression, social adjustment, and expectations of treatment outcome. The results showed that measures of therapist performance contributed significantly to the prediction of patient-rated change and change in the apathy associated with depression but not to measures of social adjustment at 16 weeks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the cognitive structure of interpersonal problems treated in psychotherapy.

Examined problems in the general form "I can't . . . (do something)" that were mentioned in intake interviews by 28 patients about to begin psychotherapy. Each complaint was simplified to highlight the problem behavior, and 50 undergraduates classified the problem behaviors into semantic categories. From the results of this classification, a matrix was formed to show how often each 2 problem behaviors were classified together. This matrix was then subjected to a multidimensional scaling, which yielded three dimensions: (a) the degree of psychological involvement between the S and the other person; (b) the nature of the involvement (friendly to hostile); and (c) the S's intention to influence, change, or control the other person. In addition, a cluster analysis was performed to show the major clusters of problem behaviors (i.e., intimacy, aggression, compliance, independence, and sociability). Implications for psychotherapy research are also discussed. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stages of change in psychotherapy: A follow-up report.

327 adult outpatients (aged 18–62 yrs) completed the Stages of Change (SOC) Scales (E. A. McConnaughy et al; see record 1984-11195-001), the Millon Clinical Multiaxial Inventory, and a symptom checklist battery during intake. Results confirm the McConnaughy et al findings that the SOC Scales provide a reliable method of measuring SOC in psychotherapy. Four distinct stages (precontemplation, contemplation, action, and maintenance) and 8 stage profiles emerged. Despite differences between degree of psychopathology in the 2 studies' populations, the SOC emerged as a reliable phenomenon for clients entering therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of conducting psychotherapy on psychotherapists' interpersonal functioning.

Reviews the literature and presents several scenarios concerning the impact of practicing psychotherapy on the psychotherapist, focusing on the effects on their interpersonal functioning. Findings reveal such positive consequences of practicing psychotherapy as increased assertiveness, self-assurance, self-reliance, and self respect; negative consequences include increased anxiety and higher suicide and alcoholism rates. Ways to minimize or eliminate possible negative consequences are suggested, including alerting psychotherapists to the potential problems, more adequate screening and monitoring of allied mental health professionals at the pre- and postgraduate level, and monitoring of professionals in the field by postgraduate professional organizations. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relation between specific and general dimensions of the psychotherapy process in interpersonal psychotherapy of depression.

This article examines the relation between general dimensions of the psychotherapy process, rated with the Vanderbilt Psychotherapy Process Scale (VPPS), and a type of manual-guided psychotherapy, Short-Term Interpersonal Psychotherapy of Depression (IPT). With the use of data from a training program in IPT, two types of analyses were performed. First, VPPS factors were correlated with IPT therapist competence ratings. This analysis showed that all VPPS-rated dimensions of patient and therapist behaviors were significantly correlated with IPT competence ratings. Especially strong correlations occurred between IPT competence ratings and the VPPS therapist factors of (a) Exploration and (b) Warmth and Friendliness. Second, to evaluate whether the general process features that influenced IPT competence ratings were also related to the therapy's effectiveness, correlations between VPPS process dimensions and patient outcome were performed. This analysis indicated that VPPS-rated therapist behaviors were significantly predictive of patient outcome, whereas patient behaviors were generally not significantly related to outcome. Taken together, the findings indicate the importance of general aspects of the psychotherapy process in therapist evaluation and efficacy of manual-guided psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The therapeutic context: Preconditions for change in psychotherapy.

Discusses 4 aspects of therapeutic context: therapeutic alliance, client's expectations of change, treatment rationale, and therapeutic impact. To illustrate the central role of the therapeutic context in treatment outcome, a clinical case is discussed in which systematic desensitization was used to treat a choking phobia. Throughout the therapy process, there was minimal client collaboration and the treatment failed to produce any symptom change. However, significant improvement did occur subsequent to an event high in therapeutic impact that provided a plausible treatment rationale to the client, increased the client's expectation of change, and established a therapeutic alliance. This case illustrates the importance of relationship and context in psychotherapeutic change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Quantitative assessment of interpersonal themes over the course of psychotherapy.

Analyzed the narrative episodes told by a man in brief dynamic psychotherapy, using the Quantitative Assessment of Interpersonal Themes (QUAINT). Focus was on whether 1 main theme or a variety of themes existed in the narrative and whether transfer of the S's relationship theme(s) transferred to the therapist either early or later in therapy. Data are consistent with modes that emphasize the complexity and multiplicity of relationship patterns. There was evidence that more of the negative transference pattern was apparent during the 2nd half of treatment. Methodological implications and the performance of the QUAINT are addressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Frequency of treatment and change in psychotherapy.

To test the hypothesis that frequency of weekly interview has a selective effect on psychological changes in patients in individual psychotherapy, 133 VA outpatients were randomly assigned to 3 schedules: twice, once, and bi-weekly. Changes were measured by tests based on objective evaluation of personality characteristics and assessed after 4 mo., 8 mo., and 12 mo. of therapy. The results failed to confirm that there was any major support for the hypothesis that frequency of contact produced differences in personality changes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stages of change in psychotherapy: Measurement and sample profiles.

Developed a test designed to measure 4 stages of change hypothesized to account for a temporal dimension in the change process occurring in psychotherapy: (1) precontemplation, (2) contemplation, (3) action, and (4) maintenance. An initial pool of items was reduced to a final test of 32 items on the basis of principal components analysis, Chronbach's coefficient alpha, and item analysis results. 155 Ss commencing psychotherapy were administered the questionnaire; they returned it before their 3rd therapy session. A cluster analysis was performed on the standardized scores for each S on each of the 4 scales. The resulting 18-cluster solution produced 7 major and 2 minor client profiles that were highly distinct and that represented 90% of the Ss. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adapting interpersonal psychotherapy for older adults at risk for suicide: Preliminary findings.

We report preliminary findings of the first-ever study testing a 16-week course of interpersonal psychotherapy (IPT) modified for older outpatients at elevated risk for suicide. Participants were referred from inpatient and outpatient medicine and mental health services. Psychotherapy sessions took place in a therapist’s office in a teaching hospital. Twelve adults 60 years or older (M = 70.5, SD = 6.1) with current thoughts of suicide (suicide ideation), a wish to die (death ideation), or with recent self-injurious behavior were recruited into weekly sessions of IPT; 1 participant was subsequently excluded due to severe cognitive impairment. Participants completed measures of suicide ideation, death ideation, and depressive symptom severity at pretreatment, midtreatment, posttreatment, and at 3-month follow-up periods, and measures of therapeutic process variables. Preliminary findings of this uncontrolled pretreatment/posttreatment study support the feasibility of recruiting and retaining older adults at risk for suicide into psychotherapy research and suggest that adapted IPT is tolerable and safe. Findings indicate a substantial reduction in participant suicide ideation, death ideation, and depressive symptoms; controlled trials are needed to further evaluate these findings. We discuss implications for clinical care with at-risk older adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An interpersonal approach to psychotherapy with older persons with dementia.

This article presents theoretical and practical information about the application of Sullivanian interpersonal concepts of psychotherapy with persons with dementia. The approach focuses on management of anxiety in a therapeutic relationship. Anxiety is construed as the underlying cause of catastrophic reactions of dementia. The patient's premorbid personality and history affects manifestation of the dementia in terms of affect, cognition, and behavior. Thus, understanding the dementia in the context of the patient's entire life is seen as crucial for effective therapy. Case material and suggestions for conducting this form of treatment are offered. Finally, special problems in assessing the efficacy of psychotherapy for older persons with dementia are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of the longitudinal course of postpartum depression following interpersonal psychotherapy.

Objective: We examined the course and predictors of postpartum depression in the 18 months following interpersonal psychotherapy (IPT). Method: We enrolled 120 community women with major depression in a 12-week randomized trial of individual IPT during the postpartum period (O'Hara, Stuart, Gorman, & Wenzel, 2000). At 6, 12, and 18 months posttreatment, women participated in clinical interviews to establish the course of depression over the previous 6 months. We used survival analyses to characterize recovery and recurrence in the follow-up and growth curve modeling techniques to identify predictors of change in depression during the follow-up period. Potential predictors included severity, chronicity, and personal history of depression. Results: Of 35 women who recovered with acute treatment, 20 (57%) achieved sustained recovery during follow-up; average time to recurrence was 33.40 weeks (SD = 18.43 weeks). Over 80% of women who did not recover with acute treatment experienced recovery at some point during follow-up; average time to recovery was 28.60 weeks (SD = 17.51 weeks). Time depressed each month decreased over the follow-up period. Posttreatment depressive severity and length of the index episode predicted changes in depression over time. Posttreatment depression severity, personal history of depression, and weeks of treatment in the follow-up were significant predictors of time depressed during follow-up. Conclusions: IPT resulted in long-term benefits past the termination of acute treatment, even for women who did not initially recover. Though the vast majority of women who did not recover with acute treatment did recover during the follow-up period, continuation of IPT may accelerate the process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)