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)     

Use of transference in short-term dynamic psychotherapy.

Reviews progress in the theory and technique of work with transference in short-term dynamic psychotherapy (STDP). It has been suggested that while the roots of current work with transference in STDP go back as far as Freud's original development of the construct, evolution in technique has been in need of clarification. Major challenges (e.g., S. Ferenczi, 1921 [1950]) to Freud's views are described. Transference work in major current approaches to STDP (e.g., D. Malan, 1963, 1976) is highlighted. Recommendations for working with transference in STDP stress an active, interpersonal approach to transference manifestations that act as resistance to the therapeutic focus. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceptions of the psychotherapy relationship in long- versus short-term therapy.

Examined participant perceptions of therapy by comparing long- with short-term therapy dyads. 30 therapy dyads from 3 large midwestern community mental health centers were included. Therapists and clients (20–49 yrs old) completed the Therapy Session Report 4 times and the Survey of Interpersonal Values twice immediately following scheduled therapy sessions. Results indicate that therapists and clients in long-term therapy dyads were more phenomenologically congruent in their feelings toward psychotherapy and each other and in their perceptions of therapeutic goals and processes than were therapists and clients in short-term therapy dyads. Often these perceptions were shared at the very outset of therapy. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The reunion process: A new focus in short-term dynamic psychotherapy.

Short-term dynamic psychotherapy (STDP) has established itself as an effective treatment for common psychological disorders, but little attention has been given to cases of treatment failure or relapse. In this article, I present a case of relapsing panic disorder. I suggest that STDP has focused mainly on the memories of disturbing past experience, but we have not systematically explored the positive memories of early attachment experiences. The negative memories are explored and processed until they are revised, resulting in less disturbing versions of the original events and new meanings for the patient. In the language of memory research, the patient has now established more than one memory trace of a particular situation, and the therapist hopes that the newer version will have "trace dominance"; that is, it will be the memory that governs the patient's behavior. In a new model called the reunion process, the therapist helps the patient reactivate and strengthen these distress associated with negative memories and experiences. positive memories to revise the internal working models of early attachment figures. The process also involves the use of imagined attachment scenarios that never actually happened to compensate for gaps in historical experience. The result is a sense of reunion with the patient's parents, and the internalization of an affect-regulating process to calm the distress associated with negative memories and experiences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Teaching and learning short-term dynamic psychotherapy: Parallel processes.

Examines the parallels between teaching and short-term therapy by characterizing the latter in terms of 4 categories—structure, attributes, actions, and experiences—and discusses the experience of teaching short-term dynamic psychotherapy in a didactic seminar. Student-therapists spontaneously introduce a time limit, experience anxiety, and resist change. The teacher-therapist forms a good learning alliance and interprets resistances and anxiety in a way that parallels the therapist's approach to the patient. A case study of consultation with a therapist treating a 23-yr-old male illustrates how the therapist can assimilate and act on the consultant's attitudes. The therapist used his experience with the consultant in order to understand the patient's experience with himself. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between GSR and speech disturbances in psychotherapy.

"… the relationship between points of emotional arousal or anxiety as defined by the GSR and the occurrence of speech disturbances in psychotherapy [was investigated]. Synchronized GSR and verbal recordings… provided the basic data." Speech disturbances were maximal at times coincident with GSR deflections and decreased in frequency on either side of GSR deflections. Additional validity is provided for both speech disturbances and the GSR as measures of momentary changes in anxiety level in psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The evolution of short-term dynamic psychotherapy: Treatment of the future?

Traces the evolution of short-term dynamically oriented therapy from Freud to present-day clinicians. A variety of forces have led to the current development of this form of short-term therapy, including pressure from 3rd-party payers, demands placed on an overburdened mental health system, and a greater emphasis on effective psychotherapy. The features that distinguish short-term psychotherapy from traditional psychoanalysis are explored. These include an active stance, time limitations, focality, intensification of affect, extensive use of the transference, and T-C-P (transference, current life figures, and significant past figures) interpretations. Areas for future study are explored. It is suggested that standard outcome techniques be used, so comparative studies may be designed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between therapist and client social class and participation in psychotherapy.

Conducted a replication of a study by the 1st author and T. M. Namenek (see record 1970-21092-001) in which therapists' estimates of their typical clients' social class were significantly related to the therapist's own discipline and self-ascribed socioeconomic background. The relationship between the therapist's discipline and socioeconomic background was also significant. Based on independent estimates of the social-class background and present social class of 48 therapists (mean age 39 yrs) and 98 of their clients, the present study partially replicates only one of Mitchell and Namenek's findings, namely, that the relationship between the therapist's discipline and background status tended toward significance. There was, however, a significant difference between the social class of typical as opposed to actual clients for all therapists and for each discipline separately. This difference was primarily due to the preponderance of lower-class clients among the actual clients of all 3 therapist groups (psychologists, psychiatrists, and both groups together). (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

One determinant of the capacity to free-associate in psychotherapy.

The hypothesis tested was that "clients whose behavior when asked to free associate is highly variable, flexible, or productive exhibit significantly greater variability when judging the extent of autokinetic movement on successive trials than Ss whose behavior at the outset of psychotherapy is highly inflexible, stereotyped, or rigid." 7 neurotic college student analysands in the extremely flexible group were matched with 10 Ss of the extremely rigid group for relevant personal variables. Sherif's autokinetic apparatus was used, and each S's judgmental variability was determined. The highly significant difference between autokinetic variability scores of the 2 groups lends strong support to the hypothesis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The next step in short-term dynamic psychotherapy: A clarification of objectives and techniques in an anxiety-regulating model.

Describes a 2-stage approach in an anxiety-regulation model of short-term dynamic psychotherapy (STDP) in which the primary objectives represent the underlying principles of psychodynamics. The 1st stage is the restructuring of defensive behavior, and the 2nd stage focuses on affective responding. Specific behavioral changes to be achieved within each stage are identified, as well as time-efficient interventions integrated from other theoretical orientations. The treatment structure and objectives of STDP and of cognitive, behavioral, and interpersonal approaches are compared. Careful operationalization of stages and interventions not only can be of help in allowing research comparisons among treatment models, but can also be useful in providing clear treatment guidelines for practitioners as well as research therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rorschach and MMPI-2 indices of early psychotherapy termination.

This study was an investigation of the differences between 97 patients who had prematurely terminated psychotherapy (M?=?1 session) and 81 who had participated in individual psychotherapy for at least 6 months and 24 sessions (M?=?18 months/72 sessions) on selected Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and Rorschach variables. None of the between-group comparisons using the MMPI-2 proved to be significant. However, a multivariate analysis of variance of 9 Rorschach variables in 3 conceptual categories, (1) interpersonal relatedness, (2) psychological resources versus resource demand, and (3) level of psychopathology, proved to be significant at p?=?.008. The Rorschach scores from the interpersonal-relational category proved to be the most robust in differentiating the 2 groups. The theoretical implications of interpersonal variables are discussed in relation to the termination and continuation of patients in psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preliminary relationships between adherence and outcome in dynamic deconstructive psychotherapy.

This study examined adherence to specific psychotherapeutic techniques as a predictor of outcome in dynamic deconstructive psychotherapy (DDP), a new psychodynamic therapy for treatment-resistant clients with borderline personality disorder (BPD). Ten clients dually diagnosed with BPD and alcohol use disorders underwent 12 months of DDP. Outcome indexes included measures of borderline symptoms, depression, dissociation, social support, alcohol misuse, parasuicide, and institutional care. Independent raters coded videorecorded sessions on adherence to DDP techniques, using a scale developed for this study, as well as therapeutic alliance and standard cognitive–behavioral and psychodynamic techniques. The adherence instrument demonstrated excellent interrater and test–retest reliability. Adherence to DDP techniques was positively related to improvement in BPD symptoms (ρ = .64) and most secondary outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between locus of control and psychotherapy: A review of the literature.

A survey of the literature reveals that the locus of control (LOC) construct has been empirically associated with psychotherapy, i.e., as a causal or mediating factor, as well as an end goal in the treatment process. The present paper critically reviews the evidence with respect to the interactive relationship between LOC and psychotherapy. The review is divided into 4 sections: effect of therapeutic intervention upon LOC, effect of LOC upon therapy outcome, effect of LOC on therapy process, and influence of LOC on client?×?modality. Findings generally indicate that LOC has been systematically modified by several therapeutic approaches and within various S populations. Further studies are needed to examine the impact of direct and mediating mechanisms contributing to change in LOC expectancies, the dynamics of LOC in relationship to general psychotheraptic success, generalizability of results to other populations, and permanence of LOC modification over time. (56 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Research in dynamic psychotherapy.

The Psychosocial Treatments Branch of NIMH held two conferences during 1982 and 1983 at which groups of experts in dynamic psychotherapy and research examined the feasability of mounting a special research program on dynamic psychotherapy. Recommendations regarding such a research program are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The dose–effect relationship in psychotherapy.

Applied probit analysis to 15 sets of data to specify the relationship between length of treatment and patient benefit. Data were based on more than 2,400 patients, covering a period of over 30 yrs of research. The probit model resulted in a good fit to these data, and the results were consistent across the studies, allowing for a meta-analytic pooling that provided estimates of the expected benefits of specific "doses" of psychotherapy. Analysis indicated that by 8 sessions approximately 50% of patients were measurably improved, and approximately 75% were improved by 26 sessions. Further analyses showed differential responsiveness for different diagnostic groups and for different outcome criteria. Findings hold promise for establishing empirical guidelines for peer review and 3rd-party financial support of psychotherapy. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Internalization of therapeutic relationships in short-term psychotherapy.

Structural Analysis of Social Behavior was used to chart the internalization of the therapeutic relationships of 48 clients in short-term psychotherapy at 2 university counseling centers. After initial and final sessions, clients reported their perceptions of counselors' actions and attitudes toward them, their own actions and attitudes toward counselors, and their intrapsychic dispositions. Results suggested clients internalized dispositions that they perceived counselors held toward them. Furthermore, results indicated that clients perceived interpersonal complementarity at the beginning but that the degree of interpersonal complementarity did not increase over time. In contrast, clients perceived a lack of interpersonal–intrapsychic complementarity early in therapy but perceived an increase in this complementarity at the end of therapy. This study proposes an integration of interpersonal and psychodynamic theories of psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bias in the assessment of psychotherapy.

Using an outcome study design, 17 therapists rated 54 male veteran psychiatric outpatients on 6 Interpersonal Behavior Inventory (IBI) factors before and after a 4-mo period of psychotherapy. Therapists were divided into 2 groups and given different emphases to selectively augment any bias on either IBI factor, Mistrust (Mis) or Inhibition (Inh). To obtain these emphases, therapists in 1 group rated each of their Ss 5 extra times during the study on Mis alone; the other group made similar ratings on Inh. Analyses of covariance showed no consistent exaggeration of improvement on emphasized factors. Tentative evidence was found in 1 therapist group that some had exaggerated improvement while others had shown an opposite reverse bias. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Weakenings and repairs of the working alliance in short-term psychotherapy.

Investigated how the weakening and repair of the working alliance in short-term psychotherapies relates to change in therapy. In 6 short-term, time-limited therapies involving 4 therapists and 6 patients, weakenings and repairs were identified with a unitized process ratings scale. Though the data must be considered preliminary, interesting relations emerged. Patients with greater ego strength had a higher initial quality of alliance with their therapist and were better able to work to repair any weakenings. These patients also exhibited a growing use of observing ego in their increasing ability to initiate talk about weakenings. Highest levels of patient alliance were preceded by high levels of therapist repair action. The success with which weakenings and repairs were handled was predictive of the general outcome of therapy. Surprisingly, more frequent interpretations of transference allusions were associated with poor outcome. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early identification of treatment failures in short-term psychotherapy. An assessment of therapeutic alliance and interpersonal behavior

Gender awareness and sensitivity in disaster research and management remains uncommon and tends to focus on the developing rather than the developed world. This paper uses a feminist oral geography to present some findings about women's experiences in two floods in Scotland. It is conceptualised around public and private (masculinised and feminised) space, problematising the private domain and presenting it, in the feminist research tradition, as a legitimate object of research. It shows the ordinary and everyday to be more opaque and complex than usually imagined and makes recommendations for their recognition and incorporation into disaster management. While there is a specific focus on the private domain of the home, this is not intended to reinforce gender stereotypes but simply to recognise the reality of many of the women interviewed. It concludes that disaster research generally has yet to advance much beyond the earliest stages of feminist studies which merely sought to make women visible in society.