Predicting patient change from therapist competence and patient-therapist complementarity in short-term anxiety-provoking psychotherapy: A pilot study.

Examined therapist competence and patient–therapist complementarity, measured by the Structural Analysis of Social Behavior system (L. S. Benjamin, 1974), as to their interrelation and their unique, collective, and interactive contributions to patient change in 20 sessions of short-term anxiety-provoking psychotherapy (STAPP; P. E. Sifneos, 1979). Patients were 15 highly educated outpatients (mean age 30 yrs) with mainly anxiety diagnoses. Therapists were in postgraduate manual-guided STAPP training. Results show that competence in an early session did not relate to patient change. In contrast, patient–therapist complementarity ratings predicted patient change both alone and over and above competence. Predictions were strongest for changes in general distress and dysfunctional attitudes and for shorter term change rather than for longer term change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of transference work, the therapeutic alliance, and their interaction in reducing interpersonal problems among psychotherapy patients with Cluster C personality disorders.

The aim of the present study was to examine whether transference work, the therapeutic alliance, and their interaction predicted a reduction in interpersonal problems at treatment termination. Forty-nine patients with Cluster C personality disorders from a randomized controlled trial investigating the effectiveness of short-term dynamic psychotherapy and cognitive therapy were included. Transference work was measured with the Inventory of Therapeutic Strategies (Gaston & Ring, 1992), while the therapeutic alliance was measured with the Helping Alliance Questionnaire (Luborsky, Crits-Christoph, Alexander, Margolis & Cohen, 1983). Less emphasis on transference work predicted overall reduced interpersonal problems, whereas the effects of the therapeutic alliance did not reach statistical significance. An interaction effect was also demonstrated, indicating that greater emphasis on transference work performed on patients with lower therapeutic alliance ratings was associated with a smaller reduction in interpersonal problems at termination. However, the results also indicate that a low dose of transference work may be beneficial in reducing interpersonal problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between activating affects, inhibitory affects, and self-compassion in patients with Cluster C personality disorders.

In the short-term dynamic psychotherapy model termed “Affect Phobia Treatment,” it is assumed that increase in patients' defense recognition, decrease in inhibitory affects (e.g., anxiety, shame, guilt), and increase in the experience of activating affects (e.g., sadness, anger, closeness) are related to enhanced self-compassion across therapeutic approaches. The present study aimed to test this assumption on the basis of data from a randomized controlled trial, which compared a 40-session short-term dynamic psychotherapy (N = 25) with 40-session cognitive treatment (N = 25) for outpatients with Cluster C personality disorders. Patients' defense recognition, inhibitory affects, activating affects, and self-compassion were rated with the Achievement of Therapeutic Objectives Scale (McCullough et al., 2003b) in Sessions 6 and 36. Results showed that increase in self-compassion from early to late in therapy significantly predicted pre- to post-decrease in psychiatric symptoms, interpersonal problems, and personality pathology. Decrease in levels of inhibitory affects and increase in levels of activating affects during therapy were significantly associated with higher self-compassion toward the end of treatment. Increased levels of defense recognition did not predict higher self-compassion when changes in inhibitory and activating affects were statistically controlled for. There were no significant interaction effects with type of treatment. These findings support self-compassion as an important goal of psychotherapy and indicate that increase in the experience of activating affects and decrease in inhibitory affects seem to be worthwhile therapeutic targets when working to enhance self-compassion in patients with Cluster C personality disorders. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Evidence that therapy works in clincally representative conditions.

This article reports a secondary analysis of past therapy outcome meta-analysis. Fifteen meta-analysts provided effect sizes from 56 studies in previous reviews that met 1 of 3 increasingly stringent levels of criteria for clinical representativeness. The effect sizes were synthesized and compared with results from the original meta-analyses. Effect sizes from more clinically representative studies are the same size at all 3 criteria levels as in past meta-analyses. Almost no studies exist that meet the most stringent level of criteria. Results are interpreted cautiously because of controversy about what criteria best capture the notion of clinical representativeness, because so few experiments have tested therapy in clinical conditions, and because other models for exploring the generalizability of therapy outcome research to clinical conditions might yield different results. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Manualization and competence monitoring of short-term anxiety-provoking psychotherapy.

Developed and assessed the validity and reliability of a rating form to assess therapist performance in short-term anxiety-provoking psychotherapy (STAPP). The STAPP Therapist Competence Rating Form (STCRF) is intended for use by nonparticipant observers of taped therapy sessions. Two raters independently observed and rated 31 therapy sessions, using the STCRF. The STCRF showed acceptable coefficients of internal consistency, interrater reliability on mean STCRF scores, and convergent and discriminant validities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)