The Structural Analysis of Social Behavior (SASB; Benjamin, 1974Benjamin, ,1982Benjamin, ,1984 system was used to study the interpersonal process between patient and therapist in the 3rd session of 14 therapeutic dyads. Dyads were grouped into good and poor outcomes cases (n = 7) on the basis of the amount of change in the patients' introject as measured by the INTREX Introject Questionnaire (Benjamin, 1983). Strong support was found for the following hypotheses based on interpersonal theory, linking therapists' introject state, interpersonal process in therapy, and outcome: (a) Poor outcome cases (no introject change) were typified by interpersonal behaviors by the therapist that confirmed a negative patient introject; (b) the number of therapists' statements that were subtly hostile and controlling was highly correlated with the number of self-blaming statements by the patients; (c) therapists with disaffiliative introjects tended to engage in a much higher level of problematic interpersonal processes that have been associated with poor outcome. Implications for future research and therapist training are discussed.

Sixteen therapists were enrolled in a year-long manualized training program as part of the Vanderbilt II study of time-limited dynamic psychotherapy (TLDP). The training program successfully changed therapists' interventions in line with prescriptions of the TLDP manual, but some unanticipated changes ran counter to the intent of the training, including increased negative interpersonal transactions as indicated by process measures such as the Structural Analysis of Social Behavior (SASB). We examined therapist variables, patient variables, and training variables that appeared to mediate therapist responses to the training program. Results indicate that patient difficulty may mediate certain aspects of therapists' responses to training. Therapists with self-reported hostile and controlling introjects showed the greatest technical adherence, which was intriguing because prior research has linked hostile therapist introject to greater frequency of countertherapeutic interpersonal process. Of special interest were differences in effects of training associated with individual training faculty. This finding, if generalizable, has important implications for manualized therapy research, especially multisite trials.The 5-year Vanderbilt II project examined the effects of 1 year's training in a manualized form of dynamic psychotherapy (time-limited dynamic psychotherapy [TLDP]; Strupp & Binder, 1984) on 16 experienced therapists across 80 cases. Because of the increasing use and acceptance of treatment manuals in psychotherapy research, a primary aim of the study was to explore the process of manualized training itself. A number of therapist behaviors in different domains were measured preand posttraining, with therapists serving as their own controls. Thus, the design focused on the effects of training in a single treatment manual rather than comparing the differential outcome efficacy of several competing protocol therapies.Analyses of therapist changes at the group level revealed both intended and unintended results (Henry, Strupp, Butler, Schacht, & Binder, 1993). The training program successfully changed therapists' technical interventions in line with prescriptions in the TLDP manual. Therapists showed significant increases in interventions, such as focusing the therapeutic process on in-session transactions and the articulation of cyclical maladaptive interpersonal patterns (CMPs). However, other changes were unexpected and ran counter to the intent of the training. These included an increase in negative interpersonal transactions as reflected by such process measures as the Struc-

Research strategies employing Structural Analysis of Social Behavior (SASB) were demonstrated in a study comparing 4 therapists, each of whom saw a good and a poor outcome case (N = 8), on interpersonal process variables in the third session. SASB represents complex interactive processes in a manner that is both theoretically cogent and empirically sound. Good versus poor therapeutic outcome was differentiated on the basis of the following interpersonal process variables: greater levels of "helping and protecting" and "affirming and understanding*' and significantly lower levels of "blaming and belittling" were associated with high-change cases. Patient behaviors of "disclosing and expressing" were significantly more frequent in high-change cases, whereas "walling off and avoiding" and "trusting and relying" were significantly more frequent in low-change cases. Additionally, negative complementarity was greater in poor outcome cases. Implications for research methodology and interpersonal theory are discussed.

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The present article describes the development and subsequent revisions of a therapy-process instrument designed to capture characteristics of the patient, the therapist, and their interaction that might be related to outcome. The article also reports on a study that used the current version of the scale to investigate the predictive relationship of three process dimensions-patient involvement, therapist-offered relationship, and exploratory processes. Process ratings were obtained for audiotaped segments of the first three therapy sessions for 38 college males with symptoms of depression, anxiety, and social introversion. Overall, patient involvement was the most powerful predictor of outcome. The predictive association, however, increased across the three sessions from virtually no association in the first session to a consistent association in the third session. This progression suggests that the formation of critical aspects of the therapeutic relationship occurs in this very early phase of therapy.