The authors argue that the Rorschach can and should be used best with a nomothetic foundation that adds an idiographic approach depending on the goal of the assessment. The research supporting this position is reviewed as are conceptual models that are advantageous to this conceptual position. The authors posit that method variance has a powerful impact on the measurement process. Each method is of value in some areas and of limited relevance in others. Self-report measures are most likely to be useful when interest is focused on consciously available and behavioral dimensions of functioning. Depth-oriented, indirect measures such as the Rorschach are most likely to be useful when interest is focused on unconscious, longitudinal, and structural dimensions of functioning. However, to have a full picture of human beings, heteromethod assessment is necessary to capture the full range of functioning and to implement the analytic model of assessment.The purpose of this Special Section is to address the question "Is the Rorschach valid?" This question cannot be answered because, indeed, a similar question about any psychometric device would be unanswerable. The two terms in the question, Rorschach and valid, contain considerable ambiguity, and it is that ambiguity that makes the question so difficult to answer.Although the Rorschach inkblots (Exner, 1993) are standard, its administration, scoring, and interpretation all vary, and the variations include well-defined systems and clinician-developed idiosyncratic approaches. Research on the Rorschach must specify the clinical approach that was taken, and any clinical application of those findings must use the same approach. These concerns apply to any personality test but only to a limited extent when personality inventories are used because of their more uniform standardization.A test is not valid or invalid; rather, there are as many validity coefficients as there are purposes for which the test is used. The Rorschach can demonstrate its utility for several purposes and can be found wanting for several others. This same caveat applies, for example, to the Minnesota Multiphasic Personality Inventory-2nd edition (MMPI-2), and any comparison between the two tests must be on a criterion-by-criterion basis, with global conclusions unlikely. Bearing these cautions in mind, we address the various questions that were put to us, and we rarely repeat the necessity to standardize the clinical approach to the Rorschach or the criterionlimited nature of any conclusions.
Learning to do psychotherapy is emotionally difficult as well as cognitively challenging. This article addresses some of the intrapsychic conflicts with which beginning therapists are faced and points out some of the ways that novices cope by identifying with psychotherapeutic schools and "heroes."The added emotional burdens of learning an integrated approach are discussed, as are some solutions to these conflicts.
Chapter 10 discusses assimilative psychodynamic psychotherapy, and covers integrative approach, assessment and formulation, applicability and structure, processes of change, the therapy relationship, methods and techniques, a case study, empirical research, and future directions.
This study examined the relationship between Psychodynamic-Interpersonal (PI) and Cognitive-Behavioral (CB) techniques used in a Short-Term Psychodynamic Psychotherapy with the therapeutic alliance early in treatment. Ninety-one outpatient participants rated their alliances, and independent videotape ratings of technique were made. Our findings did not support the primary hypothesis of a relationship between technique integration and overall patient-rated alliance. However, our findings did demonstrate a significant association between the integration of PI and CB techniques with the two alliance subscales Goals & Task Agreement and Confident Collaboration. In addition, specific PI and CB techniques were significantly correlated with higher patient alliance scores on these two subscales. Psychodynamic therapists who are more collaborative in identifying specific goals and explicitly defining the focus of the treatment with their patients, as well as providing a clear rationale for their model, may facilitate a stronger therapeutic alliance specific to patient confidence in, and agreement with, the treatment process.
This is the first study with acceptable inter-rater reliability to examine specific therapeutic techniques related to change in anxiety disorder patients during short-term psychodynamic psychotherapy. The study first examined the effectiveness of short-term psychodynamic psychotherapy and results showed significant and positive pre-/post-treatment changes on both patient and independent clinical ratings for anxiety, global symptomatology, relational, social, and occupational functioning. Likewise, the majority of patients (76%) reported anxiety symptoms within a normal distribution at termination. Importantly, psychodynamic interventions rated early in treatment (third/fourth session) were positively related to changes in anxiety symptoms. Further, results showed that several individual psychodynamic techniques were meaningfully related to outcome including (1) focusing on wishes, fantasies, dreams, and early memories; (2) linking current feelings or perceptions to the past; (3) highlighting patients' typical relational patterns; and (4) helping patients to understand their experiences in new ways. Clinical applications are discussed.
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