We used a randomized clinical trial to investigate the interaction of two patient personality characteristics (quality of object relations [QOR] and psychological mindedness [PM]) with two forms of time-limited, short-term group therapy (interpretive and supportive) for 139 psychiatric outpatients with complicated grief. Findings differed depending on the outcome variable (e.g., grief symptoms, general symptoms) and the statistical criterion (e.g., statistical significance, clinical significance, magnitude of effect). Patients in both therapies improved. For grief symptoms, a significant interaction effect was found for QOR. High-QOR patients improved more in interpretive therapy and low-QOR patients improved more in supportive therapy. A main effect was found for PM. High-PM patients improved more in both therapies. For general symptoms, clinical significance favored interpretive therapy over supportive therapy. Clinical implications concerning patient-treatment matching are discussed.
Predictors of dropping out were focus on transference, significantly investigated for patients who participated differentiated dropouts from completers. in time-limited, interpretive individual psychotherapy in a randomized clinical trial. A sample of 22 dropouts was compared with a sample of 22 matched completers on both pretherapy and therapy process variables. None of the pretherapy predictors, which included demographic, diagnostic, and initial disturbance variables, significantly differentiated the two groups. In contrast, several of the therapy process variables, including the therapeutic alliance, work, patient exploration, and
The Edmonton Day Treatment Program offers a uniquely effective approach to two major problems. First, it has proven to be successful in the treatment of patients with personality disorders, a group which usually does not respond well to treatment. Second, by using time-limited, group-oriented day treatment, it maximizes scarce staff time and financial resources. Psychiatrists, therapists, clinicians, researchers, and administrators will find it an invaluable assistance in evaluating and developing similarly effective programs.
The relationships between patient personality variables and outcome for 107 psychiatric outpatients with complicated grief who completed either interpretive or supportive short-term group therapy were investigated. The personality variables were assessed prior to treatment with the NEO-Five Factor Inventory (NEO-FFI). For patients in both forms of therapy, extraversion, conscientiousness, and openness were directly associated with favorable treatment outcome. In contrast, neuroticism was inversely related to favorable outcome for patients in both forms of therapy. Agreeableness was directly related to favorable improvement in grief symptomatology for patients in interpretive therapy, but not for those in supportive therapy. The results highlight the importance of assessing patient personality in order to predict response to short-term group therapy. Possible explanations and clinical implications of these findings are discussed.
This prospective study investigated the impact of group composition on the outcome of 2 forms of time-limited, short-term group therapy (interpretive, supportive) with 110 outpatients from 18 therapy groups, who presented with complicated grief. The composition variable was based on the patient's level of quality of object relations. The higher the percentage of patients in a therapy group who had a history of relatively mature relationships, the better the outcome for all patients in the group, regardless of the form of therapy or the individual patient's quality of object relations score. The findings have direct clinical implications for composing short-term therapy groups for outpatients with complicated grief and possibly for other types of group therapies and patient problems.
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