This study investigates the facets of the alliance and their relationship with estimated effectiveness of psychotherapy using a measure called the Combined Alliance Short Form (CASF; Hatcher, 1999; Hatcher & Barends, 1996; Hatcher, Barends, Hansell, & Gutfreund, 1995). Because the CASF has both patient and therapist versions, it was possible to compare ratings of various facets of the alliance from each perspective. Data were collected from 125 patient-therapist dyads, and all participants completed the CASF as well as measures of perceived progress during therapy. Convergence was examined for each alliance subscale for the patient-therapist dyads. Both the patient and therapist Confident Collaboration factors were found to be primary predictors of perceived improvement in psychotherapy. Number of psychotherapy sessions was related to patient estimates of improvement and therapist ratings of the amount of help received by their patients as well. Confident Collaboration, a factor that reflects the level of confidence and commitment a patient experiences regarding the therapy as well as the degree to which the therapy is experienced as worthwhile, is discussed in relation to previous research. Implications regarding the presence of this factor during psychotherapy are considered in detail.

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This study investigates the effects of structured clinician training in a Therapeutic Model of Assessment (TMA) and Short-Term Psychodynamic Psychotherapy (STPP) on therapeutic alliance variables measured early in treatment. Thirty-four outpatients received psychotherapy from clinicians who had undergone structured training in a TMA and STPP. A 2nd group of 34 outpatients were assessed using a

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We examined the differences between narcissism, mode of defense, and level of aggression on the Rorschach. We also investigated differences in borderline, narcissistic, and Cluster C personality disorders by examining responses to Rorschach content variables. The Lerner Defense Scale (P. Lerner & H. Lerner, 1980), the aggressive content section of the Holt (1977) method for assessing primary process manifestations, a modified version of Exner's (1986a) Egocentricity Index, Wagner's (1965) exhibitionistic M score, and grandiosity were scored on the Rorschach protocols of 17 borderline, 17 narcissistic, and 17 Cluster C personality disorders. Borderlines were found to employ primitive defensive structures to a greater degree and severity, show more intense and overall aggression as well as more responses on the three forms of aggression in the Holt method, and have higher levels of grandiosity. Narcissists evinced significantly higher levels of egocentricity than borderlines and higher levels of idealization than the Cluster C group. Convergent validity was found on the measures of defense and aggression, which showed a strong relationship between primitive aggression and primitive defense.

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-(a) interpersonal relatedness, (b) psychological resources versus resource demand, and (c) level of psychopathology-proved to be significant alp = .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. Although a great deal of research has focused on the process and outcome of psychotherapy, far less has been written about premature termination from psychotherapy. This is surprising in view of the high dropout rates reported in the literature. For example, Garfield (1994) summarized 20 studies, mostly from the 1950s and 1960s; he reported that the median number of psychotherapy interviews for outpatient clinics clustered around six interviews. Garfield indicated that more recent studies are quite consistent with the earlier ones. In an earlier summary (Garfield, 1986), the median number of psychotherapy sessions was between five and eight. Taube, Burns, and Kessler (1984) found similar results in a study of psychologists and psychiatrists in private practice, and Blackwell, Gutmann, and Gutmann (1988) found that the modal number of treatment sessions was a single visit for patients belonging to a health maintenance organization and for patients in a fee-for-service arrangement in a hospital-based outpatient clinic. A report by Howard, Davidson, O'Mahoney, Orlinsky, and Brown (1989) indicated that, in a national survey of the utilization of mental health services, 44% of the patients made fewer than four visits. Howard, Kopta, Krause, and Orlinsky (1986) summarized 15 studies, in which the median number of sessions reported ranged from 4 to 33 sessions, with a median of 12 for the sample. Scogin, Belon, and Malone (1986) also reported that approximately two thirds of psychotherapy patients in the clinic they sampled terminated their treatment prematurely, the majority in less than five sessions, and Phillips (1985) reported a 30% dropout rate after one session and a 50% dropout rate after two sessions. Depending on the criteria used and the patient population stud

We replicated prior research on Rorschach and MMPI-2 convergent validity by testing 8 hypotheses in a new sample of patients. We also extended prior research by developing criteria to include more patients and by applying the same procedures to 2 self-report tests: the MMPI-2 and the MCMI-II. Results supported our hypotheses and paralleled the prior findings. Furthermore, 3 different tests for methodological artifacts could not account for the results. Thus, the convergence of Rorschach and MMPI-2 constructs seems to be partially a function of how patients interact with the tests. When patients approach each test with a similar style, conceptually aligned constructs tend to correlate. Although this result is less robust, when patients approach each test in an opposing manner, conceptually aligned constructs tend to be negatively correlated. When test interaction styles are ignored, MMPI-2 and Rorschach constructs tend to be uncorrelated, unless a sample just happens to possess a correlation between Rorschach and MMPI-2 stylistic variables. Remaining ambiguities and suggestions for further advances are discussed.

We used a survey of internship training directors to examine the nature of assessment use and assessment skills training at 382 internship settings in professional psychology across the United States and Canada. For the purposes of this study, we created a questionnaire that inquired about the types of assessment instruments used at each internship setting, the amount and type of training offered at internship sites, and the type of assessment experience desired of interns before beginning their rotations. The results revealed several differences across type of internship facility surveyed as well as several trends in the current use of assessment in applied settings. The findings further demonstrate the important role of projective assessment in the training of graduate students and lead to the conclusion that major discrepancies may exist between what is being taught in graduate school and what students are expected to know on entering their internship positions.