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.
A randomized clinical trial investigated the efficacy of interpretive and supportive forms of shortterm individual psychotherapy and the interaction of each form with the patient's quality of object relations (QOR) and psychological mindedness (PM). The psychiatric outpatient sample included 144 therapy completers and 27 dropouts. Eight experienced therapists provided distinct forms of manual-guided therapy. Outcome was assessed by a comprehensive battery. The dropout rate was higher for interpretive therapy than for supportive therapy. Patients in both forms improved, but they did not differ on outcome from each other. A multivariate interaction effect indicated a direct relation between QOR and outcome for interpretive therapy and almost no relation for supportive therapy. A multivariate main effect indicated a direct relation between PM and outcome for both forms. The relevance of patient personality to outcome in different forms of therapy is addressed.
This study explored the relative strength of two patient characteristics, psychological mindedness (PM) and alexithymia, as predictors of psychotherapy outcome. Data were provided by two comparative trials of interpretive versus supportive therapy. One involved short-term group therapy for 107 outpatients with complicated grief. The other involved short-term individual therapy for 144 outpatients of mixed diagnoses. Prior to beginning therapy, patients were assessed for PM using the Psychological Mindedness Assessment Procedure and for alexithymia using the 20-item Toronto Alexithymia Scale. For both trials, the association between PM and alexithymia was small and non-significant. The therapy approach (interpretive vs. supportive) did not differentially affect the relationship between either predictor variable and outcome. There were significant direct relationships between PM and favourable outcome, and between alexithymia and favourable outcome in both trials. There was an additive relationship between PM and alexithymia in predicting outcome. Implications of these results are discussed.
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