Forty-two therapists trained in the C. E. Hill dream model (1996, 2004a) conducted single dream sessions with 157 volunteer clients. Clients who profited most from dream sessions had poor initial functioning on the problem reflected in the dream, positive attitudes toward dreams, salient dreams, low initial insight into the dream, and poor initial action ideas related to the dream. When initial stages of the session were evaluated positively, later stages were also evaluated positively. Process (therapist competence/adherence and client involvement) was positively related to session outcome. Perspective also influenced the findings, such that clients', therapists', and judges' perceptions of process related to their own, but not others', evaluations of process and session outcome. Implications of findings for dream work and research are presented.

Eighty-eight East Asian volunteers were paired with 6 East Asian therapists who provided low or high input in single-dream sessions. Volunteer clients with poor initial functioning on the target problem associated with their dreams and high self-efficacy for working with dreams profited more from dream sessions than did their counterparts. Although no main effects were found for therapist input, volunteer clients who scored higher on attachment anxiety had better outcome in the low-input condition, whereas clients who scored lower on attachment anxiety had better outcome in the high-input condition. Volunteer clients with lower Asian values evaluated low-input sessions more positively, whereas volunteer clients with higher Asian values evaluated high-input sessions more positively. Implications for dream work and future research are suggested.

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Forty-seven psychoanalytic therapists completed a questionnaire about dream work. Overall, results indicated that therapists had very positive attitudes toward dreams, worked with their own dreams, sought out dream training, and felt competent working with dreams. Therapists estimated that they worked with dreams with about half of their clients about half of the time in psychotherapy. They were most willing to work with dreams when clients had recurrent or troubling dreams or nightmares, were psychologically minded, were seeking growth, were interested in dreams, and were willing to work with dreams.

Using a variety of different measurement methods, it has been shown that clients valued insight in dream sessions and that they gained insight into their dreams as a result of sessions. However, very little is known about the mechanisms through which insight is attained in dream sessions, other than the fact that client involvement and therapist adherence and competence are related to insight gains and that therapist interpretation may not be necessary for insight gains. Knowledge about how client insight develops in dream sessions might provide clues about how insight develops in therapy more generally, a useful pursuit given that insight is a major goal of many therapies. The purpose of the present study, then, was to investigate the development of insight within a single case of dream work. Because we currently know little about how insight develops in dream sessions and because insight might develop differently across clients, we studied one case of a client who developed insight during a dream session. We used a combination of quantitative and qualitative methods to maximize our ability to highlight the development of insight in this case. In this chapter we first describe the process and outcomes of the session, documenting that insight did occur. We then explore factors suggested from psychotherapy process research; dream work research; and our clinical experiences that may have facilitated or inhibited insight gains. (PsycINFO Database Record (c) 2010 APA, all rights reserved)