An interpersonal model of psychotherapy: Linking patient and therapist developmental history, therapeutic process, and types of outcome.

Abstract

This study empirically evaluated a 3-stage causal model based on interpersonal theory that relates patient and therapist early parental relations, the therapeutic alliance, and outcome. Data were from the Vanderbilt II database and encompassed 64 psychodynamic psychotherapies. Interpersonal variables were assessed using the Structural Analysis of Social Behavior. Initial support for the model was found, suggesting a direct effect of patient early parental relations on process and outcome, a direct effect of therapist early parental relations on process, and a direct effect of process on outcome--and thus indirect effects of both patient and therapist early parental relations on outcome mediated by the process. The psychotherapy process was assessed from 3 perspectives: patient and therapist self-report and reports by independent observers. Little convergence was found between the 3 perspectives.

Patient interpersonal factors and the therapeutic alliance in two treatments for bulimia nervosa

“…Additionally, patients who possess poor object relations or have experienced negative early relationships with important others have been shown to have difficulty forming quality alliances with their therapists (e.g., Hilliard et al, 2000;Kokotovic & Tracey, 1990;Piper, Azim, Joyce, & McCallum, 1991;Piper, Boroto, Joyce, & McCallum, 1995). Such associations make sense from an interpersonal perspective in that the interpersonal behaviors and patterns that a patient brings to therapy should invariably affect the (inherently interpersonal) therapeutic alliance (e.g., Kiesler & Watkins, 1989;Safran & Muran, 2000;Safran & Segal, 1990).…”

“…For example, therapist warmth, flexibility, and interpretive accuracy have been positively associated with alliance quality (see Ackerman & Hilsenroth, 2003), while therapist rigidity, criticalness, and inappropriate self-disclosures have been negatively associated with alliance quality (see Ackerman & Hilsenroth, 2001). Furthermore, the nature of the alliance has been differentially associated with the therapist's own interpersonal history, interpersonal style, and self-concept (e.g., Henry, Strupp, Butler, Schacht, & Binder, 1993;Hersoug, 2004;Hersoug, Hoglend, Monsen, & Havik, 2001;Hilliard, Henry, & Strupp, 2000).…”

Services for personality disorder: organisation for inclusion

“…Data from a study in which 67% of patients had an Axis II disorder suggest that the early parental relationships of both patients and therapists had an effect on the therapeutic process, which in turn has a direct effect on outcome (Hilliard et al, 2000).…”

Memories and Future. Storia e sviluppi di un gruppo di ricerca italiano: dagli studi di efficacia alle analisi delle resistenze al cambiamento

“…Sono stati analizzati i trascritti di sedute appartenenti a 10 coppie di pazienti (con stessa diagnosi DSM-IV-TR, APA, 2000), ciascuna delle quali trattata dallo stesso terapeuta, con esiti opposti (valutati a 0, 6 e 12 mesi attraverso la somministrazione dell'SCL-90-R e di una scala Ciò è risultato essere in linea con quanto evidenziato in letteratura (Henry, 1996;Henry, Schacht, & Strupp, 1986;Henry & Schacht, 1994;Henry & Strupp, 1994;Hilliard, Henry, & Strupp, 2000;Nelson, 2004), rispetto al potere predittivo del livello di ostilità/aggressività sull'esito delle psicoterapie. Nel nostro campione, pur evidenziandosi un minor numero di moti caratterizzati da ostilità, la differenza fra i due gruppi d'esito è statisticamente significativa.…”

“…Alcuni studi hanno rilevato un ruolo tendenzialmente controproducente di una modalità terapeutica di intervento direttiva, individuando come fattore discriminante tra terapie a esito differente una scarsa alleanza terapeutica e a un alto livello di controllo da parte Ricerca in Psicoterapia / Research in Psychotherapy 2010; 2 (13): 53-77 http://www.researchinpsychotherapy.net _____________________________________________________________ del terapeuta (Svartberg & Stiles, 1991;Horvath & Greenberg, 1994;Hilliard et al, 2000;Horvath, 2009). …”