An interpersonal stage model of the therapeutic process.

Abstract

A 3-stage interpersonal model of the successful therapeutic process (high complementarity, low complementarity, high complementarity) has been proposed and supported in the literature. However, recent work on the interpersonal circumplex and its definition of complementarity have called into question the validity of this model. A revised conception of the stage model is proposed. This revision takes into account the moderator variables of social norms and roles, differential interpretation of hostile and friendly behaviors, manifest versus latent communication, and individual differences in adjustment. The revised model differentiates the middle conflict stage into 2 substages: the dissatisfaction substage, characterized by high negative (hostile) complementarity, and the unstable substage, characterized by low complementarity.

Pathoplasticity of bulimic features and interpersonal problems

“…For example, Bruce et al 31 found that bulimic women with avoidant personality disorder became more inhibited relative to bulimic women without avoidant personality disorder when serotonin was agonized, suggesting differential treatment for women with bulimia depending on their interpersonal style, as is also suggested in interpersonal psychotherapy process research. 32 Research supports some elements of the pathoplasticity hypothesis for bulimia. For example, Bornstein 33 reported meta-analytic data suggesting that dependency, while related to bulimic features, is equally related to other forms of psychopathology.…”

“…Complementarity is a theory of reciprocal relations in dyadic behavior defined by two rules: (a) dominance and submissiveness pull for their opposites, and (b) warmth and coldness pull for the same. Tracey 32 showed a pattern in successful psychotherapy defined by complementarity rapport-building early in treatment, which led to intermediate stages during which the therapist evoked clinical change by progressively increasing noncomplementary conflict, and a final stage characterized by complementary resolution. Matching bulimic patients with therapists and therapies that are likely, based on an initial assessment of interpersonal functioning, to engender trust and build the alliance early in treatment, then pull for a healthier interpersonal style once an alliance is Notes: Drive for thinness and body dissatisfaction descriptives reflect within-sample standardized EDI scores.…”

Possible role of more positive social behaviour in the clinical effect of antidepressant drugs

“…Furthermore, while behaviours along the dominant-submissive dimension tend to be reciprocal, for example with dominant behaviours resulting in a submissive response, on the agreeable-quarrelsome dimension there is correspondence, with agreeableness producing an agreeable response and quarrelsomeness producing a quarrelsome response. Many studies [50][51][52][53][54][55][56] support the idea that quarrelsomeness tends to evoke quarrelsomeness and agreeableness tends to evoke agreeableness, although the exact response can be modulated by the context. Moskowitz and Côté 57 used an ecological momentary assessment method to study behaviour along the agreeable-quarrelsome dimension and mood during individual social interactions.…”

Interpersonal change as an outcome of time-limited interpersonal therapy.

“…(261) A series of studies by Tracey and colleagues has strongly and consistently supported this model (e.g., Tracey, 1987Tracey, , 1993Tracey & Ray, 1984;Tracey, Sherry, & Albright, 1999). This U-shaped pattern of complementarity in cases with successful outcomes suggests that initial complementarity and later noncomplementarity may be important to outcomes.…”

“…The authors found that depressed people with submissive styles tended to elicit dominant reactions. Tracey (1993) made the point that the principles of complementarity described above are probabilistic, not deterministic. Complementarity should be understood in terms of pulls to engage in a certain pattern of behavior that may or may not correspond with how a person typically behaves in interpersonal situations.…”