Rorschach and MMPI-2 indices of early psychotherapy termination.

Abstract

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

Rorschach Comprehensive Variables and Assessment for Psychodynamic Psychotherapy

“…However, for the remaining variables from this cluster the results were not positive. In this thesis, AG is interpreted as indicating forcefulness rather than a more hostile kind of aggressiveness, and the positive results for AG are in agreement with the finding by Hilsenroth et al (1995), that patients terminating psychodynamic psychotherapy prematurely had fewer AG and more COP than had those remaining in treatment.…”

“…However, according to Weiner (1998), a high score on AG is not always an indication of maladaptation, AG may indicate more assertiveness than anger. Hilsenroth, Handler, Toman, and Padawer (1995) found that patients terminating psychodynamic psychotherapy prematurely had fewer AG and more COP than those remaining in treatment. Moreover, research concerning the relation between patients' affective responses and therapy outcome indicates that the patient's total affective reactions to therapy (negative and positive reactions) are related to positive therapy outcome (Orlinsky, et al, 1994).…”

Effectiveness of child psychoanalytic psychotherapy in a clinical outpatient setting

“…Secondly, based on the literature, variables considered important to evaluate psychotherapy outcome were selected (Weiner and Exner, 1991;Blatt and Ford, 1994;Hilsenroth et al, 1995). Among the variables chosen are the ones that: 1) Table 5.…”

Correspondence Among Observer Ratings of Rorschach, Big Five Model, and DSM-IV Personality Disorder Constructs

“…Using a variety of non-Rorschach assessment methods, many studies show that interpersonal variables and defenses are related to important psychotherapy process and outcome variables (e.g., Filak, Abeles, & Norquist, 1986;Ogrodniczuk, Piper, Joyce, & McCallum, 2001;Paivio & Bahr, 1998;Perry, 2001). Regarding the Rorschach in particular, various types of Rorschach interpersonal scores are related to treatment variables such as treatment outcome (e.g., Alpher, Henry, & Strupp, 1990;Blatt & Ford, 1994), therapist-client agreement on treatment goals (Bihlar & Carlsson, 2000, 2001, and dropout (Hilsenroth, Handler, Toman, & Padawer, 1995).…”