The relationship of patient-therapist interaction to outcome in brief psychotherapy.

Abstract

Therapist-patient interactions in 16 cases of brief psychotherapy were examined. Three types of therapist intervention (patient-therapist interpretations, patient-significant other interpretations, and clarifications) were compared in terms of the frequency of patient affective or defensive behavior that occurred in the three minutes following each. In addition, therapist-intervention and patient-response episodes were investigated to determine their relationship to outcome at termination of therapy. Results indicate that patient-therapist interpretations followed by patient affect bears a significant relationship to improvement at termination, whereas an intervention (of any type) followed by defensiveness correlates negatively with outcome. These findings suggest that an examination of patient-therapist interaction episodes may be more productive than examining process variables in isolation.

Orienting patient to affect, sense of self, and the activation of affect over the course of psychotherapy with cluster C patients.

“…We hypothesize that, in accordance with previous research (e.g., McCullough et al, 1991;Town, Hardy, McCullough, & Stride, 2011), a therapist orienting a patient toward affect will produce an affective response in the patient but, additionally, that relationship will be moderated by the patient's sense of self. Accordingly, we make three hypotheses:…”

Pastoral Counseling of Older Adults: Toward a Short-term Integrative Approach

“…He reports studies suggesting that the client's capacity to form attachments (Mohr et al 1990;Piper et al 1990) and openness to therapeutic interventions (McCullough et al 1991) are important determinants of outcome. To explain, brief therapy is possible only when clients' problems do not interfere with the rapid formation of alliance (Strupp 1980).…”

Is There an Optimal Adjustment of Interpretation to the Patients’ Level of Defensive Functioning?

“…Addressing defensive behavior may have a positive impact on the outcome, as demonstrated in some studies (10)(11)(12)(13). In cases with improved alliance and good outcome, the therapists addressed the patients' defenses and linked problematic feelings in relation to the therapist with the subjects' defenses more frequently than in cases with less favorable outcome (13), but the sample size was very small (N = 6).…”

“…The therapists had practiced dynamically oriented individual therapy for a mean of 10 years (range [4][5][6][7][8][9][10][11][12][13][14][15][16][17], and mean years of postgraduate formal professional training in dynamic therapy was 6.5 (range 4-11). Their mean age was 44.…”