What interpersonal problems are related to different therapeutic techniques early in treatment?

Abstract

The current study seeks to explore the relationship between patient-reported interpersonal problems and therapist interventions in early psychodynamic psychotherapy for 71 outpatients. Pretreatment ratings on the Inventory of Interpersonal Problems Circumplex Scales (IIP-C) total and subscale scores were examined in relation to early treatment process. Independent clinicians reliably rated therapist use of psychodynamic-interpersonal (PI) and cognitive-behavioural (CB) interventions using the Comparative Psychotherapy Process Scale (CPPS) over two early treatment sessions (third and ninth). Intraclass correlation (ICC) values were in the excellent range for CPPS-PI and CPPS-CB scale scores (CPPS-PI = 0.86; CPPS-CB = 0.78). A significant positive correlation was found between interpersonal problems and global PI therapist technique. A significant positive correlation was also found between interpersonal problems and specific PI interventions, most significantly experience and expression of feelings in session. In specific interpersonal problem subscales, most significant was that Cold/Distant and Socially Inhibited octants positively related to global PI and to specific PI techniques, including exploration of uncomfortable feelings. Multiple regression analyses revealed most significantly that CPPS Intervention 7 (discussion of patient-therapist relationship; positive) and CPPS Intervention 11 (therapist explanation of rationale behind treatment; negative) explained 15.6% of variance in interpersonal problem score. These findings demonstrate that the use of psychodynamic techniques tend to occur alongside patient-reported interpersonal problems early in psychotherapy treatment. Clinical implications are discussed for this area of research, and future directions are explored.

Patient personality dimensions, relational patterns and therapeutic alliance in clinical practice: An empirical investigation

“…Although little is still known about the active ‘ingredients’ of the therapeutic action able to promote positive outcomes (Kazdin, 2007), it is well established that the clinician–patient relationship makes substantial contributions to psychotherapy success, independent of the type of treatment (e.g., Norcross & Lambert, 2019). Overall, the quality of the therapeutic relationship is strongly influenced by various elements, such as patient characteristics, therapist features, intervention strategies and techniques, and by how these variables interact all together (e.g., Hilsenroth et al, 2012; Lingiardi et al, 2018; McMillen & Hilsenroth, 2019; Wampold & Imel, 2015).…”

Patients' interpersonal problems as moderators of depression outcomes in a randomized controlled trial comparing mindfulness‐based cognitive therapy and a group version of the cognitive‐behavioral analysis system of psychotherapy in chronic depression

“…It is important to consider interpersonal problems in psychotherapy practice and research due to several reasons. Individual and group therapy are interpersonal situations and interpersonal problems can influence in‐session processes that are relevant for a good outcome, for example, the therapeutic alliance (Muran, Segal, Samstag, & Crawford, 1994), therapeutic factors in group therapy (Macnair‐Semands & Lese, 2000), or the application of therapeutic techniques (McMillen & Hilsenroth, 2019). As patients' interpersonal problems can affect in‐session processes, it is crucial to investigate whether the patients' interpersonal problems are predictors of psychotherapy outcome as well.…”

Between a rock and a hard place: Associations between Mentzos' “dilemma”, self‐reported interpersonal problems, and psychosocial functioning in individuals with non‐affective psychoses

“…This model provided the theoretical basis for the IIP, which was designed to operationalize research in the field of interpersonal problems. The IIP was shown to be a valuable tool in psychotherapy research (Bressi, Porcellana, Marinaccio, Nocito, & Magri, ; Huber, Albrecht, Hautum, Henrich, & Klug, ; McMillen & Hilsenroth, ; Philips, Wennberg, Werbart, & Schubert, ) but has rarely been used in patients with psychotic disorders. A limited number of smaller studies, however, suggest that patients with psychoses may share a characteristic pattern of interpersonal problems, with higher loads on the “socially avoidant”, “exploitable”, “non‐assertive”, and “self‐sacrificing” subscales of the IIP (Berry, Barrowclough, & Wearden, ; Lysaker, Tsai, Henninger, Vohs, & Viverito, ; Mondrup & Rosenbaum, ; Startup, ).…”