This study explored how introject affiliation and trainee self-efficacy (TSE) are related and change during training in cognitive-behavioral, psychodynamic, and psychoanalytic therapy. The study was conducted in Germany, where psychotherapy training contains extensive personal therapy. Therefore, we could examine the impact of both personal therapy and introjects on changes in the trainees' self-perceived efficacy. In all, 171 participants filled out questionnaires concerning introjects (Structural Analysis of Social Behavior-Intrex) and TSE (Healing Involvement subscale of the Work Involvement Scales) as well as additional questions concerning length of and satisfaction with personal therapy. Seventy-one participants filled out the same questionnaires 3 years later. The degree of affiliation in the trainees' introjects was positively correlated with their self-efficacy. Furthermore, after 3 years of training, introjects demonstrated more affiliation and TSE increased. In addition, the trainees' satisfaction with, but not length of, their personal therapy had a moderating effect on the relation between the change in their affiliative introjects and self-efficacy. Introject affiliation of psychotherapy trainees is not invariant but changes during the course of training, at least in trainings that include personal therapy. Changes in affiliation were significantly related to positive changes in TSE-but only if the trainee's personal therapy was considered to be highly satisfactory.

The study aimed to test whether countertransference reactions contain valid information about the patient. The authors examined whether a significant part of the variance in emotional, cognitive, and motivational responses to recorded therapy sessions is attributable to the patient. Six student raters listened to 605 audiotaped sessions of 81 patients with major depression treated by 19 therapists and indicated their reactions using a modified version of the Countertransference Questionnaire. The relative amount of variance in countertransference reactions due to differences between patients, ranging from 2% to 16%, was significant for most of the countertransference dimensions. Reactions were influenced by type of treatment and severity of depression but not by comorbid personality disorder or interpersonal problems. The relative amount of variance due to differences between raters was large, averaging at 23%. The authors conclude that—albeit having a relatively low “signal-to-noise ratio” in raters without psychotherapy training—countertransference reactions contain valid clinical information.

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In a naturalistic study, we examined the effectiveness of two integrative psychodynamic psychotherapies-Guided Imagery Psychotherapy (GIP) and Hypnopsychotherapy (HY) -in an outpatient setting. A mixed sample of patients was assessed at the beginning of therapy (N ϭ 300) and after 30 months (N ϭ 97), using the IIP, the IPO-16, the FLZ M , and the PMS as well as health economic measures. The BSI was employed at the beginning of therapy and every 6 months after that. Therapists rated CGI-S and GAF at the beginning and end of therapy. There was no control group. Improvements were found on all measures for GIP and for all but 1 measure for HY. Effect sizes ranged from d ϭ .12 to d ϭ 1.76. The percentage of patients who changed reliably ranged from 18% to 82.5%. We statistically controlled for the number of treatment sessions and whether the treatment had been completed within 30 months. For the BSI, improvement was found within the first 6 months of treatment and again within the following 18 to 24 months-indicating a regressive but steady alleviation of symptom distress over the course of longer treatments. In conclusion, under naturalistic conditions, GIP and HY have been shown to be effective with regards to different outcome modalities.

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