This paper presents a theoretical and methodological approach to studying the ways in which psychotherapy patients create and interpret mental representations of their therapists and the psychotherapeutic process both during therapy and after termination. A network of measures, The Therapist Representation Inventory, was developed to specify the interrelationships between the stylistic, functional and formal properties of such symbolic evocations across different states of consciousness and in different situations. It includes a method of examining the ability to formulate a concept of the psychotherapist and guidelines for interpreting both the thematic content and conceptual level of that object representation. The second scale measures the ability to specify the formal properties of therapist representations, as distinct from their particular contents. The third instrument seeks to identify the functions which therapist “introjects” serve for a given individual. Normative data, based upon a sample of 206 psychotherapists who themselves have been patients in psychotherapy and/or psychoanalysis indicate that the vividness of the representation and the use of the representation for the purpose of continuing the therapeutic dialogue are significantly correlated with self-perceived improvement.

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This single-case study examined frank disclosure of important topics in a brief exploratory psychotherapy, including topics closely related to a recent, unintegrated stressor life event. Quantitative measures of emotion and control variables showed heightened levels of both emotionally and defensive control during discourse on the topic of the stressor event. In future studies, such measures of verbal and nonverbal signs of emotional expression and defensive control might be used to identify topics in an unresolved state.

The authors conducted an archival study of 149 new clinic patients at a large community mental health center. The dropout rate for patients in brief psychotherapy in which the length of therapy was specified at the outset of treatment (time-limited psychotherapy) (32%) was about one-half the dropout rate for patients in brief (67%) and long-term (61%) individual psychotherapy. The difference in dropout rates could not be explained by patient demographic or diagnostic variables or by therapist characteristics measured in the study. The results suggest that setting a specific time limit on individual psychotherapy at the outset of treatment can reduce the patient dropout rate in a public mental health clinic.

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