Dimensional measure of self and interpersonal functioning: Comparisons with treatment alliance and readiness for inpatient psychotherapy

Abstract

The social cognition and object relations scale-global rating method is a clinical rating system assessing 8 domains of self and interpersonal functioning. It can be applied to score numerous forms of narrative data. In this study, we investigate the SCORS-G relationship to measures of alliance and readiness for psychotherapy with an adolescent inpatient sample. Seventy-two psychiatrically hospitalized adolescents were consented and subsequently rated by their individual and group therapist using the SCORS-G. The unit psychiatrist also completed an assessment of patients' readiness for inpatient psychotherapy. The patients completed a self-report of their alliance with the inpatient treatment team as a whole. SCORS-G ratings were positively correlated with assessments of readiness for inpatient psychotherapy and patient-reported alliance. This study further demonstrates the clinical utility of the SCORS-G with adolescents.

Assessment of personality functioning in ICD-11 posttraumatic stress disorder and complex posttraumatic stress disorder.

“…Nevertheless, in treatment settings of individuals with CPTSD the clinicians have to not only balance severe impairment in personality functioning but also symptoms of recollective intrusions of traumatic experiences in the present, avoidance, and a sense of current threat. In light of the prior findings (Haggerty et al, 2018; Koelen et al, 2012; Leichsenring et al, 2019; Papamalis et al, 2020), the results from the present study suggest that treatment of patients with CPTSD is likely to be a complicated matter requiring lengthy treatment. Treatment of PTSD disorders may benefit from matching duration and intensity of therapy with the magnitude and intensity of the patient's personality problems (Bach & Simonsen, 2021).…”

“…Furthermore, two studies have also found that the degree of personality functioning interact with readiness and motivation for psychotherapeutic treatment along with therapeutic alliance (Haggerty et al, 2018; Papamalis et al, 2020). The individuals with the most severe levels of personality dysfunction showed the lowest treatment engagement, lowest readiness for psychotherapy, and reported lower alliances with clinicians (Haggerty et al, 2018; Papamalis et al, 2020). However, in a recent study of inpatient treatment, it was found that the patients with the most severely impaired personality functioning had the largest pre–post treatment effect of psychodynamic inpatient treatment (Leichsenring et al, 2019).…”

“…Accordingly, most of the included studies showed moderate to large effect sizes in terms of changes in general symptomatic distress and psychosocial functioning (Koelen et al, 2012). Furthermore, two studies have also found that the degree of personality functioning interact with readiness and motivation for psychotherapeutic treatment along with therapeutic alliance (Haggerty et al, 2018; Papamalis et al, 2020). The individuals with the most severe levels of personality dysfunction showed the lowest treatment engagement, lowest readiness for psychotherapy, and reported lower alliances with clinicians (Haggerty et al, 2018; Papamalis et al, 2020).…”

Object relations assessment predicts outpatients' attrition, early working alliance and psychotherapy process

“…Currently one of the best validated measures of object relations is the Social Cognition and Object Relations Scales (SCORS) rating system, which is most commonly applied to thematic apperception test (TAT) story protocols (Stein & Slavin‐Mulford, 2018; Westen, 1991b; Westen, 1995), but can also be rated from other narratives such as outpatients' early memories (e.g., Pinsker‐Aspen et al, 2007 with Westen's, 1995 eight‐scale SCORS) or clinicians' interactions with inpatients on the unit and in therapy over time using Stein and Slavin‐Mulford's SCORS‐G (Haggerty et al, 2018). According to Westen, using spontaneously told stories about pictures to assess object relations provides access to interpersonal, cognitive and affective motivational patterns.…”

“…A body of literature that links SCORS to psychotherapy is growing, supporting the idea that object relations assessment can contribute to understanding the alliance, as well as readiness for therapy among inpatients (Haggerty et al, 2018) and how therapy contributes to improved object relations functioning (reviewed in Conklin & Westen, 2001, for the 1995 SCORS; and in Stein & Slavin‐Mulford, 2018, for the SCORS‐G). Outpatients' 1995 SCORS data have been related to number of therapy sessions attended (Ackerman, Hilsenroth, Clemence, et al, 2000) and to clients' ratings of the alliance (Pinsker‐Aspen et al, 2007).…”