Quality of Object Relations versus Interpersonal Functioning as Predictors of Therapeutic Alliance and Psychotherapy Outcome

Piper, William E.; Azim, Hassan F. A.; Joyce, Anthony S.; McCallum, Mary; Nixon, George W. H.; Segal, Perry S.

doi:10.1097/00005053-199107000-00008

Cited by 160 publications

(121 citation statements)

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“…Additionally, patients who possess poor object relations or have experienced negative early relationships with important others have been shown to have difficulty forming quality alliances with their therapists (e.g., Hilliard et al, 2000;Kokotovic & Tracey, 1990;Piper, Azim, Joyce, & McCallum, 1991;Piper, Boroto, Joyce, & McCallum, 1995). Such associations make sense from an interpersonal perspective in that the interpersonal behaviors and patterns that a patient brings to therapy should invariably affect the (inherently interpersonal) therapeutic alliance (e.g., Kiesler & Watkins, 1989;Safran & Muran, 2000;Safran & Segal, 1990).…”

Section: Correlates Of the Therapeutic Alliancementioning

confidence: 99%

Patient interpersonal factors and the therapeutic alliance in two treatments for bulimia nervosa

Constantino

Smith-Hansen

2008

Psychotherapy Research

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Section: Correlates Of the Therapeutic Alliancementioning

confidence: 99%

Patient interpersonal factors and the therapeutic alliance in two treatments for bulimia nervosa

Constantino

Smith-Hansen

2008

Psychotherapy Research

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“…Most studies have found no or few differences between various types of disorders or diagnostic variables and the helping alliance (18)(19)(20), even if there are indications that patients with borderline and other personality disorders tend to have greater difficulties in establishing a good therapeutic alliance (18,21). Concerning personality and interpersonal variables, studies have shown that the patient's past object relations influenced the establishment of the therapeutic alliance, as did current interpersonal relations (18,20,22,23). There are also studies showing that experiences of earlier social support as well as current social support have a positive impact on the establishment of the helping alliance (24,25).…”

Section: Helping Alliance and Client Factors In Psychotherapeutic Andmentioning

confidence: 99%

Helping alliance and early dropout from psychiatric out-patient care

Johansson

Eklund

2006

Soc Psychiat Epidemiol

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This is an author produced version of a paper published in Social Psychiatry Psychiatric Epidemiology. This paper has been peer-reviewed but does not include the final publisher proof-corrections or journal pagination. Abstract:Background: The study examined client factors of relevance for the establishment of the helping alliance and for dropout in a routine psychiatric setting, admitting a variety of diagnoses and staffed with a multi-professional team. Method: Newly-admitted patients (n= 122) and staff completed questionnaires regarding the helping alliance, and the patients also regarding motivation, symptoms and interpersonal problems. The patients were also diagnosed according to the ICD-10 and followed up concerning early dropout. Results: Several variables correlated with the helping alliance and multivariate analyses showed that the cold/distant factor, motivation and the interpersonal sensitivity factor were the most important factors in establishing the helping alliance. Moreover, it was the alliance as perceived by the patients and not the staff that proved to be the most essential variable. A logistic regression analysis showed that early dropout was predicted by low helping alliance, low age and cold/distant. Conclusion:The most important client factors for establishing the helping alliance and for predicting early dropout seem to be those relevant to interpersonal processes. Further, the therapists'/staff's responsiveness to these client factors seems to be of decisive importance.

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“…A clinical implication is that assessment of quality of object relations can yield information that is valuable and relevant for interpretations of transference in psychodynamic psychotherapy (Piper & Duncan, 1999). Results have indicated that quality of relations is related to outcome of interpretive but not supportive dynamic psychotherapy, to therapeutic alliance and to improvement (Høglend, 1993;Piper et al, 1991;Moras & Strupp, 1982;Piper, Joyce, McCallum, & Azim, 1998;Piper, Azim, McCallum, Joyce, & Ogrodniczuk, 1999).…”

Section: Research Concerning the Cs And Dynamic Psychotherapymentioning

confidence: 99%

Rorschach Comprehensive Variables and Assessment for Psychodynamic Psychotherapy

Nygren¹

2005

PsycEXTRA Dataset

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Rationally selected Comprehensive System (CS; Exner, , 1993Exner, , 2003 Rorschach variables and suitability for psychodynamic psychotherapy were investigated in four studies with different designs. The participants comprised three clinical samples (n = 52, 25, and 69) of patients applying for and/or selected for dynamic psychotherapy. With few exceptions the CS variables were the same in the studies, and in all the studies the Rorschach was independent of clinical ratings/assessments and/or selection of patients for treatment. The first study dealt with the relation between 17 rationally selected CS variables and suitability for psychotherapy as represented by ratings of Dynamic Capacity and Ego Strength and by selection of therapy applicants for psychotherapy. The second and third studies concerned CS score differences between groups of patients differing in suitability for dynamic psychotherapy. In the second study, differences for CS variables were predicted for three groups of dynamic psychotherapy patients with mixed diagnoses. In the third study, CS score differences between two groups, differing in suitability but similar in comprising personality disordered patients, were predicted and tested. In the fourth study, correlations were predicted between 18 pre-therapy CS variables and patient post-therapy satisfaction with therapy and also with therapist post-therapy ratings of their patients' suitability for dynamic therapy.For the four studies taken together, positive results were obtained for EA, FC, the D Score, Blends, Zf, F%, MQo, and AG. The results for m, SumT, WSUM6, X-%, S, and FrrF were negative, whereas the results for YFY, FD, COP, and PER were too weak to permit interpretation.The main limitation of the research in this thesis is the lack of psychometric data concerning the clinical ratings whereas the strength is the ecological validity. The results are positive for some of the CS variables selected, mainly concerning control and cognition but also touching upon emotional integration and interpersonal forcefulness. The usefulness of the CS in psychotherapy assessment may be enhanced if only those CS variables that are found valid for the purpose are used and general personality descriptions are avoided.

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Quality of Object Relations versus Interpersonal Functioning as Predictors of Therapeutic Alliance and Psychotherapy Outcome

Cited by 160 publications

References 0 publications

Patient interpersonal factors and the therapeutic alliance in two treatments for bulimia nervosa

Patient interpersonal factors and the therapeutic alliance in two treatments for bulimia nervosa

Helping alliance and early dropout from psychiatric out-patient care

Rorschach Comprehensive Variables and Assessment for Psychodynamic Psychotherapy

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