The purpose of this proposal is to further develop a scientific understanding of the efficacy of dynamic/interpersonal psychotherapy for a variety of mental disorders. Four set of studies are proposed. The first set focuses on the development of measures that will assist studies of the process and outcome of dynamic therapies. Included are method development studies on measures of the accuracy of therapists' interventions and measures (both clinician judged and self-report) that assess change in core conflicts. The second set of studies involves analysis of the process of interpersonal and cognitive therapies for major depression in order to better understand the effective ingredients of treatment. Thirdly, treatment development projects designed to standardize dynamic therapy, collect preliminary efficacy data, and train therapists for outcome research will be conducted. Manual guided dynamic treatments will be developed for generalized anxiety disorder, treatment resistant chronic depression, and avoidant and obsessive-compulsive personality disorder. Finally, if successful, the treatment development projects will lead into comparative outcome trials. In addition, a comparative outcome study evaluating dynamic therapy for cocaine dependent patients (particularly those with high levels of non-substance abuse psychiatric symptoms) will be conducted.
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