This project continues a series of studies on brief dynamic psychotherapy with an older adult population. The primary goal is to determine how therapist interpretations facilitate or hinder the process and outcome of psychotherapy. Specifically, we hypothesize that accurate interpretations correlate with immediate (in-session progress) as well as with therapy outcome. The brief (16-session) psychotherapies of 25 older-adult patients (50 to 90 years of age) will be studied. Extensive data on these patients are available in the Mount Zion Psychotherapy Data Bank, including verbatim transcripts of each therapy session, transcripts of pre- and post-therapy interviews, and a variety of pre- and post-treatment test scores. Accuracy of interpretations will be defined in a case-specific way by developing a reliable formulation for each case and then rating therapist interventions for their adherence to this formulation. To study the effect of interpretations on the process of therapy (Process Study), all therapist interpretations in each case will be identified and rated on a therapist accuracy scale. Segments of patient speech immediately before and after each interpretation will be rated on several process measures. Ratings of change (from before to after the interpretation) on these measures will be correlated with the accuracy ratings. To study the effect of interpretations on therapy outcome (Outcome Study), the accuracy ratings will be averaged for each therapy session and correlated with treatment outcome. Finally, the case-specific measure of accurate will be compared with several other process-outcome measures (Comparative Study).
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