A major neglected area of psychodynamic psychotherapy research is the target of the proposed study: To determine the extent to which the quality of interpretive interventions by the therapist are associated with (1) patient improvement from psychotherapy, and (2) gains in self-understanding (insight) which are in turn related to global benefits from treatment. Secondary aims of this project are to examine whether the impact of therapist interpretations are moderated by (1) the level of the patient's overall psychological adjustment and (2) the formation of a positive helping alliance. These questions will be addressed in data from two large samples: 60 patients from the Penn Psychotherapy Project and (for cross-validation purposes) 40 patients from the Penn Re-Pairing Study. An extensive outcome assessment and tape recordings of all sessions exist for these patients. Several sessions per patient will be scored for measures of the therapist's response to the patient's main communications, the extent to which the therapist effectively responds to the patient's core conflictual relationship theme, the extent to which the therapist is following recommended guidelines for psychoanalytically oriented psychotherapy, and a measure of errors in technique. Also assessed will be the patient's response to therapist interpretations, especially in terms of insight into aspects of the core conflictual theme. This study represents a unique opportunity to address these important questions in two samples of relatively long-term psychodynamic psychotherapy.
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