Based on 10 years of previous research by the Vanderbilt research team, a specialized form of time-limited dynamic psychotherapy (TLDP) has been developed. This study is designed to test the following hypothesis: (1) TLDP is a set of specifiable principles and techniques that can be taught to experienced therapists and will influence the manner in which these therapists conduct treatment; (2) therapy conducted along TLDP guidelines will improve therapeutic process and outcome; and (3) the greatest relative improvements of process and outcome will occur in patients whose potential for dynamic psychotherapy is considered low. The basic design calls for a comparison of the process and outcome of therapy (maximum 25 hours) conducted prior to therapists' training in TLDP (i.e., """"""""therapy as usual"""""""") with process and outcome of therapy conducted after TLDP training. Patients will be placed along a continuum of potential for dynamic psychotherapy, and each therapist will be assigned a realtively """"""""high"""""""" and a relatively """"""""low"""""""" potential patient, both before and after TLDP training. Fourteen therapists will each treat two patients before and after TLDP training (n=56). The intensive study of individual patient-therapist dyads will be a significant feature of data analysis. Therapists will be well-trained and reasonably experienced psychologists and psychiatrists. Patients will evidence moderately severe and chronoc characterological difficulties, comparable to outpatient psychiatric populations, who may be more or less suitable for dynamic psychotherapy. Comprehensive assessments will be made prior to therapy, during therapy, at termination, and one year later. It is anticipated that this research will accomplish the following goals: (1) advance scientific understanding of the therapeutic process; (2) expand the range of patients who might benefit from the time-limited dynamic psychotherapy; and (3) result in a specialized training program (based on a treatment manual) that will have direct clinical applications.
