Analysis of the patient-therapist relationship in dynamic psychotherapy: an experimental study of transference interpretations.
OBJECTIVE
The purpose of this study was to measure the effects of transference interpretations (the assumed core active ingredient) in dynamic psychotherapy, using an experimental design.


METHODS
One hundred patients were randomly assigned to two groups. One group received dynamic psychotherapy over 1 year, with a moderate level of transference interpretations, while the other group received dynamic psychotherapy with no transference interpretations. The most common axis I disorders were depression and anxiety disorders. Forty-six patients fulfilled the general criteria for personality disorder. Seven experienced psychotherapists treated patients in both groups. Five full sessions from each treatment were rated by two evaluators with process measures in order to document treatment integrity. Outcome variables were the Psychodynamic Functioning Scales, Inventory of Interpersonal Problems Scale-Circumplex version, Global Assessment of Functioning Scale, and Symptom Checklist-90-R. Quality of Object Relations Scale (lifelong pattern) and personality disorders were preselected as possible moderators of treatment effects. Change was assessed using linear-mixed models. Clinically significant change was also calculated.


RESULTS
The authors could not demonstrate differential treatment effects between the groups. However, the moderator analyses showed that transference interpretations were more helpful for patients with a lifelong history of less mature object relations. Small negative effects were observed for patients with mature object relations.


CONCLUSIONS
The authors could not show differences in average effectiveness between treatments. However, the moderator analyses indicated that treatment worked through different active ingredients for different patients. Contrary to common expectation, patients with poor object relations profited more from therapy with transference interpretations than from therapy with no transference interpretations.
Høglend
Per
P
Psykiatrisk Institutt, Vindern, P.O. Box 85, 0319 Oslo, Norway. p.a.hoglend@medisin.uio.no
Amlo
Svein
S
Marble
Alice
A
Bøgwald
Kjell-Petter
KP
Sørbye
Oystein
O
Sjaastad
Mary Cosgrove
MC
Heyerdahl
Oscar
O
D000328:Adult; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D009769:Object Attachment; D010555:Personality Inventory; D010817:Physician-Patient Relations; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011575:Psychoanalytic Therapy; D013811:Psychotherapeutic Processes; D011613:Psychotherapy / Q000379:methods*; D011614:Psychotherapy, Brief; D012720:Severity of Illness Index; D014167:Transference, Psychology; D016896:Treatment Outcome