title: Therapist affect focus and patient outcomes in psychodynamic psychotherapy: a meta-analysis.
abstract: OBJECTIVE
  The authors systematically examined the relationship between therapist facilitation of patient emotional experience/expression and outcome in psychodynamic psychotherapy.
  
  
  METHODS
  Computer and manual searches were conducted for relevant publications, and 10 independent samples of short-term dynamic psychotherapy were included in a meta-analysis. Data analysis included calculation of an overall effect size of the relationship between therapist affect focus and outcome, statistical significance, and test for homogeneity. In addition, moderator analyses were conducted to examine the potential impact of type of outcome construct used and the methodological quality of individual studies.
  
  
  RESULTS
  The overall average weighted effect size across all outcome types was statistically significant (r=0.30), and the homogeneity statistic was nonsignificant. Moderator analyses indicated a statistically significant relationship between therapist facilitation of patient emotional experience/expression and outcome when more than one outcome construct was included but not when either a single or an unclear outcome construct was used. There were no significant relationships between methodological quality and the size of the effects, although use of audio- or videotaping for supervision demonstrated a moderate effect.
  
  
  CONCLUSIONS
  These data indicate that therapist facilitation of patient affective experience/expression is associated with patient improvement over the course of psychodynamic psychotherapy. Although the size of this relationship was not significantly related to methodological quality, results suggest the importance of close supervision of actual techniques through the use of audio- or videotapes. Additionally, results highlight the importance of defining outcome in a multidimensional way to properly assess theoretically relevant effects.
authors.affiliation: Addiction Institute of New York, ST. Luke's-Roosevelt Hospital Center, New York, and the Derner Institute of Advanced Psychological Studies, Adelphi University, Garden City, NY, USA. melekhdiener2@aol.com
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Diener
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Hilsenroth
authors.forename: Joel
authors.initials: J
authors.lastname: Weinberger
mesh_terms: D000339:Affect; D003627:Data Interpretation, Statistical; D006801:Humans; D011369:Professional-Patient Relations; D011575:Psychoanalytic Therapy / Q000379:methods; D013811:Psychotherapeutic Processes; D011613:Psychotherapy / Q000379:methods*; D011614:Psychotherapy, Brief / Q000379:methods; D012107:Research Design / Q000592:standards; D016896:Treatment Outcome