Transference interpretations in dynamic psychotherapy: do they really yield sustained effects?
OBJECTIVE
Transference interpretation has remained a core ingredient in the psychodynamic tradition, despite limited empirical evidence for its effectiveness. In this study, the authors examined long-term effects of transference interpretations.


METHODS
This was a randomized controlled clinical trial, dismantling design, plus follow-up evaluations 1 year and 3 years after treatment termination. One hundred outpatients seeking psychotherapy for depression, anxiety, personality disorders, and interpersonal problems were referred to the study therapists. Patients were randomly assigned to receive weekly sessions of dynamic psychotherapy for 1 year with or without transference interpretations. Five full sessions from each therapy were rated in order to document treatment fidelity. Outcome variables were the Psychodynamic Functioning Scales (clinician rated) and the Inventory of Interpersonal Problems (self-report). Rating on the Quality of Object Relations Scale (lifelong pattern) and presence of a personality disorder were postulated moderators of treatment effects. Change over time was assessed using linear mixed models.


RESULTS
Despite an absence of differential treatment efficacy, both treatments demonstrated significant improvement during treatment and also after treatment termination. However, patients with a lifelong pattern of poor object relations profited more from 1 year of therapy with transference interpretations than from therapy without transference interpretations. This effect was sustained throughout the 4-year study period.


CONCLUSIONS
The goal of transference interpretation is sustained improvement of the patient's relationships outside of therapy. Transference interpretation seems to be especially important for patients with long-standing, more severe interpersonal problems.
Høglend
Per
P
Department of Psychiatry, Vinderen, University of Oslo, PO Box 85, Vinderen, N-0319 Oslo, Norway. p.a.hoglend@medisin.uio.no
Bøgwald
Kjell-Petter
KP
Amlo
Svein
S
Marble
Alice
A
Ulberg
Randi
R
Sjaastad
Mary Cosgrove
MC
Sørbye
Oystein
O
Heyerdahl
Oscar
O
Johansson
Paul
P
D000223:Adaptation, Psychological; D000328:Adult; D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy*; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D010554:Personality Disorders / Q000523:psychology / Q000628:therapy*; D011573:Psychoanalytic Interpretation; D011575:Psychoanalytic Therapy / Q000379:methods*; D014167:Transference, Psychology