title: Long-term effects of analysis of the patient-therapist relationship in the context of patients' personality pathology and therapists' parental feelings.
abstract: OBJECTIVE
  Analysis of the patient-therapist relationship (relationship work) is considered a core active ingredient in dynamic psychotherapy. However, there are contradictory findings as for whom and under what circumstances these interventions are beneficial. This study investigates long-term effects of relationship work in the context of patients' level of personality pathology and therapists' self-reported parental feelings.
  
  
  METHODS
  One hundred outpatients seeking psychotherapy for depression, anxiety, and personality disorders were randomly assigned to weekly dynamic psychotherapy, either with or without relationship work, for 1 year. Personality pathology was evaluated before treatment as the sum of fulfilled personality disorder criteria items on the Structured Clinical Interview for DSM-III-R Personality Disorders. Therapist feelings were assessed using the Feeling Word Checklist-58. The outcome variables were the Psychodynamic Functioning Scales and Inventory of Interpersonal Problems, measured at pretreatment, midtreatment, posttreatment, 1 year, and 3 years after treatment termination.
  
  
  RESULTS
  A significant interaction of treatment group (relationship work vs. no relationship work) by personality pathology by parental therapist feelings was present, indicating that parental feelings were differentially associated with long-term effects of relationship work, depending on the level of personality pathology. In the context of low parental feelings, relationship work was positive for all patients. However, when parental feelings were stronger, the specific effects of such interventions were even more positive for patients with high levels of personality pathology, but negative for patients with low levels of personality pathology.
  
  
  CONCLUSIONS
  The interaction of parental therapist feelings and patients' personality pathology was strongly associated with the long-term specific effects of analysis of the patient-therapist relationship.
authors.affiliation: Institute of Clinical Medicine, Division of Mental Health and Addiction, University of Oslo.
authors.forename: Hanne-Sofie J
authors.initials: HS
authors.lastname: Dahl
authors.affiliation: Institute of Clinical Medicine, Division of Mental Health and Addiction, University of Oslo.
authors.forename: Jan Ivar
authors.initials: JI
authors.lastname: Røssberg
authors.affiliation: Department of Psychiatry, University of Pennsylvania.
authors.forename: Paul
authors.initials: P
authors.lastname: Crits-Christoph
authors.affiliation: Department of Psychiatry, Baylor College of Medicine.
authors.forename: Glen O
authors.initials: GO
authors.lastname: Gabbard
authors.affiliation: Institute of Clinical Medicine, Division of Mental Health and Addiction, University of Oslo.
authors.forename: Anne Grete
authors.initials: AG
authors.lastname: Hersoug
authors.affiliation: Institute of Community and Family Psychiatry, McGill University.
authors.forename: John Christopher
authors.initials: JC
authors.lastname: Perry
authors.affiliation: Department of Mental Health and Addiction, Vestfold Hospital Trust.
authors.forename: Randi
authors.initials: R
authors.lastname: Ulberg
authors.affiliation: Institute of Clinical Medicine, Division of Mental Health and Addiction, University of Oslo.
authors.forename: Per A
authors.initials: PA
authors.lastname: Høglend
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000628:therapy; D003866:Depressive Disorder / Q000628:therapy; D004644:Emotions; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D010290:Parents; D010554:Personality Disorders / Q000523:psychology* / Q000628:therapy*; D011369:Professional-Patient Relations; D011613:Psychotherapy / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome