Faculty Bibliography

The Core Conflictual Relationship Theme (CCRT) method is one of the most widely used and tested instruments developed within a psychoanalytic context for assessing central relationship patterns or characteristic patterns of relating to others. The Swedish version of the Central Relationship Questionnaire (CRQ), a recently developed self-report instrument based on the CCRT, was tested in a sample of Swedish psychology students (31 men, 60 women) and compared with responses of Swedish outpatients (15 men, 15 women) and North American students (49 men, 49 women). The subscales of the Swedish CRQ showed acceptable internal consistency and correlated with each other in a predictable fashion, displaying a pattern of intercorrelations similar to the English version. The CRQ showed meaningful patterns of correspondence with self-reported interpersonal problems as well as meaningful differences between the Swedish students and Swedish outpatients, indicating preliminary convergent and divergent validity.

The role of therapist characteristics in therapy training was examined for 62 therapists in a multisite psychotherapy outcome study that included cognitive therapy (CT), supportive-expressive (SE) psychodynamic therapy, and individual drug counseling (IDC) for cocaine-dependent patients. Demographic variables and experience and competence ratings prior to training were correlated with measures of change in competence during the training phase. Higher competence ratings before training were associated with greater change in competence for SE and higher average competence for IDC. More years of experience were associated with greater change in competence for CT therapists, but more hours of pre-training supervision in the CT treatment modality were associated with less change.

The construct of transference has been central to theories of dynamic psychotherapy. This investigation evaluated the similarity between patients' interpersonal themes, derived from pretreatment interpersonal interviews, and the theme evident in psychotherapy narratives about the therapist for 18 patients (mean age 38 yrs) treated in supportive-expressive psychotherapy for major depression. This investigation was designed to sort out the potential confound of the therapist's influence on the report of interpersonal themes and to explore how transference might vary over the course of therapy. The results indicated that 33% of patients demonstrated a significant relation between the most pervasive theme evident from the pretreatment narratives and the narratives about the therapist. These results remained consistent when early and late session therapist narratives were evaluated separately. Further, patients rated with higher quality of interpersonal relationships and lower symptoms prior to treatment demonstrated greater similarity between their pretreatment interpersonal themes and the theme described in the therapeutic relationship.

Examined the relation between core interpersonal patterns measured by the Core Conflictual Relationship Theme (CCRT) method and psychopathology in 55 27-53 yr old patients selected for long-term dynamic psychotherapy. Psychopathology was assessed by the Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R), symptom self-report, and the Karolinska Psychodynamic Profile (KAPP). Patients with different DSM-III-R diagnoses did not differ in their CCRTs abstracted from the Relationship Anecdote Paradigm interview. Furthermore, lack of flexibility (pervasiveness) in the use of different CCRT components was not associated with psychiatric symptoms. Only one significant correlation between character pathology and the CCRT was found: problems concerning the patients' experience of social significance were associated with more negative responses of the other. Limitations of the CCRT method and the sample used are discussed.

Change in self-understanding of maladaptive interpersonal patterns has been an important mechanism of symptom change in theories of dynamic psychotherapy and has been specified as an important treatment outcome by psychotherapy clients. The current investigation evaluated the reliability and validity of a new self-report measure of Self-Understanding of Interpersonal patterns (SUIP). The measure was administered to 3 clinical samples and a student sample. The measure demonstrated good internal consistency, test-retest reliability, and discriminant validity. The SUIP further demonstrated convergent validity with measures of analytical and self-improving personality traits in a clinical sample. Finally there was significantly greater change in self-understanding in a dynamic psychotherapy as compared with a medication treatment condition, despite comparable symptom change across both treatment conditions.

We argue that there are important areas of overlap in the types of patient change processes that occur in cognitive therapy and dynamic therapy. These common processes of patient change have been obscured by differences in language and theoretical constructs between the two traditions. We suggest that the acquisition of adaptive skills describes patient change processes that are common to both therapies. More specifically, we propose that the concept of adaptive skills encompasses both the compensatory skills model of cognitive therapy (Barber & DeRubeis, 1989) and some of the patient changes that occur in dynamic therapies. In clarifying these areas of overlap between cognitive and dynamic therapies encompassed by the adaptive skills acquired in both, the present article highlights the fact that the two therapeutic traditions employ radically different techniques to achieve some of the same outcomes. Recognizing the overlap between change processes in the two types of therapy, and adopting a common language for them, allows for further theoretical and empirical investigation of therapy process and outcome.

In this article, we review the development of short-term dynamic psychotherapy (STDP) and introduce some of the important questions to be addressed in studying STDP. We begin by surveying some of the areas not covered in this special edition (e.g., the efficacy of STDP, recent developments in dynamic formulation) because they were recently reviewed elsewhere. We then introduce the four articles included in this special mini-series. We conclude by looking at which questions could benefit from further study and recommend that more data be gathered regarding (a) the differences between the many different forms of STDP; (b) the efficacy of these forms of therapies for specific disorders, including personality disorders; (c) the essential theoretically relevant processes occurring in those treatments; (d) matching patients to different therapies; (e) the interrelations between different therapeutic processes; and (f) the different strategies for teaching STDP.

The present study examined the extent to which individuals' central relationship patterns, specifically their desires or wishes, their perceptions of others' responses to them, and their own responses to both of these, vary across different types of significant others in a non-patient sample. Fifty undergraduates (21 females, 29 males with a mean age of 21 years) were asked to complete a measure of central relationship patterns separately for their mothers, fathers, same-sex friends, and romantic partners. Analyses suggested that participants made differentiations among significant others, particularly romantic partner, and at the same ti me, provided considerable consistency in their central relationship patterns across differ ent types of significant others. Contrary to expectations, greater consistency across the four relationships was related to fewer interpersonal difficulties.

BACKGROUND: This was a multicenter investigation examining the efficacy of 4 psychosocial treatments for cocaine-dependent patients. METHODS: Four hundred eighty-seven patients were randomly assigned to 1 of 4 manual-guided treatments: individual drug counseling plus group drug counseling (GDC), cognitive therapy plus GDC, supportive-expressive therapy plus GDC, or GDC alone. Treatment was intensive, including 36 possible individual sessions and 24 group sessions for 6 months. Patients were assessed monthly during active treatment and at 9 and 12 months after baseline. Primary outcome measures were the Addiction Severity Index-Drug Use Composite score and the number of days of cocaine use in the past month. RESULTS: Compared with the 2 psychotherapies and with GDC alone, individual drug counseling plus GDC showed the greatest improvement on the Addiction Severity Index-Drug Use Composite score. Individual group counseling plus GDC was also superior to the 2 psychotherapies on the number of days of cocaine use in the past month. Hypotheses regarding the superiority of psychotherapy to GDC for patients with greater psychiatric severity and the superiority of cognitive therapy plus GDC compared with supportive-expressive therapy plus GDC for patients with antisocial personality traits or external coping style were not confirmed. CONCLUSION: Compared with professional psychotherapy, a manual-guided combination of intensive individual drug counseling and GDC has promise for the treatment of cocaine dependence.