Object Relations Assessment Predicts Outpatients' Attrition, Early Working Alliance, and Psychotherapy Process.

This study investigated the predictive utility of assessing clients' object relations functioning to prognosticate therapy dropout, quality of the early working alliance, and psychotherapy process events reported by clients after their first five sessions. Clients accepting a recruitment invitation were administered the Thematic Apperception Test (TAT) shortly after intake, and those still in treatment three to four sessions later rated the working alliance and psychotherapy process events. Participants were 47 clients beginning psychotherapy with advanced doctoral practicum students at a university-based community-serving training clinic. The Social Cognition and Object Relations Scales (SCORS), an object relations scoring system for TAT stories, was used to assess object relations functioning. The California Psychotherapy Alliance Scales-Patient form measured four dimensions of the alliance. The Therapy Orientation Process Scales, created from the Psychotherapy Process Q-set, measured clients' perceptions of therapy process events as involving relatively more psychodynamic or cognitive behavioral techniques. The SCORS significantly predicted remaining in therapy, client ratings of stronger working alliance, and typical therapy process as more psychodynamic than cognitive behavioral. SCORS Complexity of Representations and Capacity for Emotional Investment in Relationships scales were the strongest predictors, especially of the Patient Commitment facet of the alliance. The f...
Source: Clinical Psychology and Psychotherapy - Category: Psychiatry Tags: Clin Psychol Psychother Source Type: research