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Research Office
Title:An Investigation of Personality Assessment with Challenging Psychotherapies
Principal Investigator: Steven Smith / Merith Cosden
Total Project Amount: $39,213
Agency: Society for Personality Assessment
Project Dates: 4/01/2009 – 6/30/2011
Abstract:
Freud (1937) described challenging or difficult therapeutic reactions in which both patient and analyst were locked in “interminable” treatments. He believed that such difficulties could be due to either patient or therapist contributions to the relationship (i.e., transference-countertransference interactions). In the growing body of literature on the importance of the working alliance, the issue of negative therapeutic interaction has been recast in the language of ruptures in the alliance (Safran & Muran, 1996). Despite these different labels and conceptualizations, there are times in all forms of psychotherapy when patients and therapists feel “stuck,” challenged, and that the work is not progressing as well as might be hoped. Such challenges may be due to patient factors, therapist factors, or the match between them.
The purpose of the present study is to investigate the utility of a therapeutic model of assessment (TMA; Finn, 2007; Finn & Tonsager, 1992, 1997; Fischer, 1994; Hilsenroth & Cromer, 2007) to inform challenging psychotherapies. Given the empirical evidence that TMA aids in the formation of working alliance in early psychotherapy (Ackerman, Hilsenroth, Baity, & Blagys, 2000; Hilsenroth & Cromer, 2007; Hilsenroth, Peters, & Ackerman, 2004), it is expected that a therapeutic assessment intervention will help inform both patients and therapists who are challenged by the work of psychotherapy. This study will rely on a randomized experimental design. Patients seen for psychotherapy in private practice settings, community outpatient clinics, and a college counseling center will be randomly assigned to a TMA condition or a consultation (CON) condition. In both conditions, clinicians will provide a collaborative feedback session with both patient and therapist present. Dependent variables will include assessments of alliance, session evaluation, psychotherapy process, psychological symptoms, feelings of well-being, self-esteem, and therapist activity. It is hypothesized that patients and therapists in both the TMA and CON conditions will find the interventions useful and informative, but that TMA will result in greater improvements in alliance, changes in therapeutic technique, and improvements in patients’ feelings of well-being and self-esteem.