engleski

The dynamics of empirically derived factors in the therapeutic relationship

The therapeutic relationship is the source of major concepts within psychoanalytic clinical theory. Psychoanalytic concepts such as resistance, transference, counter-transference, and the alliance are fundamental and basic, even though there may be shifts in meanings between theoretical schools and clinical contexts. There is some disagreement over the nature of the alliance and its essential components in the clinical psychoanalytic literature. Empirical studies using reliable patient, therapist and observer scales to assess the alliance in psychotherapy demonstrate a correlation with positive psychotherapeutic outcomes. In this study we follow 13 patients for 6 to 33 months of psychodynamic psychotherapy, and assess their views of the therapeutic relationship, and several outcome measures, on a weekly basis. Statistical analysis revealed that the therapeutic relationship, as reflected in the patients’ weekly responses to our St. Louis Therapeutic Relationship Rating Scale, had four distinct components: the Therapeutic Alliance, Resistance, Transference Love and Negative Transference. On a week by week basis, the Therapeutic Alliance was the strongest predictor of improvement in general adjustment as reflected in such areas as self-esteem, positive affect, social relations, work productivity, satisfaction, and optimism. Time plots of the variables show the typical time course for the components of the therapeutic relationship, as well as for improvement on outcome variables. The results indicate that the Therapeutic Alliance, Transference and Resistance are central components of the psychotherapeutic relationship which vary in their effects on the process and its outcomes.

psychodynamic psychotherapy; alliance; resistance

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