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The accuracy of therapists' interpretations and the outcome of dynamic psychotherapy.

Temple University, Filadelfia, Pennsylvania, United States
Journal of Consulting and Clinical Psychology (Impact Factor: 4.85). 09/1988; 56(4):490-5. DOI: 10.1037/0022-006x.56.4.490
Source: PubMed

ABSTRACT This study developed a measure of the accuracy of therapists' interpretations based on the core conflictual relationship theme method and examined the relation of accuracy to the outcome of dynamic psychotherapy. Accuracy was assessed on therapists' interpretations from two early-in-treatment sessions of 43 patients receiving moderate-length dynamic therapy. The results indicated that accuracy about the main wishes and responses from others that were expressed in the relationship themes was significantly related to outcome, even after the effects of general errors in treatment techniques and the quality of the helping alliance had been controlled for. Our hypothesis that accurate interpretations would have their greatest impact in the context of a positive helping alliance was not confirmed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)

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    ABSTRACT: Statement of the Research Problem Interpretation is generally held to be the major curative factor in psychoanalysis, psychoanalytic psychotherapy, and short-term dynamic psychotherapy. (Freud, 1912; Strachey, 1934; Luborsky, 1984; Arlow, 1987). Described by Bibring (1954) as the "supreme agent in the hierarchy of therapeutic principles" (p. 763), interpretation is regarded as a central activity of the therapist, around which other aspects of treatment are organized to maximize its effectiveness. Despite the consensus of its clinical import, there is no universally accepted definition of an interpretation. The concept of interpretation has evolved, as has its relationship to the therapeutic process. For Freud (1900, 1912, 1914), interpretation referred to the translation of the manifest into the latent content, whether this involved dreams, associations, symptoms, or behaviors of the neurotic patient. As the scope of psychoanalysis broadened to include patients with preoedipal and narcissistic pathology (referred to in this study as lower functioning), interpretation also acquired new dimensions. With lower functioning patients, the intent of interpretation shifted in relation to resistance, transference, and reconstruction. In a revised developmental and relational psychoanalytic framework, some authors (Ornstein and Ornstein, 1975; Pine, 1986a, 1986b, 1990) view interpretation primarily as a contact rather than a content or an insight promoting agent. In sharp contrast to traditional psychoanalysis of higher functioning (primarily neurotic) patients, with lower functioning patients, the transference neurosis is avoided in favor of providing a "holding environment" (non-interpretive intervention) (Winnicott, 1965). Such therapy is typically more active and supportive, as well as less intense and interpretive. In actual practice, however, most clinicians are reported to use a mixture of interpretive (expressive) and holding (supportive) techniques early in treatment and throughout its course (Luborsky, 1984; Waldinger, 1987).
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