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  • Title: Long-term effects of analysis of the patient-therapist relationship in the context of patients' personality pathology and therapists' parental feelings.
    Author: Dahl HS, Røssberg JI, Crits-Christoph P, Gabbard GO, Hersoug AG, Perry JC, Ulberg R, Høglend PA.
    Journal: J Consult Clin Psychol; 2014 Jun; 82(3):460-71. PubMed ID: 24660675.
    Abstract:
    OBJECTIVE: Analysis of the patient-therapist relationship (relationship work) is considered a core active ingredient in dynamic psychotherapy. However, there are contradictory findings as for whom and under what circumstances these interventions are beneficial. This study investigates long-term effects of relationship work in the context of patients' level of personality pathology and therapists' self-reported parental feelings. METHOD: One hundred outpatients seeking psychotherapy for depression, anxiety, and personality disorders were randomly assigned to weekly dynamic psychotherapy, either with or without relationship work, for 1 year. Personality pathology was evaluated before treatment as the sum of fulfilled personality disorder criteria items on the Structured Clinical Interview for DSM-III-R Personality Disorders. Therapist feelings were assessed using the Feeling Word Checklist-58. The outcome variables were the Psychodynamic Functioning Scales and Inventory of Interpersonal Problems, measured at pretreatment, midtreatment, posttreatment, 1 year, and 3 years after treatment termination. RESULTS: A significant interaction of treatment group (relationship work vs. no relationship work) by personality pathology by parental therapist feelings was present, indicating that parental feelings were differentially associated with long-term effects of relationship work, depending on the level of personality pathology. In the context of low parental feelings, relationship work was positive for all patients. However, when parental feelings were stronger, the specific effects of such interventions were even more positive for patients with high levels of personality pathology, but negative for patients with low levels of personality pathology. CONCLUSION: The interaction of parental therapist feelings and patients' personality pathology was strongly associated with the long-term specific effects of analysis of the patient-therapist relationship.
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